Temporo-manidubular joint disorders (jaw pain)
If you are experiencing jaw pain, issues with opening the mouth, clicking and locking in the jaw then most likely you may have TMJ issues.
The TMJ is comprised of the mandible and temporal bone of which both surfaces are round. You can imagine it is like trying to join 2 ball bearings together. It just doesn’t work. That is why we have a disc that is concave on both sides to hold it together. Other than holding the joint together it also has to glide and follow the jaw as you yawn, eat, chew and talk. Throw in bad teeth, grinding habits, poor bite patterns due to dental issues and poor neck postures and now we have a very angry disc.
Signs and symptoms of TMJ issues
- Shifting, clicking, clunking or locking of the jaw
- Pain localised in the jaw joint or diffuse pain around the side of the head or neck
- Mouth feels tight when opening or unable to open fully
- Headache around the temples or side of head
- Jaw doesn’t appear midline / asymmetry to the jaw
Types of TMJ disorders
Myogenic: muscle related, when there is weakness, tightness or there is poor muscle control of the jaw muscles. When there is tightness the jaw will get pulled towards that side. When there is weakness or poor coordinationthe jaw won’t open and close like it should.
Discogenic: disc related, when the disc does not glide normally when opening or closing the mouth.The disc can shift out of place “sublux” or dislocate causing locking issues. In other words it feels like the disc rides over a speed hump when opening or closing the mouth creating a click or clunk.
Both myogenic and discogenic: This is the most common as muscle and joint issues come hand in hand
Growth issues: where there are uneven jaw growth issues or trauma to the jaw
How can physio help
Treatment can include:
- Functional massage of the jaw muscles: temporalis, masseter, lateral and medial pterygoids
- Correction of neck posture
- Trigger point release techniques
- Manual therapy techniques: joint traction, compression
- Motor control training
- Western acupuncture to relax the tight muscles
- Corrective exercise for imbalanced / dysfunctional jaw muscles
- Self – massage techniques: I can teach you how to massage the muscles of the jaw; intra-oral (some of the muscles of the jaw are accessed within the mouth) and extra-oral
On the first session you should have less pain or improved opening and closing ability. Sometimes collaboration with a dental specialist may be required such as getting a splint made or fixing the bite of your teeth. A TMJ physiotherapist will be able to determine whether you may need other treatment to fully fix your jaw problem.
What you can do
Don’t chew gum constantly – the chewing muscles will become overworked and tight.
Don’t rest your hand on one side of your face – you are putting pressure on your TMJ and squashing your disc.
Sleeping on your jaw – again you are putting pressure on your disc.
Dental issues and poor biting patterns
Neck pain or restriction – often relating to poor posture
Grinding your teeth at night – may be associated with stress or anxiousness