The ‘temporomandibular joint’… it’s quite a mouthful to say which is ironic since it is the medical name for the jaw joint. If you place your fingers on the sides of your head just in front of your ears, and open and close your mouth – the movement you are feeling is the jaw joint gliding open and closed.
Now this joint is not quite as simple as a joint in your finger or toe. The joint contains a small disc and uses a combination of movements on either side to allow talking, chewing, biting an apple and yawning. However, the complexity of the joint also means there are a lot of different problems that can occur. The umbrella term “TMJ disorders” or TMJD/TMD is used to cover a wide range of these problems.
The good news is that most of the time the pain and symptoms can be reduced without surgery!
What are the symptoms of TMJ problems?
- Pain in one or both sides of the jaw
- Pain that extends into the ear, teeth or along the jaw
- Quite often chewing or opening the mouth very wide can cause pain
- Sometimes even lying on that side can be painful
- Clicking in the joint when opening/closing your mouth and in some cases locking, where the joint is locked into a certain position
Some people with TMJ problems also clench their jaw or grind their teeth, but that doesn’t mean it is causing the problem as lots of people do this and have no pain.
Is it really TMJ/jaw or could it be something else?
Some of the symptoms are quite obvious – like click or locking of the jaw. However, simply pain in the region around the jaw could be coming from a different source.
The joints and muscles in your neck and head can refer pain to the jaw area. Even issues with your teeth can cause pain in the jaw area, when the jaw itself is completely fine.
Your physiotherapist and/or dentist will use clinical tests to determine if the pain is true TMJ/jaw pain or if it is being referred from a different location.
Causes of TMJ pain:
There are lots of things that can cause TMJ disorders, including:
- Acute pain could be caused by trauma, such as a car accident, cycling accident or even football/rugby when a hit to the face is sustained
- Acute pain can also follow a lengthy tooth or throat procedure or operation, where your jaw is held open whilst you are asleep for a long period of time
- Pain that starts gradually is much more common and can be from a wide range of issues
- Poor posture in the upper back, shoulders and neck can place increased stress in this area
- Poor jaw habits can put increased load and demand on the jaw joint that it might not be used to (see below)
- Grinding teeth or clenching the jaw
- Even stress or anxiety can cause pain into this area
- Arthritis or other inflammatory conditions (such as rheumatoid arthritis) can occur in this joint just like every other joint
What will the physio do?
A physiotherapist will look at the movements of your jaw and take measurements. They will also assess your posture and the movements of your neck and shoulders. These areas can contribute to jaw issues and prevent the jaw from improving, but they can also refer pain to the jaw.
The physio will feel around the outside and inside of your mouth and jaw to look for muscle tightness and tenderness in certain areas.
They will then take the information they have found and provide you with a diagnosis (what we think is the problem and what is causing your symptoms). In some cases, the problem is something that a physiotherapist cannot help with and we will refer you back to your dentist for management. However, in most cases, we can provide conservative treatment that will help reduce your pain and symptoms.
Treatment will generally include:
- Advice on good jaw habits (see below)
- Massage of the muscles surrounding the joint
- Mobilization of the jaw joint (gentle movements to reduce pain and improve function)
- Gentle exercises for the jaw itself including stretches and strengthening exercises
- A further exercise program to improve your posture
- Treatments for the neck and shoulders if issues are found here as well
The treatments we provide for any injury/problem will be targeted at reducing the pain initially, but then we will target the cause of the problem to ensure it does not return.
What to do when you already have pain (or, good jaw habits):
- Do not lean your chin onto your hand excessively when reading a computer screen or waiting at a table
- Do not chew or use your jaw unnecessarily – such as chewing pens or gum
- Ensure your desk is set up correctly to have good posture and avoid sticking your chin forwards to read the computer screen
If you have more severe pain:
- Avoid eating very chewy foods like steak or bread
- Stick to soft foods – yogurt, soup, eggs, cooked vegetables, etc.
- Avoid opening your mouth too wide – for example, yawning or eating a large burger – instead, keep your tongue on the roof of your mouth whilst yawning and cut your food up into smaller pieces
- Heat or ice may help reduce your pain
- You can try sucking on an ice block or a very small icepack outside your jaw
- To apply heat, use a small heat pack on the outside of your jaw
- Relaxation techniques such as mindfulness can help reduce stress and tension, which could help reduce clenching or grinding
Jaw pain can be quite complex due to the joint itself being quite complex. Pain in that area can be referred from a number of different sources and it can be difficult to know who to see first.
If you have jaw pain, Back In Motion Mentone provides FREE initial assessments. This means, if our physiotherapists cannot help you or believe the pain is due to a dental cause – we will not charge you for the assessment. You will simply be referred back to your dentist with a letter explaining what we found in our assessment.
Author: Amanda (Mandy) Lowe
Practice Director & Principal Physiotherapist