Today I had the opportunity to consult with a young lady suffering from TMJ Dysfunction. She has been unable to open her mouth very wide and experiences a lot of clicking, popping and ‘locking’ of her jaw when talking and eating. My consult with her had me thinking about all of the patients I have helped over the past 27 years who had TMJ Dysfunction. A couple of patients with jaw pain from TMJ Dysfunction were most memorable. But, before I tell you about them, first you should know something about the jaw or TMJ.
What is TMJ and TMJ Dysfunction?
The joint that connects your jaw to your skull and allows you to open and close your mouth is the temporomandibular joint. When you have problems with the muscles or joints in that area it is called TMJ dysfunction, or more accurately temporomandibular disorders, or simply, TMD.
This disorder is characterized by pain and stiffness on one or both sides of the jaw. The jaw may also lock or get stuck in either a closed or open position. Patients may also notice a popping, clicking, or grating sound in the jaw when chewing, yawning, or when closing or opening their mouths. They may also have trouble chewing or talking and even experience swelling associated with their pain.
What Causes TMJ Dysfunction?
- Trauma to the head, face or neck
- Whiplash injuries
- Arthritis in the jaw
- Grinding the teeth (bruxism)
- Stress that causes clenching of the jaw
- Movement of the disc, or soft cushion, that lies between the socket and ball of the jaw
- Repetitive motion injuries – such as from chewing gum, pen caps, etc..
Diagnosis and Treatment for TMJ
Many conditions can mimic the symptoms of TMD. A complete medical history is important to get to the root cause of the problem. As your chiropractic physician, I will check the joints in the jaw for popping, clicking, or grating. More importantly, I will observe how the jaw moves when it is opened and closed. Does it open smoothly or “cath” part-way through the motion? Does the bottom jaw deviate to one side or the other during motion? I typically also check the upper cervical spinal structures, suboccipital muscles, and jaw muscles to see if they play a role in the patient’s problem. Sometimes subluxations and muscle spasms in the spine or a nerve condition called trigeminal neuralgia can cause jaw and facial pain even when the TMJ is functioning properly.
Chiropractic Care for TMJ
The Temporomandibular Joint or the jaw can become subluxated just like the spinal vertebrae or pelvic joints. When this happens, just like untreated spinal subluxations, a small problem can snowball and become a bigger and more encompassing health issue. Chiropractic for TMJ is not only common but very effective.
Temporomandibular Joint Disorder, or TMJ Dysfunction, is a condition that affects the jaw AND the associated nearby joints of the skull and neck. It can be extremely painful and even debilitating physically and socially. Chiropractic care is a viable treatment for TMJ pain and dysfunction.
At first, this may seem counter-intuitive simply because it is widely believed that chiropractors only treat the spine and neck. This commonly held belief is not entirely accurate. Chiropractors treat all joints of the body, which of course includes the spine (lower back, middle back & neck). A chiropractor may treat ankles, wrists, knees, and, yes, even the jaw. When it comes to problems with the jaw, nearby joints of the skull and neck may contribute to TMJ dysfunction. the muscle tension in the face, jaw, and neck that inhibits the jaw from aligning and healing properly.
This is why chiropractors may perform neck or spine adjustment as well as adjustments to the jaw. There are also physiotherapies and soft tissue treatments that can be applied during the course of treatment for TMJ to reduce pain and inflammation.
Now, let’s get back to those patients with memorable cases of TMJ Dysfunction.
The first patient that comes to mind was an older gentleman who was repairing a window frame in his home. As he was pulling, the frame came out suddenly and struck him in the jaw and side of the head. As a result of the injury, he suffered from continual jaw, neck, and shoulder pain. Even worse than that, 2 days after the injury he began to notice that he was losing his hearing on the side he was struck. The hearing loss progressed until he could only hear the loudest sounds from that ear. I met this gentleman about 8 months after his injury. He was extremely hard of hearing and could not turn his head more than 10 degrees from side to side. As a result of his suffering, he was not a happy person – as you can imagine. He was also a reluctant patient because he had already been to his MD and an EENT, and none of the treatments he was given had helped. I found subluxations in his neck and jaw on the side he was struck by the window and a lot of guarding muscle tension. For him, I started his care by addressing the muscle tension, tuning electric muscle stimulation to calm the tight muscles, and then adjusted the subluxations in his neck and jaw. On this man’s 4th visit to my office, I noticed something different about him…He was smiling! After his third adjustment, his hearing returned! He was so happy! With a few more treatments, he was able to turn his head, the muscle spasms had mostly resolved and he wasn’t having any jaw or neck pain.
The second most memorable patient with TMJ dysfunction was a young man who had recently had his braces removed from his teeth. His teeth looked great, but, once he was free of the metal mouth, he began to notice popping and locking of his jaw when eating. At first blush, I was thinking that the braces had somehow created an alignment problem with his jaws – that can happen. Fortunately, that wasn’t the case. This young man LOVED bubble gum. And, once his braces were off, he began chewing bubble gum – and blowing bubbles- daily. I can still picture him now with his smiling freckled face, blowing bubbles in my waiting room. Of course, the bigger the piece of gum, the bigger the bubbles he could blow, so he had gotten into the habit of chewing very large pieces of gum. Doing this everyday overworked his pterygoid muscles. You know what happens when you work muscles hard, right? They get bigger and stronger. So, the hypertrophy and strength of the muscles on one side of his jaw began pulling the bottom jaw to that side when he chewed, creating a tracking and alignment problem. The solution for him was fairly simple: (1) He needed to stop chewing gum, (2) he needed to do stretching exercises for those muscles, and (3) I needed to adjust his jaw to get the alignment back.
I will often recommend lifestyle and diet changes to my patients. This offers the patient the opportunity to treat the whole body as opposed to just one small area of complaint. They may apply cold packs or heat packs to the area, recommend supplements, and teach the exercises designed to lessen the pain and encourage healing.
Chiropractic is a safe, effective, and non-invasive treatment for TMJ.
So if you or a loved one have been diagnosed with TMD and/or are experiencing TMJ pain, give us a call. Our Doctor of Chiropractic is here to help!