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Treating TMJ Symptoms: Don’t Ignore the Source

Discomfort caused by tension in the face and neck are common symptoms with TMJ disorder. But treatment that focuses on muscle relaxation may actually lead to increased joint damage in the jaw by ignoring the source of the problem.

That pain in the neck may be coming from your jaw…

TMJ disorders are involved with either the muscles that move your jaw, or the jaw joints, just in front of the ears. Symptoms can range widely from a variety of headache patterns including migraines, tooth pain, neck pain, and ear pain. Difficulty moving the jaw or limited opening is also a sign of a TMJ disorder. The incidence TMJ/TMD is reported to be 6.3% in women, almost twice as often as men.

As I’ve written about earlier, the jaw joints can often become dislocated or damaged from uneven jaw growth, your “bite”, or trauma from clenching/bruxing (grinding the teeth). When the jaw joints (TMJ) don’t work well the muscles will tighten. Patients often feel tension in the muscles of the face and neck but not necessarily pain in the joints.

Treatments based on muscle relaxation, massage, rest can decrease the muscle pain, but the damage in the joint (that causes the tight muscles) is slowly worsening. Some of these well-meaning approaches can delay treatment of the joint until it has advanced arthritic damage.

A study reported this month in The Journal Of Craniomandibular & Sleep Practice vol.3, num2, Apr. 2015, pp91-97  found a relationship between limited range of motion in the neck and the presence of a TMJ disorder. The report of headaches and limited neck motion had an even higher incidence of TMD. Click here to read the Abstract with all of the medical lingo.

They looked at female patients who presented to a physical therapy clinic with and without headaches (pain anywhere in the head or face). Those with restriction in the neck to a specific examination; tucking the chin down and turning the head to the side (an active exam by the physical therapist) were shown to have a TMD problem while those who didn’t have neck restriction were not found to have TMD. Patients with headache and neck restriction had a higher incidence of TMD than those without headache. Patients without neck restriction did not have TMD to any significant degree.giraffe-614141_640

Why is that? The muscles on the front and side of our neck are used to open the mouth and move it side-to-side. The posterior neck muscles have to also contract to keep the head upright when the jaw is moving. Damage in the TMJ causes more resistance to movement (requiring additional muscle force) as well as a lot of neurologic inter-connections and linking of jaw/neck muscles that you probably don’t want me to go on and on about.

I enjoyed this first of its kind clinical research because the neck mobility measures they used are what I have used to screen TMJ patients for neck problems. Physical therapists and Chiropractors will find this useful to consider a TMJ problem if their patients don’t’ show this particular restriction and their treatment doesn’t fully resolve the pain of limited neck motion.

Lack of neck mobility is just one of many possible indications of TMD. Contact our office to schedule an appointment and find out the true source of your discomfort.

 

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