What is the Temporomandibular Joint?
The Temporomandibular Joint (TMJ) is the jaw joint and is located just in front of the ear. It is a flexible joint which allows the lower jaw to move and function with the upper jaw. The TMJ is one of the most frequently used joints of the body. It is made up of two bones (the head of the TMJ mandible and the mandibular fossa of the temporal bone), which are separated by a fibrocartilaginous disc. The joint is surrounded by muscles and ligaments which all assist in controlling the movement and position during jaw function. When the muscles are relaxed and balanced and both jaw joints open and close and move from side to side comfortably, we are able to talk, chew and yawn without any pain.
The TMJ is not an area of the body that a lot of people would think an osteopath could treat but, like any other joint in the body, it is part of the musculo-skeletal system and therefore, when symptomatic, can be treated using a variety of osteopathic techniques. There are a number of theories about what causes jaw dysfunction and how most TMJ syndromes occur. The onset of symptoms tends to develop over a long period of time, often years after the initial problem began. As the joint is primarily controlled by muscles, it is believed that the syndrome is often a secondary effect of muscular dysfunction.
Typical symptoms of a TMJ sufferer:
- Localised jaw pain – usually dull ache which can radiate along the cheek bone, lower jaw and into the neck, which is particularly worse in the morning
- Neck pain and stiffness – particularly in the upper neck
- Joint noise – cracking, clicking or popping – upon opening and during eating
- Limited mouth opening – caused by the tightening of the closing muscles of the jaw
- Headaches – which can last for days
- Jaw locking
- Deviation of lower jaw on opening
Below is a list of the causes and contributing factors that have been reported to me by patients I have treated for TMJ dysfunction, which may have caused, and or assisted, in the development of their symptoms:
- Clenching/grinding teeth particularly when stressed or during sleep
- Trauma to jaw/ temporomandibular joint
- Whiplash injury – affecting muscles of head and neck
- Stress – commonly released when a person continuously or unconsciously clenches/grinds their teeth
- Malocclusion – problem in the way the upper and lower teeth fit together in biting or chewing
Contributing factors may include:
- Occupational tasks – holding the telephone to your ear using your shoulder
- Chewing gum regularly
- Habits – nail biting, chewing your lip, pen, pencils
When there is a muscular restriction on one side of the jaw – for example the left TMJ – as a person opens their mouth the right TMJ glides forwards allowing this side to move smoothly and freely, whilst the left is restricted. This causes a deviation of the chin from its normal alignment to the restricted side (the left side). As the TMJ is a muscular joint, theoretically if the muscle imbalance is corrected by ensuring the muscles on both sides of the jaw are equal and working simultaneously, normal jaw alignment should be restored. Osteopathy can help to address these muscular imbalances by performing a variety of techniques, including cranial techniques to assist in re-establishing normal head and neck function.
Below is some advice if you are suffering with TMJ dysfunction:
- Avoid hard foods (French bread, nuts) and sticky foods (lollies and toffee)
- Eat small pieces of food
- Reduce stress levels – perform relaxation exercises (yoga and meditation)
- Avoid chewing gum
- Do not bite nails
- Avoid biting food using front teeth – chew using back teeth
- Suppress your yawn to reduce how wide your mouth opens
- Perform stretching exercise for muscles of neck and jaw
- Seek professional help if emotional problems become too hard to manage
If you are experiencing jaw pain and have any of the symptoms written above, get in contact with the clinic to discuss if osteopathic treatment could help alleviate your symptoms and assist you on the road to recovery.