Temporomandibular Joint Pain (TMJ)
Article by John Miller
What is Your Temporomandibular Joint?
Your Temporomandibular Joint or 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 Dysfunction Symptoms
You may or may not experience jaw pain or tenderness with TMJ dysfunction. The most common symptoms include:
TMD sufferers are often teeth grinders or clenchers. TMD can cause jaw 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.
The most common causes of TMD include:
Contributory factors include:
TMJ Dysfunction Classifications
The common presentations of TMJ dysfunction may be classified into three clinical diagnostic groups:
(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.
During your TMJ examination, your Craniofacial or TMJ Physiotherapist will assess your:
Your TMJ Physiotherapist will be able to identify if your problem is an opening issue.
TMJ Opening problems include:
TMJ Closing problems include:
What is the Best Treatment for TMJ?
The best treatment for TMJ does vary based upon the clinical diagnosis, the TMJ dysfunction and the chronicity.
As a general rule TMJ opening disorders (how the jaw moves when opening or closing) are more likely to be successfully treated with jaw movement improvement techniques such as massage, dry needling/acupuncture, muscle stretch/relaxation/coordination exercises or joint capsule stretching techniques that are provided by your physiotherapist.
Your dentist is usually involved in the management of TMJ closing disorders such as bruxism (teeth grinding) due
If you are unsure what treatment direction is best for you, we recommend that you seek the advice of your TMJ physiotherapist for pain, clicking or lack of motion when opening your mouth your dentist for problems when you clench your teeth. Either way, seek the advice of your TMJ health professional who will refer you on to the most relevant health professional suitable for your TMJ condition if they feel it is in your best care.
After your TMJ assessment, your physiotherapist will commence corrective treatment if appropriate. TMJ physiotherapy is normally very successful for the treatment of TMJ opening disorders due to the problem being a movement disorder that is affected by your muscle and joint control.
What is the Cause of Jaw Clicking?
Clicking jaw is a sign of articular disc displacement, which is commonly treated by a TMJ physiotherapist. Clicking can occur during jaw opening, closing or both directions. Please seek the clinical assessment of TMJ physiotherapist for a specific diagnosis and treatment plan.
TMJ Treatment Prognosis
Prognosis is favourable in the vast majority of patients treated conservatively and symptoms may improve without treatment. (Michelotti A, 2010).
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 our clinical results. The vast majority improve within a few weeks of commencing TMJ treatment. This compares to a more sluggish resolution in the non-physiotherapy treatment group studied by Rammelsberg in 2003, who found that spontaneous resolution occurs in a 33% of TMD sufferers over a 5-year period.
Locked Jaw Treatment
Locked jaw can be both temporary or permanent. Your TMJ physiotherapist is usually able to unlock your locked jaw via gentle manipulation. Should manipulation fail, you may require an Oral Surgeon to perform a manipulation under anaesthesia or another surgical procedure known as an arthrocentesis (joint washout). In chronic cases, open surgery may be required to identify or remove any physical obstructions, in permanent locked jaw, but this is relatively rare.
TMJ Physiotherapy Treatment & TMJ Exercises
TMJ exercises and treatment may include:
Your specific TMJ exercises will be prescribed following a thorough TMJ assessment by your TMJ physiotherapist.
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.
TMJ Dysfunction - What to Avoid?
Until you seek the advice of your TMJ physiotherapist we recommend the following:
More info about TMJ Treatment Professionals.
TMJ or Jaw Pain Treatment Options
FAQs about TMJ Dysfunction or Jaw Pain
Potential Causes of TMJ or Jaw Pain
Online Products for TMJ or Jaw Pain
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