Temporomandibular Joint Disorders

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The temporomandibular joint (TMJ) is your jaw joint. It consists of your jaw bone, called the mandible, and a socket in your temporal bone just in front of your ear. A small disc is situated in-between these two bones to form the joint and to allow for smooth movement of your jaw. The disc glides as you open and close your mouth or move your jaw from side to side. Ligaments hold the joint in place and the surrounding muscles control the movement of the TMJ.

TMJ disorders are common and the cause is often multifactorial. The main symptom of TMJ disorder is pain in the jaw area. Other symptoms can include clicking or locking of the jaw, swelling of the joint, headaches, dizziness, restricted jaw movement, ear pain, ringing in the ears and hearing problems. Talking or chewing may become difficult and painful if you have issues with your TMJ. 

Causes for TMJ disorders vary. It can be caused by a problem within the joint, such as inflammation, structural irregularity or degeneration. Or it can be caused by structures outside of the joint, such as muscle spasm, tension due to poor postural positioning, or direct injury to the jaw area. 

Inflammation can result from direct trauma to the joint (such as a direct blow like falling onto your jaw), or indirect trauma (such as whiplash injuries or excessive chewing or grinding of your teeth). Chronic overstraining of your TMJ through excessive chewing, constant teeth grinding, clenching of your jaw or postural tension can initiate the development of arthritis in your TMJ, which can also lead to an inflamed joint. 

Structural irregularities can also develop after any of the direct or indirect traumas mentioned above. Some people have a hypermobile, loose TMJ, which moves out of place frequently when they chew, open their mouth wide, or even talk. Repetitive excessive movement due to hypermobility can damage the joint over time.  

There is a very strong correlation between TMJ disorders and posture. Poor posture, such as the typical “forward head, poking chin” posture, puts strain on the muscles of your jaw. These muscles attach at or near your TMJ. Therefore, the constant tension in these muscles can strain your TMJ, eventually causing jaw pain and problems with the joint. 

When you consult us at Just Physio with jaw pain or problems with your TMJ, we will always assess your head, neck and shoulders along with your TMJ. The first session with us always starts with a discussion of your history, symptoms, general lifestyle, previous medical history, and your expectations of our treatment. We will specifically ask you whether you’ve had a previous head, neck, or facial trauma or surgery, as well as dental matters like whether you grind your teeth, clench your jaw or have had long dental procedures. 

The main aims of our treatment will be to address your main concerns based on the problems we found during the physical assessment. Our focus will mainly be on relieving your pain, minimising stiffness, and improving or restoring the proper functioning of your jaw. 

For acute inflammatory TMJ problems, we will address pain and swelling first. We can use modalities such as ultrasound, ice, gentle electrical stimulation, and massage to do so. Once your pain settles, we will start working on restoring your jaw alignment and movements. Treatment may then include further soft-tissue releasing techniques, dry needling, manual therapy on your TMJ and neck, as well as specific exercises. Postural correction is vital and we will guide and advise you accordingly.

Treatment for long-standing TMJ disorders will be based on the same principles of reducing discomfort and restoring optimal jaw function. Here, posture correction exercises and stretches will also be a major part of your treatment. 

temporomandibular joint disorders

Although most TMJ disorders improve significantly within a few weeks of appropriate physiotherapy, we always look out for other potential causes for TMJ disorders like referred pain, nerve-related problems, vestibular disturbances, sinus problems, tumours, etc. If ever we suspect any of these, we will refer you to the best possible medical professional to address the issue. Your commitment to your physiotherapy treatment plan will determine how successfully your TMJ disorder is resolved.

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