Tooth pain, ear pain, joint clicking, headaches? It could be your TMJ.
I consulted a patient, let’s call her Mary who had not been able to open her mouth more than 20mm (that’s about a finger width) for about a month. To try and open any wider was simply too painful. A few treatments, some good education around the cause of the pain and a bit of homework and Mary was well again. Mary’s pain was arising from her jaw joint or TMJ.
What is your TMJ?
TMJ stands for Temporomandibular Joint. If you stick your index finger immediately in front of the ‘tragus’ of your ear (that’s the little knobbly bit in front of your ear canal) then open and close your mouth you will feel the TM Joint moving.
What are TMJ problems?
Pain around the jaw, head, ears and teeth are often caused by the TMJ and categorised as Temporomandibular Disorders or TMD’s. Here are several examples of symptoms associated with TMD.
Tooth pain
I have many stories of patients that have just mentioned in passing a tooth ache. A brief treatment has saved them a trip to the dentist. This is because several jaw muscles can refer pain into teeth, even though the teeth are perfectly healthy.
Jaw pain
Pain in front of the ear, pain in the ear, pain under the eye like sinus pain and pain along the jaw line can all be caused by various jaw muscles.
Headaches
Many headache presentations are entirely caused by the jaw or are a combination of neck and jaw pain patterns.
Clicking, clunking and Locking.
Jaw joints can click or clunk a lot due to the shape of the joint, but this is not something to worry about unless the click is very painful or very annoying. Jaws can lock open or closed also.
Where does the pain actually come from?
In many cases TMDs begin after prolonged dental procedures or in response to excessive grinding of the teeth at night.
But in the majority of cases, pain can be relieved and joint function improved with a combination of brief muscle manipulations and some specific corrective exercises. This approach can save thousands of dollars and a lot of time.
So what actually causes the pain?
This is where is gets confusing.
This is the big thing that even a lot of therapists don’t understand. Pain in the jaw joint, face or teeth is rarely arising directly from the joint. In most long term cases the pain is coming from the muscles around the joint or even the neck.
Most research and most techniques focus on the joint, after all, that is often where the pain and clunking often is. So common techniques include oral splints to alter the joint position or anti-inflammatory medication to address inflammation that is thought to be present in the joint. Yet such techniques often fail to provide relief!
The good news!
The good news is that, although TMD can be so painful that it REALLY affects your quality of life, a huge percentage of complaints can be fixed relatively quickly. And more complex complaints can also be improved or resolved with a multi-faceted approach that addresses lifestyle, sleep quality, breathing, posture and other related factors. There is always a path forward.
A little story to watch.
Enjoy this little video of a patient I saw on a visit to Brisbane last year. Her scenario is common. Watch it HERE.
Timothy J King is a Myotherapist based in Victoria, Australia. Timothy has treated musculoskeletal pain for 20 years with a special interest in Headache and TMD. Timothy and now provides training for manual therapists nationally and internationally.
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