What is the TMJ?
The temporomandibular joint, otherwise better known as the TMJ, is the articulation between the temporal bone of the cranium, the disc and the condyle of the mandible. This paired joint comprises of two key motions, rotation and translation, both of which allow the mouth to open and close. This functional relationship is important as it allows daily activities such as to chew, talk or yawn without much of a thought.
However, sometimes our TMJs can become painful or symptomatic, this is often referred to as a TMJ disorder. These symptoms can be of arthrogenic (the joint, disc etc) or myogenic (muscular) in nature. However, often these two are paired in a large portion of TMJ disorders, especially when they are chronic or ongoing.
There are factors which have shown to increase the likelihood of developing a TMJ disorder. Some of these risk factors include habitual clenching & grinding, poor occlusion, central nervous system sensitivity, certain personality traits and more.
5 signs it may be time to consult a TMJ chiropractor:
- Pain in the face, ear or head: TMJ pain can often present with pain or symptoms around the face, head or even near the ear itself. TMJ issues can often masquerade as ear complaints.
- Difficulty chewing or eating certain foods: When the muscles or joints of the TMJ are problematic, chewing or eating tasks can become difficult. This is particularly pronounced with ‘chewy’ foods that may require repetitive or increased muscle activity (e.g. muesli bar, gum).
- Difficulty opening your mouth wide: This can be due to the increased tension in muscles or reduced mobility of the jaw joints. This is often pronounced when you may be visiting a dentist and are required to open your mouth wide, or in order to eat certain foods (e.g. a hamburger, apple etc.)
- Frequent headaches: Headaches can be a common symptom of a TMJ problem, especially around the temporal and forehead region.
- Clenching or grinding issues: Otherwise known as bruxism, can be a challenging aspect for a lot of people experiencing TMJ pain. Implementing tools and strategies to reduce bruxism and the impact it can have on the TMJ can be an effective way to reduce pain, inflammation and stress in the area.
What symptoms can be involved in TMJ disorders?
While each person might experience TMJ disorders differently, some of the signs and symptoms of TMJ disorder may include:
- Localised or referred pain: This can be local to the jaw joint, or across the face, head or ear regions.
- Restricted jaw movement: Difficulty with mouth opening, side-to-side or jaw forward motions.
- Difficulty eating or chewing: Especially with ‘tougher’ foods that require more muscle and joint stress.
- Clicking or popping noises: Can be an indicator of a disc displacement, as well as intra-joint changes.
- Locking of the joint: Unable to open the mouth any further due to mechanical locking of the jaw.
- Recurrent headaches: TMJ disorders can often refer headaches around the temple and forehead regions.
- Uncomfortable or change in bite: Often reported by individuals suffering with TMJ problems.
What does a Chiropractic assessment for TMJ disorders look like?
- History: Here we really want to know about the TMJ condition, the impact it is having and the goals you’d like to achieve with care.
- Postural assessment: Evaluation the position of the spine, head and jaw. Optimising this can reduce TMJ stress.
- TMJ assessment: Focusing on muscle and joint function of the TMJ through range of motion, muscle testing, along with orthopaedic and neurological evaluation.
- External/internal TMJ assessment: Surveying the muscles of the face, head and jaw allows us to pinpoint muscles involved in pain and dysfunction.
- Referral for further diagnostic assessment (if clinically indicated)
What does chiropractic treatment for TMJ disorders look like?
- Education: Having a discussion around the nature of your problem and the treatment options available to you.
- Manual therapies: These can include mobilisations, dry needling, exercise therapy, with the aim of relieving pain and promoting better muscle and joint function.
- Exercise therapy: Self-management strategies you can do on your own to support your recovery.
- Advice: Strategies you can implement into your lifestyle to promote recovery, while minimising the risk of relapse.
What are other treatment options available for TMJ?
- Pharmaceutical: Oral NSAIDs have been shown to help reduce muscle and joint pain.
- Oral appliance/splints: Although more research is required, particular splints, such as stabilisation splits, have shown positive outcomes in TMJ pain of muscular origin.
- Injections:
- Surgery:
What can you do for yourself to help TMJ disorders?
- Stress management: Implementing strategies that are directed at reducing stress on the central nervous system can result in less muscle tension, reduce pain sensitivity and clenching behaviour.
- Sleep: Can improve your tolerance to stress and reduce pain sensitivity.
- Nutrition: Optimising your nutrition can promote better recovery and reduce inflammation in the body.
- Exercise: Shown to reduce pain and promote better muscle function. Also a proactive strategy to minimise reoccurrence into the future.
Conclusion
While TMJ disorders can often have a significant impact on the daily activities of those experiencing, these can often be alleviated with conservative therapy directed at relieving pain and improving muscle joint function. TMJ therapy is considered a primary option for those seeking conservative, non-surgical and non-pharmaceutical help for their TMJ disorder.
Other helpful resources
For more information regarding TMJ management: https://tmjcare.com.au/
For exercise regarding TMJ disorders: https://www.youtube.com/@empoweredhealthchiro
For tips, exercises and other strategies for TMJ disorders: https://www.instagram.com/empoweredhealthchiropractic/
References
Pundkar, S. U. S. H. M. A., Patil, D. E. E. P. A. L. I., & Naqvi, W. A. Q. A. R. (2019). Effectiveness of Rocabado approach and Conventional Physiotherapy on pain, ROM and QOL in patients with TMJ dysfunction: Comparative Study. J Crit Rev, 6(6), 925-929.
Rezaie, K., Amiri, A., Takamjani, E. E., Shirani, G., Salehi, S., & Alizadeh, L. (2022). The Efficacy of Neck and Temporomandibular Joint (TMJ) Manual Therapy in Comparison With a Multimodal Approach in the Patients with TMJ Dysfunction: A Blinded Randomized Controlled Trial. Med. J. Islam. Repub. Iran, 36, 328-337.
Fiorillo, L., & Musumeci, G. (2020). TMJ dysfunction and systemic correlation. Journal of Functional Morphology and Kinesiology, 5(1), 20
