Temporomandibular Joint (TMJ) and Jaw Pain? Physio Professionals Caloundra and Kawana can help!
The Temporomandibular Joint (TMJ), otherwise known as the “jaw joint”, is potentially the most used joint in the body. Movement is required at both of the two TMJs (one on each side of the jaw) to allow the mouth to open/close for daily activities including eating, chewing, yawning and talking. Being used so frequently, the TMJ is therefore susceptible to injury just like any other joint in the body. Studies suggest anywhere between 28-85% of the population have some kind of temporomandibular disorder (TMD), whether it be pain, stiffness, clicking or locking, making it an extremely commonly affected joint.
Unfortunately a lot of people with TMD symptoms are either misdiagnosed as having something else (eg. Pain from teeth, inner ear problems) or they do not realize that TMJ problems can be treated.
TMJ symptoms can really be debilitating for patients, so the team at Physio Professionals is keen to raise awareness of physiotherapists’ role in treating TMD so that this group of patients are not forgotten and can gain relief from their symptoms. Only a small percentage of people seek treatment. Physiotherapists can treat TMJ problems very effectively, as it is just like any other joint in the body.
Symptoms of TMD
TMD are characterized by one or more of the following symptoms:
- Pain, just anterior to the ear, on one or both sides of the face, especially with opening/closing of the jaw.
- Clenching/Bruxism – clenching the jaw and/or grinding of teeth can be both a symptom and a cause of TMD.
- Clicking – the jaw will click at a certain point through range when opening/closing
- Locking – the jaw can become locked in an “open lock” or “closed lock”
- Tightness – the jaw feels restricted or “tight” on one or both sides.
- Fatigue – often in association with tightness, the jaw fatigues quickly with repetitive opening/closing when eating/talking
- Crepitus – in cases of osteoarthritis (uncommon), joint cracking/creaking with movement may be heard and/or felt.
Prevalence & Aetiology
TMD can affect anyone, but is more common in females than males, and is most common in the 20-40 year old age group. Factors thought to contribute to TMD include:
- Direct trauma to the TMJ (eg. Contact sports)
- Muscle tension around the TMJ (stress, postural strain)
- Dental procedures/surgery (indirect trauma by having the TMJ in a fully-opened position for a sustained period of time)
- Other dental issues (causing malocclusion/bite misalignment, therefore uneven loading on the TMJ; wearing dentures)
- TMJ disc dislocation (thought to cause clicking and locking symptoms)
- Other joint overload (eg. Chewing gum frequently)
Assessment and Treatment
Physiotherapy assessment of TMD aims to identify the underlying cause of the TMJ symptoms. Stress, muscle tightness and postural strain can all tighten the structures around the TMJ, increasing load on the joint. A thorough physiotherapy assessment will analyse the movement patterns of the TMJs and measure the movements of the jaw, looking for symmetry and whether the movement is within a normal range or is restricted. This is measured accurately with precision technical calipers. Any clicking or locking will often be identified at a certain point in range, which then allows for treatment to be directed to that point of movement. Treatment can involve massage to muscles surrounding the TMJ, postural retraining, exercises to strengthen and correct alignment issues, and manual therapy techniques to loosen the TMJ. Other contributing factors such as neck stiffness/tightness, stress/clenching/bruxism can also be addressed if they are thought to be contributing.