Temporomandibular Joint(TMJ) problems are common source of pain in the face, neck and headaches. Often, the jaw pain is so severe that it creates major impact on quality of life. After all, TMJ is the joint responsible for some of our most important functions, such as breathing, eating and talking, In other cases, seemingly “silent” TMJ causes chronic issues with the neck or reoccurring headaches.
Physiotherapy for TMJ includes a detailed history taking and a physical examination. Commonly there is a history of trauma such as car accident or some chronic teeth clenching. Examination would often reveal jaw deviation(uneven opening) and/ or clicking of the joint. Postural analysis and neck examination are also important as TMJ function relies heavily on proper posture and neck mobility.
Physiotherapy treatment for TMJ requires postgraduate training and diverse approach. Your phsyiotherapist may choose a number of treatment techniques including manual therapy, IMS, acupuncture and specific exercise. Often, there would be a need to visit a dentist to check if mouth guard is required.
TMJ Do’s and Don’ts
Do not eat any foods that require prolonged chewing such as hard crusts of bread, tough meat, or raw vegetables.
Do not chew gum
Cut food in small bite-size pieces and try to avoid opening your mouth wide.
Try to limit opening of your mouth to a thumb’s thickness when yawning, laughing, coughing, sneezing, or singing.
Do not rest your jaw on your hand.
Breathe through your nose, not your mouth.
Maintain good posture at all times.
It is best to sleep on your back.
Try to avoid moving your jaw in such a way that it causes the joint to make a clicking, popping, or grinding sound.
What causes TMD (Temporomandibular joint dysfunction)?
Maloclusion, anxiety, trauma, poor posture and prolonged dental work are common reasons for TMJ pain. In our experience, most patients have more than one predesposing factor. Occasionally, there are cases of TMD that are completely ideopatic(no known cause).
I have no pain, but hear clicking in my jaw. Is there a reason to worry?
While clicking in itself does not predict a problem within TMJ, it is worthwhile to have the joints assessed by trained professional. Depending on the type of click and other tests, your physiotherapist can determine whether the clicking is completely benign or there is a reasonable need for an intervention. Timely intervention can prevent misalignment, and future tissue damage.
Should I visit the dentist if I have issues with my jaw?
Yes, you should. Dentists often prescribe mouth guards, to help avoid night clenching and rest the muscles. We find mouth guards to be synergistic with physiotherapy treatments.
How many treatments would I need?
It depends on the severity of the condition. Acute, non-traumatic TMJ pains often recover within 6 weeks. As most TMJ cases are chronic and last years, it might take longer time to recover ; most patients do about 10-12 visits and then occasional “tune-up” every 3-6 month.
Can car accident cause Temporo-Mandibular Dysfunction?
Absolutely. Any neck injury can cause problems with the jaw. Car accident related injuries to TMJ, often take longer time to recover as other parts of the body are affected as well.
What are the different stages of Temporo-Mandibular Dysfunction?
Stage 1. Myofascial(muscle) dysfunction – pain, clicking and occasional jaw deviation, but overall normal mouth opening range of motion. This the most common type of TMJ problem, and thankfully it responds well to treatment.
Stage 2. Disk displacement with reduction – loud click with pain during closing and opening; range of motion often starts to decrease. It happens due to disk shifting within TMJ during movement. This stage is critical for intervention. You don’t want to progress to the next stage
Stage 3. Disk displacement without reduction – very limited opening of the mouth with pain. Disk no longer reduces and is “stuck” outside of the joint. While it can take really long time, fortunately the jaw often remodeles itself enough to get proper function again
Stage 4. Arthritis – Severe pain with coarse clicking, grinding and limited movement.
Please be aware that stages 2,3 and 4 are rare. If you are trying to self-diagnose, you are 99% in “muscle pain” stage.
We offer TMJ physiotherapy services to communities of Coquitlam, Port Moody, New Westminster and Burnaby. TMJ Physiotherapy and massage therapy are offered at both of our locations.