What is the TMJ?
The temporo-mandibular (TMJ) or jaw joint joint is one of the most complicated joints in the human body, connecting the temporal bone of the skull with the mandible (lower jaw bone), just in front of each ear. Within the joint, there is a small disc, primarily made of cartilage, which separates the joint cavity into two and moves with certain movements of the jaw due its muscular attachment. The TMJ is responsible for all movements of the jaw, allowing it to move up and down and side-to-side each time we chew, talk, yawn, swallow and even breathe.
TMJ disorders: Causes and Symptoms
TMJ disorders is an umbrella term for when there is a problem with one or both jaw joints and/or the associated muscles involved in chewing and moving the jaw.
There are many possible causes for pain and dysfunction in the TMJ, including trauma (for example, a blow to the jaw or a via a whiplash injury), opening too wide, grinding or clenching the teeth, dislocation of the disc between the bones of the jaw joint, malocclusion, ligament laxity, stress, arthritis and cartilage damage. The muscles that move the jaw are also subject to overuse such as with chewing gum and biting nails, or in singers for example. It is important to note that since one TMJ can’t function without affecting the other, if one TMJ is injured, the other joint will likely become affected sometime in the future.
The most common symptoms of TMJ disorders include:
• Pain the jaw and restricted/asymmetric jaw movement
• Clicking (snapping, popping) and locking of the jaw
• Clenching and grinding of the teeth
• Neck and shoulder pain
• Facial pain
• Ear pain, fullness or stuffiness
• Dizziness (ringing in the ear)
How can osteopathic manual treatment help someone with TMJ pain?
Treatment for TMJ pain and dysfunction depends on the cause. Osteopathic manual therapy can be a very effective treatment when the dysfunction is due to postural or muscular problems, by restoring normal muscular function and balance and improving alignment. Your osteopathic manual practitioner will do a full assessment at your initial consultation to identify the underlying cause for your symptoms and to determine if osteopathic treatment would be appropriate and beneficial.
In addition to assessing your jaw movement and checking for areas of stress and tension in and around your face, jaw, neck and shoulders, your initial assessment will also include a standing postural examination, checking head-neck-spine relationships, including the relationship of your TMJ to your skull.
Based on their assessment findings, a treatment plan will then be drawn up for you, which would most likely include:
• Massaging and stretching the muscles of the jaw, head, neck and shoulders to reduce tension, restore muscle function and balance, and alleviate pain
• Mobilizing any joint restrictions in the neck and spine
• Realigning the TMJ
• Postural corrections
• Cranial manipulation to improve the relationship of the TMJ to your skull
You may also be given advice to facilitate your recovery, including the use of heat/ice, and gentle stretching exercises. Try to avoid eating hard, chewy foods, chewing gum and jaw clenching. Limit any emotional distress so that the muscles of the jaw, neck and shoulders relax, and be aware of habits such as cradling the telephone, which could irritate the jaw and neck muscles. Improving your awareness as to the possible habits that may have initially contributed to your TMJ pain and/or dysfunction will be helpful in preventing the problem from reoccurring in the long-term.
By Angela Clee BOst (UK)
Osteopathic Manual Practitioner
Okeson, D.M.D. (Ed.) (1996). Orofacial pain: Guidelines for Assessment, Diagnosis, and Management/The American Academy of Orofacial Pain. Chicago, IL: Quintessence Publishing Co, Inc.
Shankland II, W.E. (Ed.) (1998). TMJ: It’s many faces. Diagnosis of TMJ and Related Disorders (2nd ed). Columbus, OH: Anadem Publishing Inc.