TMJ Treatment for Jaw Pain
What is the TMJ?
TMJ stands for Temporal Mandibular Joint. In more simple terms it is your jaw. The mandible is your jaw bone, the temporal bone is the skull portion. The TMJ’s job is to help you chew, drink, talk, etc. by allowing the jaw to open and close. What is most interesting about the TM joint is that it is really two joints working in synergy (hopefully). If you have TMJ disorder, a painful left TMJ may be caused by a dysfunctional right TMJ. If you are dealing with TMJ disorder it is vital that the Physical Therapist you see assesses both right and left TM joints, posture, and opening/closing patterns of the jaw. This is how OrthoCore approaches TMJ treatment for jaw pain.
Muscles of the TMJ
Temporalis Muscle – Helps to close and pull the jaw back when closing. The pictures below show you where it sits on the skull and where the typical referred pain will go. This muscle is very commonly affected with TMJ dysfunction and can also lead to headache symptoms.
Masseter Muscle – Helps close the jaw and protrude/retrude the jaw. It is the main muscle of mastication (chewing) and is usually dysfunctional with TMJ issues along with the temporalis muscle.
Medial Pterygoid – Helps close the jaw and protrude the jaw. As you can see from the pictures below it sits on the inside of your jaw bone. When dysfunctional it can lead to ear pain and problems with evenly closing the jaw on both sides.
Lateral Pterygoid – Helps open the jaw by assisting in pulling the disc and jaw forward. One of the only muscles that actually helps to open the jaw. Most jaw opening is done by gravity. Patients who have difficulty opening their jaw may have a dysfunction in this muscle as well as others.
Ligaments of the TMJ
The sphenomandibular, stylomandibular and the tempomandibular ligaments are the only ligaments that help add stability to the TM joint. They also help to limit excessive movement of the disc. Any laxity in these ligaments can have an obvious affect on the function of the TMJ. The not so obvious thing is that the sphenomandibular, stylomandibular, and outer band of temporomandibular ligaments can only be truly tested in full jaw opening. The muscles of the jaw which we already talked about can limit full jaw opening which may sway testing of these ligaments.
What are Symptoms of TMJ Disorder?
Now that we have talked a little bit about the anatomy of the TM joint lets talk about TMJ disorder. Typical symptoms of TMJ disorders include;
- Difficulty opening and/or closing your jaw
- Pain with jaw movement or at rest
- Clicking and grinding – for it to be a true disc issue you need a repeatable “click” with both opening and closing
- Headache symptoms
- Difficulty or pain with chewing
- Locking of your jaw
- Swelling on the side of your face
How OrthoCore Physical Therapy Approaches TMJ Treatment for Jaw Pain
At OrthoCore Physical Therapy we treat patients with TMJ disorders differently than most Physical Therapy clinics. Most Physical Therapists that do not regularly treat patients with TMJ disorders will only look at posture during the evaluation process. At OrthoCore we perform a comprehensive evaluation on your first visit looking at your jaw function, posture, and all muscles/ligaments associated with the jaw.
Evaluation – All evaluations start with a comprehensive history of the injury. We want to know everything. When the pain started, when it bothers you, what makes it better/worse, etc. We will then look at your jaw’s ability to open and close. We check for full opening and for any deviations in both opening and closing. We will also listen for any audible “clicks” that may be occurring with opening or closing of the jaw. This gives us a starting point for function of the jaw.
The Physical Therapist you are working with will then check the ligaments of the TM joint (if full opening is achieved) to see if there is any laxity that may be contributing to the disorder. We will also feel for any trigger points (muscle knots) in the muscles that we have listed above.
Lastly we will assess your posture. Poor posture can have a direct affect on the muscles of the jaw and on the muscles of the neck involved in swallowing. It is imperative that we correct any postural dysfunctions along with the TMJ dysfunctions to be sure that once the TMJ issues are resolved they do not recur.
Treatment - Treatment will start on the first day of your visit to improve jaw functioning and decrease pain. Treatment for TMJ disorders are case specific and there is no “general” treatment. Most patients will receive functional dry needling to improve the function, and decrease the pain associated with trigger points in the muscles of the TM joint and postural muscles. If opening/closing are restricted we will use manual techniques to restore capsular patterns of the jaw. Patients will also be instructed on, and receive an exercise program specific to their needs to help improve jaw functioning and postural control.
At OrthoCore Physical Therapy our goal is always to make the patient feel better and to prevent the injury from returning once full function of the jaw is restored.