By Josh Bruner, Physical Therapist
Do you currently have pain when chewing food? What about a painful click when opening or closing your mouth? If so, you may have temporomandibular joint pain, which is commonly known as TMJ. The temporomandibular joint is where the lower jaw connects to the skull to allow the mouth to open and close for activities such as chewing and speaking. Overuse injuries to this region are very common and debilitating at times. Despite these complications, individuals will often ignore the issue of TMJ because they think nothing can be done to help it. When receiving the proper care, TMJ can be effectively treated, often with the collaboration of a variety of healthcare providers.
Understanding TMJ Disorders
Temporomandibular joint pain has been found to be present in 5-12% of the population. People with TMJ will often have similar symptoms, but the cause of their symptoms can vary significantly. Thus, a “one size fits all” approach cannot be used to treat TMJ.
The most common cause of TMJ is when the articular disc between the joint moves in and out of the joint when opening and closing the mouth. This usually leads to the clicking sound and pain most people experience.
Another source of TMJ is tightness in the muscles used to open and close the mouth due to clenching the jaw or excessively chewing food. Tightness in these muscles can restrict movement of the jaw and produce pain when attempting to open the mouth. Neck impairments, increased laxity or excessive motion of the jaw, and arthritis are a few other common causes of TMJ. Since there are many different causes, in order to effectively treat TMJ, it’s important for your healthcare providers to determine the appropriate source of pain.
Common Signs and Symptoms
- Clicking or pain with opening and closing the mouth
- Limited opening of the mouth
- Pain with chewing
- Locking of the jaw
- Grinding or clenching of the teeth
- Ear and tooth pain
- Neck pain/headaches
- More common in females than males
Physical Therapy Treatment
Physical therapy can be an effective treatment option for individuals with TMJ. A physical therapist can perform a thorough evaluation to determine the cause of someone’s TMJ in order to make an effective treatment plan.
Physical therapists can implement soft tissue mobilizations (massage) to the muscles of mastication (chewing muscles) to reduce tightness, perform joint mobilizations to decrease joint restrictions, prescribe exercises to help reduce movement of the disc between the joint, and teach patients how to modify chewing habits or avoid certain movements of the jaw that exacerbate the pain.
Activity modifications such as placing the tongue on the roof of the mouth while keeping the teeth slightly separate is a great way to prevent clenching or grinding of the teeth at rest. Also, limiting opening of the mouth with chewing activities can reduce displacement of the disc between the joint. Physical therapists can also address neck impairments and headaches that often occur with TMJ by treating joint restrictions or muscle tightness in the cervical spine.
Physical therapists and dentists will often work together when treating TMJ. Communication between a dentist and physical therapist can produce the results needed to decrease the pain experienced with jaw movement or chewing. Dentists can fit patients with oral splinting to help diminish grinding or clenching of the teeth at night while sleeping. Stabilization splints created by a dentist can also be used in combination with physical therapy treatments to help prevent excessive movement of the jaw or displacement of the disc within the joint. Occasionally, more invasive procedures such as oral surgery may be needed, but this will be determined at the discretion of the dentist.
Despite the complexity of TMJ, conservative treatments can be effective in decreasing chronic pain. Soft tissue and joint mobilizations in combination with activity modifications can be helpful in reducing pain.
TMJ should not go untreated, so make sure to reach out to your local dentist or physical therapy department to receive proper guidance with your care. For further questions or additional information, contact Rehab Services at The Orthopedic Institute at 608.342.4748.