Temporomandibular Joint (TMJ)
The temporomandibular joint or TMJ for short, is the joint that forms our jaw and connects it to the skull. We have 2 TMJ joints on either side of the skull, located just in front of our ears. The joint is created from the intersection of the mandible and the temporal bone of the skull. Our TMJ is used every day when we’re talking, eating, laughing and more. In other words, anytime you move your mouth, you are using this joint! When you start to have pain or problems with the jaw, it is referred to as temporomandibular dysfunction. Common complaints may include pain and/or difficulty chewing, or clicking, clunking, and locking in the jaw during movements.
What causes TMJ dysfunction?
TMJ dysfunction includes many different classifications of problems with the TMJ joint, disc, or the muscles around it. Normally, the jaw opens in a 2 part movement from the mandible moving on the skull. First, the mandible rolls as the jaw opens, then it must slide forward as the jaw opens further. Stiffness or improper timing during this sequence leads to the symptoms of clicking, locking, and pain. Possible causes or risk factors for TMJ dysfunction include:
- Clenching and grinding: Also known as bruxism, clenching or grinding of the teeth puts high amounts of stress on the joint and muscles at the jaw
- Direct trauma: You may develop TMJ dysfunction after a direct hit or impact to the area
- Dental issues: For example, teeth misalignment can put extra pressure on the jaw
- Stress and other psychological factors: Stress or anxiety may lead to an increase in muscular tension and can lead to jaw clenching or grinding
- Jaw overuse: Even things like eating a lot of hard food or chewing on a lot of gum may influence the jaw
- Hyper or hypomobility: One side of the jaw may move more than the other side, causing the jaw to deviate to one side and produce a “click” every time it moves
Can physiotherapy help jaw pain?
Yes! It is sometimes not common knowledge, but Physiotherapists are experts at treating the TMJ. Oftentimes, Physiotherapists will work collaboratively with dentists since they can create aids like mouth guards to help reduce strain on the jaw. However, the actual treatment of the TMJ itself is done by Physiotherapists. Notably, the TMJ can be treated like any other joint and thus follows the same treatment principles. Treatment methods may include:
- Manual therapies – These include joint mobilizations and soft tissue release to the muscles that control the jaw. The more unique part of TMJ therapy is that treatment may happen internally. In other words, some treatment may involve the therapist putting their hands inside your mouth to reach a muscle or perform a maneuver
- Personalized exercises – You will receive a personalized plan which may include stretching tight muscles, strengthening muscles of the jaw, and retraining jaw opening and closing mechanics with proper alignment
- Address the neck – Since the jaw and the neck are so closely associated and may affect each other, any neck pains or headaches must also be thoroughly assessed and treated
- Advice on posture and lifestyle changes – Many risk factors of TMJ dysfunction come from stress, or inappropriate habits and postures. As a result, learning how to manage the things that aggravate the condition is essential
Frequently Asked Questions
What are the warning signs of TMJ dysfunction?
- Clicking or popping in the jaw
- Difficulty/pain while eating or chewing
- Pain in the jaw, neck, face, temples, and even ear pain
- Difficulty opening your mouth fully, or locking while opening and closing
How long does TMJ pain last?
- Unfortunately, for most people, TMJ pain tends to become chronic if untreated. Due to the nature of the injury and the many contributing factors such as tooth grinding and stress, resolving the issue often requires outside intervention. The pain itself may come and go, lasting from a couple of days to weeks. Once starting treatment, TMJ dysfunction tends to improve within a couple of weeks.
Do I need a referral to see a physiotherapist for TMJ problems?
- Nope! You are welcome to come into the clinic without a physician referral. In the initial session, your treating therapist will perform a comprehensive assessment to determine the nature of your issue. However, if you have had treatment on the TMJ before or any imaging, feel free to bring that information in with you to help your therapist.
Can my TMJ issue be causing my headaches?
- Yes, it is very common for problems at the TMJ to refer to pain in the head or neck. One of the key symptoms is if you wake up with jaw pain or a headache in the morning. It is a very telling sign that you grind your teeth at night and are creating a lot of tension at the jaw. Thankfully, with Physiotherapy treatment and a dental appointment to get a night guard, this is a very treatable issue.
What happens if I don’t get my TMJ treated?
- We highly recommend that you address your TMJ pain as early as possible. Long-term complications of a worsening issue can include more than just pain and headaches. Eventually, it may affect your function and your ability to eat and speak. For some people, this route may lead to the necessity for surgical intervention.
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