10 EASY STEPS FOR TEMPOROMANDIBULAR JOINTPAIN RELIEF

Is temporomandibular joint (TMJ) pain causing you pain with chewing, talking and sleeping? TMJ pain can be debilitating, which is why we want to educate you on what it is, the common signs and symptoms, the causes and 10 easy steps to help control your jaw pain at home.
75% of TMJ disorders resolve their condition within 3 months of conservative TMJphysiotherapy treatment (Field 2012). With clinics located in Darra and Jindalee, our specialised TMJ physiotherapist Gilbert Chen will be sure to get to the root of your problem.

What is TMJ?
The temporomandibular joint (TMJ) is a complex joint that undergoes heavy loading with activities of daily living (talking, chewing, yawning) and can even be loaded nocturnally (grinding and/or clenching during sleep - termed as bruxism). Dysfunction of the TMJ is termed as a temporomandibular disorder (TMD) and can affect up to 15% of adults. TMD can be split up into two classifications: myogenous referring to a muscular origin (eg. involving the temporalis or masseter) orarthrogenous referring to pain in the joint (eg. subluxation, disc degeneration).

TMD suffers are often teeth grinders or clenchers and can be closely associated with cervicogenic headaches(CEH) with 44% of the CEH population also experiencing TMJ signs and symptoms (von Piekartz and Ludtke 2011) as well as ear pain, dizziness and upper neck pain.

What are the signs and symptoms of TMJ?

• Pain around the jaw, ear or teeth
• Headaches that are located on either side of the face
• Joint noises +/- pain: clicking and crepitus
• Functional limitations: biting, eating, chewing, yawning
• Locking of the jaw that is unpredictable
• Tension around the jaw or cheeks
• Neck pain which triggers jaw symptoms, or vice versa

What causes TMD?
TMJ dysfunction is considered a multifaceted musculoskeletal disorder. It can be classified into three clinical diagnostic groups – jaw muscle disorder characterised by painful movement; articular disc displacement, and arthralgia or arthritis. The most common causes of TMD include:

• Displacement/derangement of the TMJ articular disc
• Masticatory muscle dysfunction
• Bruxism: grinding of the teeth nocturnally leading to pressure in TMJ and asymmetrical movement.
• Occlusal problems: poor bite, underbite or overbite

Contributing Factors include:

• Dental procedures e.g Prolonged mouth opening and removal of wisdom teeth
• Poor cervical posture
• Myofascial pain
• Stress
• Mandibular malalignment secondary to orthodontic treatment or occlusal appliance
• Whiplash or trauma (eg. Blow to chin), tumors, infection, polyarthritic conditions

Guidelines to Help Control Acute Jaw Pain
Although it is impossible to completely rest the jaw, TMD sufferers need to give the injured tissue time to cycle through the natural stages of the healing process. Just like it hurts to keep walking on a twisted ankle, it hurts to keep using a sprained jaw joint. Following these tips will help to give your jaw a chance to recover.

DO

• Keep your jaw in neutral posture: place tongue on roof of mouth, teeth apart, lips together and breathe through your nose
• Maintain good neck posture: the jaw and neck are critically dependent on each other
• Try both heat packs and cold packs
• Trial both anti-inflammatories and analgesics (egpanadol). Do not exceed the guidelines on the packet and consult your GP if you are unsure whether it is right for you.
• Avoid Stressful situations! Do whatever works for you to relax.
• Cut food into small pieces to avoid opening your jaw past 20 mm
• Try to chew evenly on both sides of your mouth (within reason)

DON’T

• Eat hard and chewy foods, choose soft foods like pasta or fish. You don’t have to eat soup
• Tear food with your front teeth e.g crusty bread rolls
• Chew gum, pens or ice, no biting nails

By modifying your lifestyle and eating habits in accordance with these 10 simple guidelines, you should be able to avoid the jaw movements that cause your pain to persist.

Physiotherapy Management of TMJ pain.
No medical practitioner has taken full responsibility for management of this joint. Physiotherapy management has since filled the gap and demand for medical professionals required in this area. A physiotherapist with advanced training in jaw dysfunction can assess and diagnose TMD. TMJ physiotherapists will assess:

• Jaw range of movement
• Muscle tension and length
• TMJ co-ordination and movement pattern

Physiotherapists will determine if the problem is an opening or closing issue and go on to manage the pain pending on the diagnosis. Physiotherapy management consists and is not limited to:

• Posture improvement and neck treatment
• Relaxation exercises
• Muscle lengthening or jaw muscle massage
• TMJ joint mobilisation
• TMJ movement pattern and timing correction
• Passive, active-assisted, active exercises
• TMJ stabilisation exercises
• Dry needling or acupuncture

Treatment Prognosis
Although symptoms may improve without treatment; it was found that 75% of TMJ disorders resolve their condition within 3 months of conservative TMJ physiotherapy treatment (Field 2012) as compared to spontaneous resolution in 33% of TMD sufferers over a 5-year period (Rammelsberg, 2003).

If your jaw pain is not getting any better with these tips; you may need to consult our specialised TMJ therapist Gilbert Chen who will aim to manage your TMJ dysfunction with an exercise and treatment plan following a thorough TMJ assessment. Book your appointment now on (07) 3172 4332 or visit our website on: WWW.PHYSIOPHI.COM.AU