TMJ Pain: Answers You Need

TMJ stands for temporal mandibular joint.  It's essentially the hinge that allows your jaw to open.  If you put your fingers just in front of your ears and open your mouth, you will feel your TMJ move.  Pain in this area is often called TMD (temporal mandibular disorder) or TMJ syndrome. 

Dentists tend to be the first line of defense when dealing with TMD. Poor occlusion and recent dental work can all be causes or aggravating factors of TMD, but there can be more to it.

Although you may be experiencing pain around your TMJ, that doesn't mean the root of the problem is at the TMJ.  There is an intimate connection between the jaw and the neck.  Whenever there is TMJ pain the neck will be involved in some capacity and vice versa. Therefore, any treatment of TMD that does not address the neck is incomplete.  Put your fingers on the back of your neck just under the base of your skull.  Now open your mouth as wide as you can, and notice how you feel those muscle contract. Quick biomechanics lesson: whenever you open your jaw, your neck extends (bends back) slightly.

tmd.JPG

Muscle knots called trigger points (represented by the "x" in the picture) will send pain to predictable areas (represented by the blue ovals).  There may be nothing physically wrong with the jaw, but a trigger point in the neck can cause it to hurt. Fun fact: a less common trigger point all the way in the calf can also refer pain to the jaw.  

The jaw is a highly innervated area, meaning it has a huge nerve supply. This is one of the reasons why problems in other areas can manifest at the jaw and problems at the jaw can maifest in other places. Even psycological symptoms like anxiety can result in clenching of the jaw.  

Signs that you may have a problem in these areas include but are not limited to headache, jaw pain, jaw clicking, uneven jaw opening or protrusion, neck pain, ear pain, and tooth pain.

One very common fault in neck function is weak deep neck flexors. When these muscles aren't working properly other muscles are forced to take up the slack and tighten up. These muscles include the traps and jaw muscles.  Tightness in these muscles can lead to headaches, neck pain, and... you guessed it, TMD!

Use this exercise to work the deep neck flexors:

It's extremely important to avoid clenching your teeth.  Long-time clenchers wont even know they are doing so until someone points it out.  The best way to break this habit is by practicing the jaw relief position. This teaches you to keep the muscles around your jaw and neck relaxed.  

  1. Teeth slightly apart
  2. Tongue resting lightly on the roof of your mouth

  3. Lips closed

  4. This should be performed at all times when not chewing, talking, or exercising

How do we address TMD in our office?

  • Thorough exam of the neck, shoulders, upper back, and jaw to find the root of the problem and develop a baseline. 

  • Decrease pain.  We use cold laser, acupuncture, and soft tissue work around the neck and jaw to accomplish this.

  • Improve mobility.  Dry needling, soft tissue work, and adjustments are our go-to for un-sticking those stiff areas.

  • Improve stability and motor control.  Exercises like the one in the video above help retrain your brain how to use your muscles and move properly.  

  • Educate.  We help teach you the things you should be doing on your own to help further your care.  This is our most powerful tool, because it gives you the ability to take control of your situation!

If you are dealing with TMD, neck pain, or headaches, give us a call! (980) 819-5818