What is TMJ Dysfunction?
Temporomandibular Joint (TMJ) problems are a common source of pain in the face, neck and headaches. The TMJ is the joint localized in front of your ears and is responsible for some of our most important functions, such as eating, breathing and talking. Often, the jaw pain is so severe that it creates a major impact on quality of life, in other cases, seemingly “silent” TMJ causes chronic issues with the neck or reoccurring headaches. TMJ dysfunction can have a variety of causes or aggravating factors including:
- MVA or other trauma to the face, head and neck
- Poor posture such as prolonged slouch, forward head posture
- Habitual chewing of gum, nails, pencil, necklace.
- Bruxism, clenching and grinding of the teeth
- Stress and inability to relax or sleep
- Jaw in prolonged extreme position such as prolonged dental work
Symptoms of TMJ dysfunction
- Face pain
- Jaw pain
- Neck pain
- TMJ click or clunk
- Locked jaw or limited jaw movement (stiffness)
Commonly seen TMJ Syndromes and conditions may include:
- Myofascial pain
- Hypo-mobility Syndrome & Arthritis
- Hyper-mobility Syndrome with Capsulitis and/or Retrodiscitis)
- Anterior Disc Displacement with Reduction Syndrome
- Anterior Disc Dislocation without Reduction Syndrome (The locked TMJ)
What we can do
Physiotherapy is a valuable option in the management of TMJ dysfunction.
Physiotherapy for TMJ includes a detailed history taking and physical examination. Commonly there is a history of trauma such as a car accident or some chronic teeth clenching. Examination would often reveal jaw deviation (uneven opening) and/or clicking of the joint and/or abnormal joint movement patterns. Postural analysis and neck examination are also important as TMJ function relies heavily on proper posture and neck mobility.
The results of a detailed physiotherapy assessment will be used to establish an appropriate clinical diagnosis and prepare a specific treatment plan. Your physiotherapist may choose a number of treatment techniques based on various syndromes/conditions including:
- Education, including explanation of the specific condition/syndrome, the related TMJ biomechanics, prevention and treatment measures, and relaxation techniques
- Manual stretching, mobilization and massage of the TMJ and its masticatory muscles (Masseter, Temporalis and Medial Pterygoid) and the surrounding soft tissue
- Specific exercise prescriptions such as relaxation techniques for the masticatory muscles, alignment correction of poor habitual muscle pattern, normalizing the joint movement (condyle translation)
- Posture correction exercises including neck/back exercises
- Physiotherapy modalities such as ultrasound, laser, acupuncture/IMS/dry needling to stimulating healing and help with pain control
Evidence and studies
A recent systematic review (Martins et al 2015) concludes that musculoskeletal manual techniques for TMJ are effective at reducing pain and increasing mouth ROM.
An excellent randomized controlled study (Yoda et al 2003) found that for click due to anterior disc displacement with reduction, therapeutic exercises is significantly effective in reducing clicking, and thought to be much more conservative and cost-effective than splint therapy or surgery.
Often, there would be a need to visit a dentist to check if a mouth guard is required in conjunction with physiotherapy.
If you experience any of the related TMJ symptoms, we can help you find relief. Please call our clinic at 403-272-9628 for an appointment.