TMJ has become a catchall term for undiagnosed headaches, facial pain, and jaw dysfunction (problems opening or closing your mouth). Jaw dysfunction is often seen as problems opening and closing your mouth, very limited openings, jaws getting stuck when opening or closing, and popping or clicking noises when opening or closing. These aforementioned problems can have the jaw area sore, but they can also cause headache and neck pain (mild to severe). In the majority of cases, pain is the symptom that motivates patients to seek treatment.
Specifically, TMJ is short for Temporo-Mandibular Joint (“jaw joint”). When there are problems within the TM joints, this can effect the nerves, muscles, tendons, and ligaments of the head and neck. Everyone is familiar with the pain caused by a slipped disc in the back. The right and left TM joints also have a disc. Slippage or movement of this disc in the “jaw joint” throws the mandible (lower jaw) out of balance with the upper jaw. This stresses nerves, muscles, tendons, and ligaments of the head and neck. Continued stress to these structures causes an individual pain. The patient will show up with teeth pain, ear pain, eye pain, and a myriad of other symptoms. In some cases, the pain is so debilitating that it effects one’s ability to function in life!
Why is this joint so important in treating headaches and head/neck pain? The answer starts with the basic concept of a joint that has a dislocated disc. The dislocation can cause imbalance and pain in that portion of the body. If the disc is displaced in the knee, the muscles of the leg are placed under the burden of trying to protect the injured joint. The muscular effort results in spasm, cramping, and pain. When the disc is displaced (dislocated) in the TM joints, the muscles of the head are stressed and they begin to spasm and pain results. This same scenario follows joints and muscles throughout the body.
The American Medical Association Ad Hoc Committee on Headache Classification has listed 15 different types of headaches1. The AMA study illustrates that muscle contraction headaches are those which are suffered most frequently. This category comprises 90% of all headaches. Migraines comprise only 6% of all headaches. The public has used the term “migraine” synonymously with severe headache pain. In reality, most of these severe headaches are muscle contraction in origin.
Why are these facial muscles contracting? Two reasons. First, the displaced disc in the TM joints has the muscles stressed and in spasm. The second, is grinding and clenching of your teeth. The fast pace of life today has everyone under emotional stress. The result of this stress is nighttime grinding and clenching. The stories we’ve heard about people waking up with headaches and toothaches is directly attributable to nighttime grinding and clenching.
- Facial pain
- Ear pain
- Ear ringing
- Pain around and behind the eyes
- Neck pain
- Jaw pain when open and closing, or with chewing
- Inability to open your mouth very much
- Bite or meshing of the teeth feels off
- Constant sinus problems
How to treat Tmj ?
The headache, facial, and neck pain patients we see have, in most cases, been treated by numerous other practitioners. The TMJ/TMD problems are overlooked by most neurologists, orthopedists, headache specialists, physical therapists, chiropractors, dentists, and alternative medicine practitioners. With the high incidence of clenching, and the associated stress on the TM joints, facial and neck muscles, tendons and ligaments going undetected, it explains the vast number of TMJ/TMD patients.These patients seek our help because they still have pain.
TMJ/TMD mimics other problems. The Journal of the AMA dubbed TMJ “The Great Impostor” because of the mimicking and misdiagnosing1.To obtain successful treatment a practitioner must have excellent diagnosis. The key is: DIAGNOSIS! DIAGNOSIS! DIAGNOSIS!
A proper diagnosis encompasses your health history including past medical and dental treatment, history of trauma (auto accidents, falls, etc.), clinical exam, and radiographic (x-ray) examination. Based upon these findings, other diagnostic tests may be required.
Once a diagnosis is obtained, a course of treatment can be determined. In most cases, the patient requires an oral orthotic (mouthpiece) to reduce pressure on the “jaw joints” and reduce stress on the facial musculature. Physical therapy or chiropractics in conjunction with the oral orthotic is a must. The muscles have to be treated to break the pain being generated.
Many of patients have been treated with oral orthotics(mouthpieces) before. Their treatment was unsuccessful. The key is the design of the mouthpiece based on a very thorough diagnostic process. It is amazing the number of patients we see who been treated with a mouthpiece and had no x-rays taken of their temporomandibular joints.
Each pain patient is very unique. Everyone has a set of circumstances that sets them apart from everyone else. One person may have great health but lots of pain, while some one else may have a myriad of health problems that could effect head and neck pain. These could include stress, sleep patterns, nutrition, female hormone problems, ailments (diabetes, arthritis, diseases such as lymes, and many more), and structural imbalances such as one leg longer than the other or one hip or shoulder higher than the other. Therefore, each individual has to be evaluated and diagnosed very thoroughly, and then a specific treatment plan can be formulated.
Based on your bodies response to treatment, you may choose other paths of treatment. These could include special therapies to the joints and facial musculature, manipulations of the jaw, changes in the mouthpiece, nutritional recommendations, and other treatments deemed necessary.