TMJ Dysfunction

john miller physiotherapist

Article by John Miller

What is TMJ Dysfunction?

tmj

Your Temporomandibular Joint (TMJ) is the most used joint in the body. Your TMJs (jaw joints) are involved with eating, talking, breathing and, probably most importantly, expressing our feelings and emotions. 

When things go wrong with your TMJ it is known as Temporomandibular Disorder (TMD).

TMJ Symptoms

You may or may not experience jaw pain or tenderness with TMJ dysfunction. The most common symptoms include:

  • clicking, 
  • popping, 
  • grinding, 
  • limited opening, or 
  • an inability to fully clench your jaw.

TMD sufferers are often teeth grinders or clenchers. They can also suffer headaches, ear pain dizziness and upper neck pain.

Some TMJ patients report pain or inability to eat, talk or sing. Tinnitus or ear ringing can be associated with TMJ dysfunction. (Vierola et al 2012)

What Causes Temporomandibular Disorder?

TMJ dysfunction is considered a multifaceted musculoskeletal disorder. 

Most Common Causes include:

  • Masticatory muscle dysfunction, 
  • Derangement/displacement of TMJ articular disc
  • Bruxism: nocturnal grinding of teeth leads to increased pressure in TMJ and asymmetrical movement.
  • Occlusal Problems: Poor bite, Asymmetrical or Retrognathic (underbite, overbite) .

Contributory factors include:

  • Mandibular malalignment secondary to occlusal appliance or orthodontic treatment.
  • Removal of wisdom teeth,
  • Prolonged mouth opening eg dental procedure, 
  • Poor cervical posture, 
  • Myofascial pain, 
  • Neuropsychological factors,
  • Stress, and 
  • Whiplash and other less common causes include: trauma (e.g., blow to the chin), infection, polyarthritic conditions, tumors, and anatomical abnormalities.

TMJ Dysfunction Classifications

The common presentations of TMJ dysfunction may be classified into three clinical diagnostic groups:

  • Jaw muscle disorder characterised by painful movement.
  • Articular disc displacement.
  • Arthralgia or arthritis. 

(Dworkin SF, LeResche L., 1992)

How is TMJ Dysfunction Diagnosed?

TMJ dysfunction can be diagnosed by your TMJ physiotherapist, a physiotherapist with advanced training in jaw dysfunction, your dental practitioner or oral maxillofacial surgeon. TMD is a clinical movement dysfunction diagnosis. They may recommend dental X-rays, CT scan or MRI to further investigate your condition.

tmj

TMJ Assessment

During your TMJ examination, your Craniofacial or TMJ Physiotherapist will assess your:

  • jaw range of motion, 
  • muscle tension and length, 
  • TMJ co-ordination and movement pattern. 

Your TMJ Physiotherapist will be able to identify if your problem is an opening issue. 

Opening problems include:

  • Muscle disorder,
  • TMJ (joint) disorder: hypermobility, stiffness or arthritis,
  • TMJ disc displacement disorder: intermittent or permanent lock, or a
  • cervical spine posture issue.

TMJ joints that have difficulty closing problems are usually:

  • a locked open joint, which can be manipulated open, or an 
  • occlusion problem, which may require a bite assessment from your dentist.

What is TMJ Treatment?

After your TMJ assessment your physiotherapist will commence corrective treatment or refer you on to the most relevant health professional suitable for your TMJ condition. 

While your TMJ physiotherapist is an expert in the treatment of opening disorders, your dentist is usually involved in the management of closing disorders such as locked jaw and bruxism.

TMJ Treatment & TMJ Exercises

TMJ exercises and treatment may include:

  • Posture improvement and neck treatment
  • Relaxation exercises
  • Muscle lengthening or massage
  • Joint mobilisation
  • TMJ movement pattern and timing correction
  • Passive, active-assisted, active exercises
  • TMJ stabilisation exercises.

Your specific TMJ exercises will be prescribed following a thorough TMJ assessment.

TMJ Treatment Results

Prognosis is favourable in the vast majority of patients treated conservatively and symptoms may improve without treatment. (Michelotti A, 2010).

Rammelsberg 2003, found that spontaneous resolution occurs in a 33% of TMD sufferers over a 5 year period.

Field 2012, found that with conservative TMJ physiotherapy treatment, 75% of the TMD group resolved their condition within 3 months, which is certainly consistent with my personal clinical results. The vast majority improve within a few weeks of commencing TMJ treatment.

TMJ Dysfunction - What to Avoid?

Until you seek the advice of your TMJ physiotherapist I recommend the following:

AVOID:

  • uncontrolled, wide-opening eg yawning,
  • biting hard foods eg carrots, apples,
  • eating burgers or hard rolls,
  • chewing gum, 
  • nail biting,
  • jaw leaning,
  • stress, and
  • clenching pens, pencils, pipes or cigars.

Summary

Every case of TMJ dysfunction is different. Please check with your Craniofacial or TMJ physiotherapist for their professional opinion. on what treatment plan is best for you.

More info about TMJ Treatment Professionals.

Call PhysioWorks Book Online

TMJ or Jaw Pain Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Biomechanical Analysis
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Deep Neck Stabilisation Exercises
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Strength Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • FAQs about TMJ Dysfunction or Jaw Pain

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • How Does Kinesiology Tape Reduce Swelling?
  • Heat Packs. Why does heat feel so good?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Musculoskeletal Physiotherapy?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What is the Correct Way to Sit?
  • What to expect when you visit PhysioWorks?
  • Potential Causes of TMJ or Jaw Pain

  • Cluster Headaches
  • Cramps
  • Facet Joint Pain
  • Migraine
  • Muscle Strain (Muscle Pain)
  • Neck Headache
  • Rheumatoid Arthritis
  • Tension Headache
  • TMJ Dysfunction
  • Wry Neck
  • Online Products for TMJ or Jaw Pain

    Jaw Injuries

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    Last updated 10-Mar-2016 06:02 PM

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