The Temporomandibular joint (TMJ) is more commonly known as the jaw. The TMJ is the point where the mandible (jaw bone) joins the skull. You can feel this joint directly when you place your fingers behind your cheek and in front of your ear when your jaw is moving up and down while you chew. The muscles of mastication (chewing) are essential and are often the site of dysfunction. They can be a source of pain, headaches, and difficulty opening the jaw!
How do Those Muscles Cause Pain?
Many muscles influence the movement of the jaw. In fact, opening our jaw requires two consecutive motions. First, the mandible (your jawbone) must hinge in a groove, which it sits in on the skull (picture a ball in socket joint.) This movement creates more space for the jaw to move. This movement is then followed by a slight forward gliding motion, which allows for the depression of the mandible and opens the jaw. The multiple steps involved are part of the reason temporomandibular dysfunction is so common. If any of the muscles acting on the jaw are out of sync, the jaw will not move smoothly. This can lead to dysfunction and inflammation, ultimately progressing to pain.
Many muscles are acting on this joint. Some of the muscles involved in moving the jaw are the masseter, the medial and lateral pterygoid, digastric muscle, sternohyoid, geniohyoid, mylohyoid, buccinator, and the temporalis. Many of these are tiny facial muscles most people would have never heard of. With muscles acting on the jaw as well as the complex motion, there is plenty of room for things to go wrong!
How Can You Get Jaw Pain?
We can experience jaw pain from many different sources. Some of the more traumatic forms of a jaw injury can occur with a deep yawn or a strenuous depression of the jaw. In extreme cases, this can cause dislocation of the condyle and is a serious injury. The joint can be relocated by pressing down on your lower posterior molars while pushing the jaw posteriorly (Saladin, pg. 295).
More commonly than dislocation, however, many people may experience jaw pain periodically throughout the day for no reason at all. It may be followed by a clicking sound in their jaw when opening wide chewing, or yawning. This can occur with a displacement of the disk, or it can be a sign of a muscular imbalance. If there is an imbalance between the muscle tone and activation from one side to another, the joints will not move smoothly and result in clicking of the joint. This can be brought on by teeth grinding, excessive chewing (think gum), or chewing of harder food.
How Can You Help Me With Jaw Pain?
MN Spine and Sport offers many treatment options for those who are suffering from Jaw Pain. Before making an appointment, try eating soft foods, applying ice to the area, try to avoid eating hard or tough foods that may aggravate the pain. Also, be mindful when yawning. When altering your diet and avoiding chewing harder items is no longer effective, treatment of the TMJ may be needed.
Manual therapy techniques can be an extremely effective treatment of jaw pain. These techniques include manual therapy, stretching, mobilization, and dry needling. As described above, pain and dysfunction can be a result of a muscular imbalance. After adequately identifying which muscles are dysfunctional, manual therapy and other modalities can relax overactive muscles and de-activate trigger points.
As jaw motion decreases, the muscles and the joints of the head and neck compensate, leading to further dysfunction and pain in the neck and head. Spinal adjustments to the upper cervical spine (upper neck), as well as manual therapy may also influence the TMJ’s function. These have been shown to help manage jaw pain. Exercises to strengthen neck muscles and increase jaw range of motion are equally as important.
Additional treatment options include acupuncture, and laser therapy. Acupuncture can help decrease the pain and relax tight muscles. Laser therapy is great for decreasing pain and inflammation, especially when the pain is bad, or when you are having a flare up!
What Else Can I Do?
Other tools available to help manage the pain include working through the root cause of the jaw pain. They may include stress management and spending less time at the computer. Sometimes the main cause of jaw pain is not from chewing food, but instead grinding your teeth. It is very common to grind your teeth without any knowledge while you sleep, and this can put significant stress on the muscles, ligaments, and joints. A referral to your dentist may be in order. They can help by evaluating your teeth for any signs of grinding and prescribing a mouth guard to wear at night, which can reduce wear and tear if you grind your teeth while you sleep.
The TMJ is a very complex joint that can become very painful. Many people are unaware of the conservative treatment options that are available right here in Woodbury! Dr. Schreiber is the only chiropractor in Woodbury that has additional certifications in the treatment of jaw pain. He also has the ability to identify what is causing your pain, multiple methods of treatment and refer if necessary!
Saladin, K. S. (2012). Anatomy & physiology: the unity of form and function (7th ed.). New York: McGraw-Hill.
Pearson Education, HealthDent.com/tmj