The temporomandibular joint (also known as TMJ) is located in front of the ear on either side of the head where the upper and lower jaws meet. It is used throughout the day during activities like talking, eating and chewing. In most cases, TMJ dysfunction requires a visit to a dentist or orthodontist.
Physical therapy is not normally considered the first choice for treatment. However, it is important to note that the muscles of the neck and jaw are closely connected to the muscles of the shoulders and neck. Weakness or dysfunction in the neck and shoulder muscles affects the muscles surrounding the jaw and this is one of the (several) causes of TMJ problems. These muscles are some of the most actively used in the body. As a result, untreated TMJ dysfunction has the potential to evolve from a mere nuisance to a rather debilitating condition.
In the early stages, an individual may experience difficulty talking, chewing, yawning, sneezing, and swallowing. Over a period of time, the symptoms can get worse. They may include headaches, ear pain, bite problems, clicking sounds, and locked jaw.
Causes of TMJ dysfunction include teeth grinding, habitual gum chewing or nail biting, dental problems (jaw abnormalities or missing teeth) and trauma or injury to the jaws. Occupational tasks (holding the phone between the head and the shoulder, staying hunched over the computer for extended periods of time) that trigger muscle imbalances in the neck and shoulder also play a role.
When muscle imbalance is a contributing factor, the TMJ attempts to compensate for the misalignment. Normally, TMJ motion is smooth and coordinated, allowing the jaw to move in several directions including side to side, forward/backward and open/close. When the movement becomes imbalanced, the result is increased strain on the ligaments and the muscles of the jaw. This can lead to a number of symptoms including jaw and facial pain, clicking and popping when opening and closing the mouth, difficulty opening the jaw, neck pain and headaches.
Stress is a common trigger for TMJ dysfunction. Self-awareness and relaxation techniques can be beneficial. Avoiding hard, crunchy, or chewy foods help reduce pain. Hot or cold towels can alleviate swelling or muscle spasms and further help in pain reduction.
A dentist can evaluate TMJ problems and may recommend a dental appliance or dental work. However, if TMJ dysfunction is associated with headache or pain in the jaw, neck or shoulders, ask for a referral to a physical therapist.
The therapist will evaluate the TMJ to determine the degree of strength, mobility and tension in the surrounding muscles. This information serves as the foundation for an exercise program to address muscle imbalances. Strengthening, stretching, and relaxation techniques prescribed by the physical therapist will help reduce pain and restore function.
Untreated TMJ dysfunction can result in impaired concentration, inability to chew food (leading to poor nutrition), difficulty sleeping and psychological distress. If you are experiencing any of the symptoms of TMJ dysfunction, consider the services of a physical therapist as part of your treatment. Physical therapy can reduce the pain and limitation associated with TMJ problems and speed up the recovery process. We look forward to hearing from you, and will be happy to answer any questions you may have.
Dr. Daniel Skulavik, PT, DPT, OCS, is with Advanced Physical Therapy located in the Food Lion Shopping Center, Clinton.