Temporomandibular Joint (TMJ)

You’ve probably heard people talk about “TMJ.”  There’s a good chance that you even know someone who has a problem with theirs.  Or maybe you are suffering from “TMJ” yourself.  So what is it, exactly?

When people talk about the “TMJ”, they are talking about the Temporomandibular Joint.  It is the place where your jaw bone attaches to your skull.  You have two of them, one on each side.  They are basically a pair of sliding hinges that let your jaw open and close.  Normally, you should be able to open your mouth, chew, eat and talk without pain.  However, patients suffering from TMJ disorder often have difficulty with these activities and / or suffer from pain in their jaw, teeth or face.  It is estimated that ten million Americans suffer from TMJ disorder, with women being affected more often than men. 

SO WHAT ARE THE SYMPTOMS?

There is a wide variety of symptoms associated with the TMJ, and some are more serious than others.  For instance, many people report a “click” or other sounds coming from the joint.  If the clicking isn’t painful and doesn’t get in the way of chewing or other activities, it probably isn’t anything to worry about. 

Many TMJ patients cannot open their mouth all the way or their jaw “cocks” to one side when they try to open it.  Usually, I find that this happens because one or more of the muscles that opens or closes your jaw is tight.  There is also a good chance that you (or your dentist) will notice that your teeth don’t line up properly anymore.  There has been a fair amount of debate among scientists as to whether this is the cause – or the result – of altered function of the TMJ.

Pain is probably the most common TMJ symptom that brings patients into my office.  When the joint – or the muscles that move it – aren’t functioning properly, it can produce pain in the face, jaw, sinuses or teeth.  Since these muscles have a strong functional and neurological relationship to the neck muscles, there is also a good chance that you will also notice pain or stiffness in your neck.

SO WHAT CAUSES IT?

Many things can cause pain and dysfunction of the TMJ.  Most of the time, several interrelated factors are at play. 

There are several strong functional links between the neck and the jaw, and when one of them isn’t working properly, there is a good chance the other isn’t either.  For instance, when your neck and jaw are both working properly, your head actually tips backward when your jaw opens.  Think of a little kid being told to say, “aaaahh.”  Most likely, you’ll picture her tipping her head back when she opens all the way.  On the other hand, patients with TMJ pain usually tip their heads much less – and may not tip their heads at all.

Maybe you’ve heard of “tech neck” – that posture you get when you stare at screens or your phone all day.  This results in a posture where your head and shoulders lean forward.  When this happens, it puts tension on the muscles under your chin and on the front of your neck that pull your mouth open.  When these muscles are tight, the muscles that close your jaw have to work harder to keep you from walking around with your mouth hanging open.  Over time, this extra tension can lead these muscles to develop trigger points that restrict jaw opening, cause headaches, toothaches and other pain. 

Trigger points in the neck can also “refer” pain from the neck up into the jaw, temple jaw and forehead.  What’s more, they can also cause the muscles that move your jaw to tighten up, too.  I see this scenario in patient’s who have been in car accidents and also in people who have stressful jobs. 

Other common causes of TMJ pain include grinding your teeth at night, biting your nails, trauma, arthritis or other damage to the joint.

SO WHAT CAN I DO?

Often, TMJ-related pain is mild and goes away on its own.  However, if the pain or limited mobility interferes with chewing or talking, is extremely painful or is associated with other symptoms like dizziness or hearing loss, it is time to seek out a medical professional.  The good news is that TMJ pain and dysfunction usually responds to conservative treatment.  For instance, your dentist may give you a mouth guard. 

In our office, we take a sports medicine approach to treating patients with TMJ.  By “sports medicine approach,” I mean that we focus on assessing and improving the biomechanics of your neck, shoulder girdle and jaw.  Often, by improving function, pain and other symptoms will go away on their own.

On your first visit, we will discuss your treatment goals.  Then, we’ll assess your posture and how the muscles and joints of your neck, jaw and upper extremity are working.  We’ll also locate any Trigger Points that may be contributing to your pain and other symptoms.  Based on what we find, we will put together a treatment plan using dry needling, electroacupuncture and soft tissue techniques to help you improve your posture, correct muscle imbalances and help restore normal function of the neck and jaw.  Our goal is to help restore normal, pain-free movement, relieve pain and help improve your quality of life.