What is TMJ?

TMJ refers to the Temporomandibular joint, which connects the lower jaw with the head. TMJ disorders may develop when inflammation occurs, usually as jaw clicking, teeth grinding, clenching, jaw swelling, and tense or locked jaws. These painful sensations can cause serious problems allowing chewing or speaking easily. Sometimes TMJ disorder can be accompanied by chronic headaches, popping sounds, poor posture, and hearing loss. Individuals are experiencing TMJ pain or chronic jaw pain.

Diagnosis & Treatment

Lifestyle Changes & Physical Therapy

Physical therapy may include exercises for your jaw and facial muscles, heat, ice, and laser therapy, and trigger point massage. You will also learn ways to improve your posture and the way your posture may affect your bite.

Treatment of TMJ disorder

Temporomandibular joint disorder (also known as TMJ or TMJD) is a recurring but self-limiting condition that tends not to be progressive. Non-invasive, conservative treatments have been found to be effective. Physical Therapy treatment is very effective in relieving and managing TMJ, even when the symptoms are long-standing and severe. Most patients will significantly improve their symptoms with appropriate physiotherapy within 3 to 6 weeks.

TMJ treatment must address the underlying cause of the issues identified in the assessment.

Suppose the patient’s symptoms are acute and inflammatory. In that case, their condition is likely to be irritable, and one should proceed very gently to first relieve pain, swelling, and muscle spasms.  When the pain begins to settle, start restoring jaw movement and alignment. Treatment may include soft tissue releases to affected muscles and joint mobilization techniques.

It is also essential to treat any associated neck pain and headaches.  Posture correction should address head, neck, shoulder, and tongue position. The patient should be taught exercises to improve coordination, stability and alignment of the jaw.

The patient should be taught strategies to help them manage their condition. This may include posture education, long-term continuance of their home exercise program, good sleep habits including sleeping positions, stress management, and diet modification - a soft food diet. At the same time, the acute condition can help reduce the pain and swelling more quickly. The patient should also be taught ways to reduce stress on the TMJ by avoiding activities such as resting the chin on the hand, pencil chewing, jaw clenching while awake, wide-mouth yawning, nail-biting. They should avoid chewy foods, chewing gum, eating foods that need a wide opening, like large hamburgers, and chewing hard foods such as nuts and apples.

Manual Physical Therapy to Relieve Pain

A systematic review was published in 2015 to summarize the effectiveness of manual therapy on signs and symptoms of jaw pain associated with TMJ disorder. It showed that protocols of mixed manual therapy techniques, upper cervical mobilization or manipulation had considerable evidence for TMD symptom control and improvement in maximum mouth opening. The manual techniques included intra-oral myofascial release and massage therapy on masticatory muscles, atlantooccipital joint thrust manipulation, and upper cervical spine mobilization.

Therapists should be trained and follow the guidelines and standard procedures to perform cervical thrust manipulation if it is indicated.

Recent clinical trial results indicate that both methods, post-isometric muscle relaxation and myofascial release, can be used as effective forms of supportive physical therapy in the prosthetic treatment of pain-related TMD, accompanied by increased masticatory muscle tension.

Conclusion:

If you are experiencing TMJ issues, getting to the root cause is important. Whether those issues are popping noises, a bite problem, or significant pain in your jaw joint, I highly recommend that you seek treatment with a physical therapist with experience in treating not just TMJ but the entire mouth. In the meantime, make sure you practice self-care, take good care of your upper and lower teeth, stick with soft foods, and if your jaw pain worsens, please don't hesitate to reach out and give me a call. I'd be more than happy to help with your jaw pain!