TMJ Disorder and Pain

• Have you noticed how busy our lives are now?

• Are you noticing headaches and sleep disruption? (1)

• How about jaw tenderness, jaw locking/restriction, or clicking noises or tenderness in the muscles used to chew?

If so, you may be part of the 1 in 3 people that suffer from jaw and facial pain to an extent that it affects their quality of life (2).

Temporomandibular joint disorder, or TMJD, refers to a cluster of symptoms in the jaw and muscles of mastication (chewing). While the condition can affect anyone, females between the ages of 20 and 40 are most commonly affected (3).

Stress is thought to be a factor in TMJ. Even strenuous physical tasks, such as lifting a heavy object or stressful situations, can aggravate TMJ by causing overuse of jaw muscles, specifically clenching or grinding teeth (also known as bruxism).

SYMPTOMS OF TEMPOROMANDIBULAR JOINT DISORDER

TMJD has a wide variety of symptoms as mentioned above. In severe cases, the condition can restrict jaw movement so much that talking, eating, yawning and smiling can be difficult. It linked to other inflammatory conditions such as arthritis. TMJD often leads to referred pain which is felt as headache, toothache or even ear-ache (4).

Images courtesy of Real Bodywork – Muscle Trigger Points www.realbodywork.com

TREATING TEMPOROMANDIBULAR JOINT DISORDER

Because the symptoms of TMJD vary in type, duration and severity, the condition is poorly understood. There is some disagreement between specialists on the best way to diagnose, categorise and treat the condition.

One self-care method that can help to reduce stress and muscle tension, is the Jacobson Progressive Muscle Relaxation Technique (5).

You can do this just before going to sleep at night, to release tension in the muscles, as it is usually during the night that the jaw muscles clench in response to stress.

Another way to help the body in times of stress, is to take a good quality magnesium supplement before bed time.

Massage therapy is a great way to calm the body in times of stress (6) including work done specifically around the head, jaw and neck to reduce muscle tension and symptoms.

Physiotherapy has been shown to assist with the relief of symptoms (7) and also the long-term recovery after surgery (8).

Jaw exercises, friction massage, joint mobilisation and dry needling are all techniques your physiotherapist can use to relieve pain and stiffness, and encourage normal movement again.

It is important to seek treatment early in order to prevent symptoms becoming severe. Your dentist, GP and physiotherapist can all work together to ensure you are properly diagnosed and treated.

Talk to your physiotherapist about your TMJD symptoms and work together to feel better, and wake after your sleep feeling more refreshed.

[1] Gray, R. et al (1994) ‘Physiotherapy in the treatment of temporomandibular joint disorders: a comparative study of four treatment methods’ British Dental Journal 176(7) 257-261.

[2] Swift JQ, Roszkowski MT, Alton T, Hargreaves KM. (1998) ‘Effect of intra-articular versus systemic anti-inflammatory drugs in a rabbit model of temporomandibular joint inflammation’ Journal of Oral and Maxillofacial Surgery 56(11), 1288-1295.

[3] Shi, Z; Guo, C; Awad, M (2003). ‘Hyaluronate for temporomandibular joint disorders’ In Shi, Zongdao. Cochrane Database of Systematic Reviews (Online) (1).

[4] Neville BW, Damm DD, Allen CA, Bouquot JE. (2002) Oral & maxillofacial pathology (2nd ed.). Philadelphia: W.B. Saunders. pp. 758, 759.

[5] Muntazir Maqbool Kermane (2016) ‘A Psychological Study on Stress among Employed Women and Housewives and Its Management through Progressive Muscular Relaxation Technique(PMRT) and Mindfulness Breathing’ J Psychol Psychother 6:244. doi:10.4172/2161-0487.1000244

[6]Fateme Nazari,1 Mojtaba Mirzamohamadi,2 and Hojatollah Yousefi (2015)

‘The effect of massage therapy on occupational stress of Intensive Care Unit nurses’ Iran J Nurs Midwifery Res. 2015 Jul-Aug; 20(4): 508–515.

[7]Evane de Toledo et al. (2012) ‘The interrelationship between dentistry and physiotherapy in the treatment of temporomandibular disorders’ The Journal of Contemporary Dental Practice 13(5) 579-583.

[8] D Oh, et al (2002) ‘The effect of physiotherapy on post-temporomandibular joint surgery patients Journal of oral rehabilitation’ Journal of Oral Rehabilitation 29(5), 441-446; Kin Su-Gwan.(2001) ‘Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap’ International Journal of Oral and Maxillofacial Surgery 30(3), 189-193.