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The Temporomandibular Joint (TMJ) can be a 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, the TMJ is the joint responsible for some of our most important functions, such as breathing, eating and talking. In other cases, the seemingly “silent” TMJ causes chronic issues with the neck or recurring headaches.
Temporomandibular Disorders (TMDs) refers to the group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. Thus, “TMD” refers to the disorder, and “TMJ” refers only to the temporomandibular joint itself. People have two TMJs, one on each side of the jaw near the start of the ear.
Treatment for TMJ may commonly be provided by a physiotherapist, acupuncturist, chiropractor, or registered massage therapist. A detailed history taking and a physical examination is very important as there can be a complexity of factors causing it or aggravating it. 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 and other treatment for TMJ requires postgraduate training, experience and a diverse approach. Your physiotherapist or other practitioner 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 have an assessment there and check if mouth guard would be helpful.
TMJ Do’s and Don’ts
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).
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.
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.
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.
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.
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, Maple Ridge, and Burnaby. TMJ Physiotherapy and massage therapy are offered at all of our locations.
Coast Therapy is an award-winning provider of Massage Therapy & Physiotherapy services to Port Coquitlam, East Vancouver, Port Moody, Pitt Meadows, Maple Ridge and Coquitlam residents for over 16 years.
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