TMJ Disorder: Understanding the Signs, Symptoms & Treatments

By: Lori Blair, PT, OCS

Temporomandibular disorders (TMD) is a condition that affects 35 percent of people. This may cause pain and dysfunction in the temporomandibular joint (TMJ) and facial muscles causing these symptoms:

• Jaw and neck pain
• Headaches
• Pain or a feeling of fullness in the ear
• Difficulty chewing, talking and yawning
• Difficulty opening or closing the jaw
• Clicking in the temporomandibular joint (TMJ)
• Limited or excessive joint motion in the jaw

There are four main causes of TMD:

1. Masticatory muscle disorder affects the muscles inside of the jaw making them tight and spasm from muscle guarding or overusing the muscles from clenching, grinding your teeth and chewing your fingernails or gum. Poor posture with a forward head, stress, anxiety and poor sleeping positions can aggravate these symptoms. Forty-five percent of people with TMD have masticatory muscle disorder.
2. Myofascial pain syndrome is characterized by pain that originates from trigger points in the jaw or neck causing localized pain. Clinically, it can produce headaches, ringing in the ears, swallowing problems, TMJ joint noises, dizziness and pain in the face, ears, neck and jaw.
3. Anterior or posterior disc displacement is the second most common diagnosis among people with TMD and occurs when the disc gets displaced causing a loud click during mouth opening and closing. This leads to injury, inflammation and joint pain and may occur after a prolonged dental procedure, laughing or yawning. A patient may need a block for protection during dental procedures.
4. Joint problems include arthralgia (joint pain), osteoarthritis/rheumatoid arthritis (degeneration of the TMJ associated with inflammation), osteoarthritis (degeneration of the TMJ without inflammation), capsulitis (inflammation of the joint capsule) and hypermobility. Inflammation control and joint protection are key to managing these joint problems.

After visiting your family physician, physiatrist, ENT, dentist or oral surgeon, ask for a referral to physical therapy for an evaluation as soon as possible. Your physical therapist will:

• Evaluate and treat TMD, neck, head or ear pain
• Perform gentle range-of-motion exercises, manual therapy with joint mobilization and soft-tissue mobilization inside and outside the jaw and neck
• Provide possible modalities including heat, ice or dry needling
• Suggest a soft, healthy diet at first
• Provide TMJ hygiene including education for proper posture and body mechanics, appropriate work station ergonomics, sleep hygiene with proper positioning, correct and diaphragmatic breathing with relaxation exercises, stress management and cues for avoiding smoking
• Suggest a personalized mouth guard for all patients who clench or grind, especially while sleeping
• Provide a home-exercise program to each person to address neck and jaw range of motion, improve the pattern of jaw opening and strengthen muscles of the jaw, cervical spine and shoulder blades – yoga can be especially beneficial due to its stretching and relaxation properties

Physical therapy can help treat your TMJ disorder. Let the specialists at Sheltering Arms help you. Click here to learn more about our TMJ therapy program or call (804) 764-1000 today to schedule an appointment.