TMJ, or temporomandibular dysfunction

Do you wonder what it means when people say they have TMJ problems? Or have you ever gone to the dentist for the world’s worst toothache, and was told everything is okay? Did you know that you can go to a physical therapist to relieve pain in the face, temporomandibular joint (better known as the jaw), or to alleviate headaches related to both problems?

TMD, or temporomandibular dysfunction, is a disorder involving the joint which connects the jawbone to the skull. There can be many reasons one has pain in this joint, including grinding of the teeth (bruxism) due to stress or during sleep. Many people go to the dentist for a mouth guard to protect their teeth, but what about the muscles surrounding the jawbone?

This is where physical therapy comes into play. Just like any other joint in the body, muscles surround the jaw in order to move the joint in various directions. What makes this specific joint unique is that the jawbone sits in a horse-shoe shaped hinge and has a disc-like structure that separates the lower half of the joint to the base of the skull. Due to this junction, the way the jawbone moves around the skull requires increased activity of the muscles to create stability around the joint, causing these muscles to fatigue quickly.

The temporomandibular joint works continuously to create stability combined with normal wear and tear of talking/chewing/yawning/grinding can create increased tension of these muscles. Just like any other muscle in the body, pain occurs with overuse. However, the normal pain patterns of a muscle may not be as apparent as other muscle groups of the body. Below are the common signs and symptoms to be aware of:

Signs and symptoms of TMJ disorders may include:

  • Pain or tenderness of your jaw
  • Pain in one or both temporomandibular joints
  • Aching pain in and around your ear
  • Difficulty chewing or pain while chewing
  • Facial pain
  • Locking of the joint, making it difficult to open or close your mouth

TMJ disorders can also cause a clicking sound or grating sensation when you open your mouth or chew. If there is no pain or limitation of movement associated with your jaw clicking, you probably would not require treatment for a TMJ disorder.

Treatment

As physical therapists, we focus on the movements and patterns of joints, including the push and pull of muscle groups. To treat a TMJ disorder, various treatments are available to reduce muscle aches and tension in the jaw region.  As stated before, the muscles of the jaw are the same as the muscles of the rest of the body. Manual techniques are used for the reduction of tension and trigger points in the muscles of the jaw, cervical region, upper traps, and possibly the rotator cuff. These manual techniques include soft tissue mobilization, manual trigger point release and dry needling. Alongside of the manual interventions, your physical therapist may include exercises for mobility and strength of the cervical spine, shoulders and possible postural re-education if it is found to be a contributing factor to the pain.

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