The Temporomandibular joint (TMJ) is a joint in the lateral aspect of the head, just in front of your ear and is a common cause of ‘Jaw pain’. A variety of movements occur at the TMJ and are determined by which way the mandible (jaw bone) is moving. These movements are depression (mouth opening), elevation (mouth closing), lateral deviation, retrusion and protrusion.
Temporomandibular Joint Dysfunction
Temporomandibular Joint Dysfunction (TMJD) is an umbrella term that describes any condition or dysfunction in or around the TMJ. Affecting approximately 40% of the population and mostly seen in ages between 20-40 years old. Neck and headache symptoms are also commonly seen in individuals suffering from TMJD.
The TMJ is made up of the temporal and mandibular bones (giving the joint its name), joint capsule and the structures involved, articular disc and surrounding ligaments and muscles.
Signs and symptoms
Sharp pain when biting along with aching are commonly associated with TMJD. Pain is usually located in the joint itself. Pain can also be felt near the joint and even refer to nearby structures (face, teeth, neck or shoulders). Other symptoms include:
- Pain and/or difficulty with chewing
- Clicking of the jaw
- Locking of the jaw
- Jaw deviation when opening/closing
- Inability to full open or close the mouth
- Referred pain
- and more
The TMJ is just like a lot of joints in the body, hence the risk factors are similar. These are based around overusing or deconditioning of the joint. Risk factors include:
- Excessive clenching and unclenching the jaw
- Biting too hard
- Grinding your teeth
- Excessive chewing
- Stress + stress related habits
- Neck stiffness
- and more
Causes / types of pain
Causes of TMJ pain can be contributed by number of structures. An article by Shaffer et. al. simplifies TMJ pain into the following categories.
- Myogenic pain (muscles)
- Arthogenic pain (arthritis, internal derangement, hyper/hypo mobility all in the Joint)
- Pain due to disk displacement
- Cervical spine involvement
Other causes can include:
- Referred pain from other structures
- Serious pathology
- Hypersensitive nervous system
As you can see, the cause of TMJ pain can come from several sources. Physiotherapists have had great success in treating TMJ pain. Physiotherapy treatment involves:
- A Thorough and detailed history taking of individual in pain
- Determining which structures may be contributing to the symptoms
- Determining which risk factors may be having the biggest influence on the individuals symptoms
- Ruling out any serious pathology that may require urgent care
- Manual therapy to assist in healing, mobility and decreasing the symptoms. Including but not limited to: Massage, joint mobilisation, acupuncture and heat/ice.
- Working collaboratively with the individual to ensure the best treatment plan is in place to decrease symptoms and increase functional capacity
- Optimising recovery and ensuring measures are at place to decrease future recurrence
Dysfunction of the Temporomandibular joint is troublesome and can lead to ongoing stresses in life. Fortunately, Physiotherapists are well trained in identifying the cause and treating TMJD appropriately. If you or someone you know is suffering from TMJD come and see your friendly Physiotherapists at Back in Motion to get on top of your pain.