What is TMJ??

what is TMJ??

by Michael Beuoy, PT, Cert. MDT

Do you feel clicking, popping or grinding when you are eating? Do you limit how wide you open your mouth because of pain in the jaw? Do you feel like your teeth don’t quite fit together right? These can all be symptoms of temporomandibular dysfunction or TMD. Headaches, ear pain and even neck pain can also be symptoms of TMD as well.

The temporomandibular joint (TMJ) is where the lower jaw attaches to the head. This hinging joint allows the lower jaw to move up and down so that we can talk, eat, and yawn. Like any other joint in the body, if it is not moving correctly it can be painful. Symptoms may be intermittent, or they may be persistent. Often, we will accommodate to the pain by altering our movement, chewing on the other side or limiting how wide we open our mouth.

Overactive muscles that control the movement of the jaw are often a major source of the pain associated with TMD. Muscles that stay contracted all the time become painful. Clinching of the jaw is a problem that many people with TMD have and may not even realize it. Some people clinch or grind their teeth while sleeping. Your partner will usually let you know if you are grinding because the sound will wake them at night. But many people are clinching during the day and have no idea. Your top teeth and bottom teeth are not supposed to be in contact with each other at rest. This is a form of clinching and it keeps the muscles that control the jaw in a constant state of contraction. If you find that your teeth are in contact with each other on a regular basis, try to allow the lower jaw to relax. Make a note

to gently move your jaw up and down as well as side to side for a few seconds throughout the day. The movement may help to allow the muscles to relax and limit the contact of your teeth. Popping and clicking may also be noted with TMD. Reasons for this could be related to the disc that is in the joint or possible changes to the surface of the joint. The disc plays an important role in the function of the joint and when displaced can be a source of pain as well. Headaches and neck pain are often associated with TMD due to the hyperactivity of the muscles. High stress levels and poor posturing can create further tension in the muscles of the jaw, neck, shoulder and head.

Treatment for TMD comes in several forms. Your dentist may be able to make a splint that helps to position the jaw and relax the muscles. Some people may require orthodontic intervention for correction of the bite. Worst case scenarios may even require surgery, though that should always be the last option.

As a physical therapist, I treat pain related to joint disorders throughout the body. The TMJ is no different. A course of physical therapy treatment for TMD pain includes a thorough evaluation to determine the best course of action. Treatment by a physical therapist for this pain should include education for posture, foods that place less stress on the jaw, and avoidance of activities that are keeping the muscles hyperactive. Manual treatments are used to help the muscles to relax and exercises are performed to normalize movement of the joint as much as possible. Modalities such as heat or ice may also be beneficial to decrease pain. The cervical spine needs to be addressed to look for abnormal movements as well. If you suffer from symptoms like this, ask your doctor, dentist or physical therapist if a course of physical therapy treatment is right for you.

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by Michael Beuoy, PT, Cert. MDT

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