What is TMJ?
TMJ stands for temporo-mandibular joint which is your jaw joint. Located just below and in front of the ear is the temporo-mandibular joint, which is formed by the mandible or jaw bone and the temporal bone of the skull. There is a temporo-mandibular joint on each side of your face. The jaw joint is surrounded by a capsule enclosing it. Cartilage discs are located within each joint, separating the temporal bones from the mandible bone. The discs act as a cushion and shock absorber by absorbing forces exerted on the joints throughout the day as well as from bone-to-bone impacts. These discs are similar to the discs in your spine. A number of muscles are responsible for moving the TMJs, including those that are used during yawning, speaking, feeding, and breathing. As a result, the TMJ is one of the most used joints in the body and is predisposed to injury and disorder.
What is TMJ disorder?
‘Temporomandibular disorders’ (TMD) is a collective term encompassing a number of clinical problems that involve the muscles of mastication (feeding), the TMJ and closely related structures. It is estimated that 60–70% of the Australian population is affected by TMD. It is very common for the TMJ or jaw to become injured or sprained, resulting in jaw pain or ache, face and ear pain, neck pain, or headaches. One cause is typically stress-induced teeth clenching or grinding (bruxism). Continuous grinding and clenching of the teeth can cause spasms and pain in the muscles around the jaw joint as well as inflammation of other structures. TMJ dysfunction can result from prolonged dental work or intubation during surgery where the mouth is stretched open for an extended period. In this case, the muscle (lateral pterygoid) attachment to the disc may pull it out of place, causing a “clicky” jaw. TMJ problems can also be caused by trauma to the jaw or face, including punches to the jaw or whiplash from accidents. The result may be a fracture or dislocation of the jaw bone or damage to the cartilage disc within the joint. Various inflammatory conditions, such as rheumatoid arthritis or ankylosing spondylitis, as well as normal aging can cause inflammation of the TMJ.
The following problems are routinely investigated at Sunshine Coast Health Services Physiotherapy to determine their source and whether they respond to treatment:
Signs & Symptoms of TMD
TMJ related pain can be varied, diffuse and debilitating. Symptoms can include:
- Tenderness or pain on palpation in the mastication (chewing) muscles or the joint itself.
- Pain when chewing, clenching, or yawning or when keeping mouth open for dental work
- Facial pain or head pain that is often worse in the morning
- Jaw movement is limited or restricted
- Clicking, popping, grating, crunching, locking, and stiffness in the jaw joint
- Movements of the jaw are incoordinated, asymmetrical, or deviated
- Pain that does not originate from pathology of the teeth (nonodontogenic toothache)
- Sinus pain/facial pressure
- Associated neck/shoulder stiffness and pain
- Auditory acuity is diminished (hearing loss)
- Tinnitus (occasionally, note that tinnitus can have several causes).
- Changing occlusion (uncomfortable sensation of the teeth not meeting correctly)
- Difficulty swallowing
Causes of TMD
- Joint trauma, for example, a blow to the face/ jaw
- Stretching the jaw during prolonged dental work or during intubation
- Bruxism (clenching and grinding)
- Orthodontic treatment/dental restoration causing inadequate occlusion or altered occlusion
- Arthritic conditions
- Generalised Hypermobility
- Prolonged poor posture
- Whiplash Associated Disorder (WAD)
- Sleep apnoea
Orofacial Specialist Physiotherapy
At Sunshine Coast Health Services, we have extensive experience treating people with TMJ disorders, pain in the neck and orofacial areas, including tinnitus associated with TMJ disorders, toothache, earache, sinus pain, Bell’s Palsy, Trigeminal Neuralgia, whiplash, and post-concussion syndrome. We are passionate about addressing the underlying causes of your symptoms, through thorough assessment and with a combination of education, advice, manual therapy and self-care exercises aim to resolve your pain and prevent its recurrence. Our approach to pain management is to integrate biopsychosocial factors into a holistic multidisciplinary care approach to be able to effectively get you out of pain and back to doing the things you enjoy. Should onward referral be necessary we liaise with GPs, ENTs, Neurologists, Orofacial Pain Specialists etc in order to facilitate appropriate care for all of our clients.
How We Treat
Our treatments are tailored to each individual client’s needs and can include but are not limited to:
- Manual Therapy
- Intra and Extraoral Myofascial Release
- Dry Needling
- Rehabilitation exercises for TMJ and neck range of motion and stability
- Posture re-education
- Self-management techniques