Jaw Pain / TMJ Dysfunction

  • January 25, 2014

Jaw pain or clicking is a troublesome issue for many and is poorly treated. The jaw articulation or joint is correctly referred to as the temperomandibular joint – the articulation of the mandible (jawbone) with the temporal bone in the side of the skull.

Common symptoms are:

  • Face pain
  • Jaw ache or localised jaw pain
  • Clicking in the jaw
  • Headaches and migraine connected with the jaw.
  • Dizziness
  • Inability to open the mouth fully

Causes:

  • Internal disc damage

There is a small disc in the joint like the meniscus / cartilage in the knee which can become injured damaged and this is often cited as the cause of problems but it is rarely the cause in my experience. During a car accident / whiplash type injury to the neck and head the jaw undergoes great stress and can often dislocate and spontaneously re-align damaging the disc in the process. An MRI scan can confirm injury to this disc and surgery can be required in the worst case scenario but thankfully this is extremely rare.

  • Muscle tension

Masseter is a muscle in the jaw, which studies have shown, is the first muscle in the whole body to go into tension in stressful situations.

Lateral pterygoid muscles also exist within the mouth and jaw area and are commonly tight in people with jaw issues.

Upper neck muscles and muscles in the throat region are connected to and are involved in movement of the jaw.

  • Tooth grinding associated with stress

Many patients are given mouth guards to help reduce grinding at night – this often helps but they frequently grind though them! Better to address the deeper roots of the stress. Energy medicine, psychological assistance and techniques such as craniosacral therapy can prove very effective in resolving the roots of the problem rather than paliatively using mouth guards.

  • Orthodontic work or prolonged dental work

Altering the bite plate with orthodontic work can alter the stresses around the jaw and so cause pain. Often this is short lived but in some people they need help in settling this down.

Prolonged dental work such as in root canal work where the jaw is maintained in an open position for a long period of time can trigger problems with the jaw.

  • Upper neck issues

Many of the muscles moving the jaw come from the upper neck as described above but also altered position of the upper neck may alter the alignment of the jaw. There are positional receptors in the upper neck and jaw called proprioceptors which tell the body about the head position in space. If there are issues in the upper neck it can disturb the idea of correct head position and the jaw adapts to compensate. This explains why some patients experience dizziness with jaw problems.

  • Cranial issues

As half of the jaw joint / TMJ is the temporal bone in the skull, disturbances to the cranial sutures / joints can result in jaw pain or clicking. There are muscles like temporalis which attach to the skull which articulate the jaw so people with tension in the head muscles and scalp often experience jaw issues. 

Treatment:

Physiotherapy / manual therapy management of jaw issues is a very specialist are and most practitioners do not feel comfortable treating this condition. It does not form part of a physiotherapist’s core training.  I have been treating jaw issues now for over 10 years with some great results.

As always an integrated approach is my preferred way of working with these patients. Hands on work to the muscles, manual therapy to the joints and skull, cranial therapy, energy medicine, myofascial release, stress management and psychological assistance, lifestyle adjustments and ergonomic discussions are common techniques employed to help.

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