Do you have clicking or jaw pain when eating and/or talking? Then you may have a dysfunction of the joint at the sides of your jaw. This is a problem of the joint where the jaw meets the upper skull in the front of the ear. The joint in this area is called the Temporalmandibular Joint (TMJ). Everyone has 2 joints one on either side of the jaw. The joint contains a small disc used as a cushion which lies between the two bones that make up the joint. Pain in this area, clicking, locking and sometimes headaches could be caused by a dysfunction of this joint.
Initial injury to this area could be the result of specific trauma or from prolonged repetition from poor posture or faulty oral habits. Like most joint problems, they are slightly more common in females due to the increased flexibility they can have at the joints. Noise in the TMJ’s is extremely common. It has been reported that disk displacements of the TMJ have been estimated to be present in 40% of the general population. This was reported by the University of Minnesota Dentistry in the early 2000’s. Like any other joint once it is strained it can easily be re-injured (like a sprained ankle). Such re-injury could result from talking, eating, yawning, and laughing. This joint is constantly being moved therefore total relaxation of the joint and surrounding muscles is difficult. However, holding these muscles and joints in a relaxed position is manageable with practice.
There are self help guidelines one can follow to reduce the symptoms of TMJ dysfunction: 1) Use of heat or ice for 20 min (with a towel or cloth between the skin and element) may reduce the joint or muscle pain and relax the muscles. The choice of whether to use heat or ice is dependent on patient preference, and symptoms. One should still use ice for the first 24-48 hours of the symptoms. 2) Eating a softer diet and avoiding hard foods or very chewy foods (candies, meats) may decrease the stress to the joint and muscle area. Trying to chew with your back teeth vs the front teeth and chew equally on both sides also assists to decrease the strain and stress. Do not chew gum if you have TMJ pain. 3) Avoid caffeine as caffeine is a “muscle contracture” drug which can make muscles tighter. 4) Proper posture, positions of the tongue, teeth, and neck can greatly decrease the symptoms of headaches, jaw pain, clicking and /or locking of the joint.
Many times instruction of these postures can be taught as well as other positions and exercises by a physical therapist. Often the symptoms may be accompanied by swelling and poor joint alignment. The use of over-the-counter anti-inflammatories and/or modalities of Ultrasound, massage type techniques, or other treatments through physical therapy can decrease symptoms and prevent the reoccurrence of future difficulties.
The symptoms of TMJ dysfunction or commonly labeled TMD, are not life threatening but can limit ones daily activities, interrupt sleep, eating habits and work or recreation. Trial of the self management steps may be all one needs to decrease their symptoms. However, many times further instruction with posture, alignment correction, and treatment of swelling and pain is appropriate through physical therapy. If you have any of the above symptoms such treatment may be appropriate for you.