What is TMD?
The temporomandibular joint or TMJ, is the joint which joins your jaw bone to the rest of your skull. You can feel it just in front of your ear hole. Typically we do not give much thought to our TMJ as we go about our day, however, these joints are highly active whenever we talk, chew and swallow. It is usually not until we experience pain in this area that we understand how frequently we rely on the proper function of the TMJ. Like any other structures in the body, the muscles and joints of the TMJ are also vulnerable to repetitive stress and can become painful under certain circumstances. When this occurs it is known as temporomandibular joint dysfunction or TMD.
The muscles and joints of the TMJ can become painful for many reasons including poor posture, parafunctional habits (e.g., teeth grinding/clenching), stress, direct trauma, repetitive strain and others.
Common Symptoms:
Pain in the jaw muscles
Pain in the neck and shoulders
Chronic headaches
Jaw muscle stiffness
Limited movement or locking of the jaw
Ear pain, pressure, fullness, ringing in the ears (tinnitus)
Painful clicking, popping or grating in the jaw joint when opening or closing the mouth and/or a bite that feels “off”
Dizziness and vision problems
TMD is a complaint that may affect up to 50% of the population. Despite how common this condition occurs, there has not been a substantial amount of investigation into practical and non-invasive ways to manage acute or recurrent jaw pain. Luckily, recent research studies have identified some comfortable and effective strategies that can be easily implemented by manual health practitioners, such as chiropractors.
Treatment strategies
Appropriate Evaluation
All effective care begins with a thorough examination which includes a detailed history and physical exam. This includes not only structures of the TMJ but also related dysfunctions in the neck and shoulders. Very commonly with TMD there will be upper neck pain/dysfunction that overlaps and needs to be addressed along with the jaw.
Manual Treatment Gentle joint mobilization of the TMJ and/or neck has been shown to be effective at relieving joint pain by stretching tight muscles and ligaments surrounding the joint.
Soft Tissue Therapy Affected muscles identified during the initial examination can be targeted and specifically worked using techniques that stretch and relax the tight muscles.
Vibration Therapy
Vibration has been an emerging and successful tool to help manage joint and muscle pain, particularly for the jaw. By utilizing a handheld device, a practitioner can transmit the vibration through their hand and target specific muscles both outside and inside the mouth.
Functional Integrated Acupuncture
Acupuncture directed at specific anatomical targets in the jaw can be great addition to the management of TMD. Evidence suggests acupuncture is effective at reducing muscle tension and lowering pain intensity.
Education
Learning more about what contributes to any musculoskeletal condition is invaluable, especially when it comes to TMD. There are many factors that can contribute to this condition (lifestyle habits, stress management, posture, etc.). It is important for you and your practitioner to discuss these factors and identify how to address them within your plan of management and coordinate with other relevant health care professionals.
Bottom Line:
TMJ disorders are quite common. Manual therapy is a safe, effective, and non-invasive way to manage your jaw pain.