Do you experience pain in your jaw? Perhaps radiating to your ear, face, neck, and even your shoulder? Does this coincide with difficulty opening or closing your mouth while talking, chewing, laughing or yawning, or your jaw locking? You may be experiencing a dysfunction in your temporomandibular joint (TMJ). The TMJ joins the lower and upper jaws and is the joint responsible for opening and closing your mouth, as well as any side to side movement of the lower part of the jaw (which is important for chewing and articulation of speech). You have a right and left TMJ. You can actually feel the movement of the joint by palpating just in front of the ears as you open and close your mouth. There is a disc that is in between the joint that enables a smooth gliding motion. If this disc does not glide properly, you may experience clicking or popping sounds.
There are a variety of factors that can cause TMJ disorders, and often times it is a combination of factors that need to be addressed in order for treatment to be effective. Some of the common causes include the following: 1) Poor postural alignment. If you have habitually poor posture over time, this can greatly affect the position of your head and neck, creating chronic muscle imbalances, which in turn can affect the mobility of your TMJ. 2) Behavioural habits that create muscle tension around the jaw muscles such as grinding or clenching your teeth, excessive gum chewing or biting your nails. A common underlying cause of poor habits can be stress related. 3) Trauma to the joint. 4) Arthritis in the joint. 5) Dental problems such as abnormal alignment of the teeth when the upper and lower jaws are brought together (malocclusion). 6) Hormonal changes. Research suggests that estrogen levels can also play a role in TMJ pain (Craft, 2007.)
Treatment of your TMJ disorder may require more than one health care professional due to the nature of the potential causes. Dentists, orthodontists, ear/eye/nose/throat specialists, physiotherapists, massage therapists, physicians, psychologists, and endocrinologists may be some of the professionals involved in your treatment. It is essential to ensure your health care professional determines the cause(s) of the origin of your TMJ disorder before effective treatment can begin. Treatment may include the following, depending on the cause: Addressing your postural dysfunctions by prescribing specific strengthening or stretching exercises specific to your deficits. This also includes education about your alignment and movement patterns at work, whether you sit at a desk or have a more physical job. A physiotherapist can assist you with this. Addressing any unhealthy behavioural habits (grinding, clenching, nail biting) can be challenging. It is helpful to look at the underlying cause, which frequently is related to stress. Learning how to effectively manage your stress levels is important not only for your TMJ disorder and the muscle tension surrounding the joint, but is also important for many other systems of your body. Relaxation methods, breathing methods, appropriate exercise, regular yoga practise or perhaps some small changes in lifestyle choices can all contribute to improving the way you handle your stress. Physical Therapy can address any TMJ instabilities, inflammation, or stiffness in the joint by manual therapy methods, electrotherapeutic modalities, and prescriptive exercises to address the specific dysfunction. A visit to your dentist is important to ensure you have a thorough assessment of your teeth/mouth alignment and to determine the need for night splints or guards or any other treatment option. Occasionally, there may be a more serious problem where you need to be referred to another specialist. Symptoms that include loss of hearing, nerve involvement, weight loss, or persisting pain and immobility despite ongoing treatment indicate a visit back to your physician for a referral to an appropriate specialist.
Shelly Prosko is a Registered Physiotherapist and Yoga Therapist at Sun City Physiotherapy Winfield. She can be contacted at the Winfield clinic (250.766.2544) or by email at winfield@suncityphysiotherapy.com.