Temporomandibular joint (TMJ) disorders occur due to problems with the jaw, jaw joint and surrounding muscles that are used when chewing or moving the jaw up and down and from side to side (talking, yawning etc.). The TMJ acts like a sliding hinge that connects the lower jaw to the skull.
There are many causes of TMJ disorders. Causes may be traumatic, such as a heavy blow and whiplash. Stress can also cause TMJ disorders as a result of grinding or clenching teeth. These actions increase the load and pressure in the joint and forces contracture of surrounding muscles. This often occurs as soreness when chewing and most often most painful in the morning.
Osteoarthritis (wear and tear) and rheumatoid arthritis (inflammatory) are also causes of TMJ pain. In such cases, the joint cartilage is damaged where normal smooth and full motion is compromised.
As well as pain around the jaw joint as described above, there may also be pain in the face, neck, shoulders and also around and in the ear when you chew, talk or yawn. Movement of the jaw is often limited where you cannot open your mouth fully, or it may also become “locked” or “stuck”. Clicks and grating sounds which are often accompanied by pain are also common when opening and closing your mouth.
Other common associated symptoms include
· Tinnitus (ringing in ears)
Assessment and diagnosis
Symptoms common in TMJ disorders also occur with tooth, gum and sinus problems. However, the jaw is a complex area, where diagnosis is often difficult due to there being many different contributing factors. Therefore, a careful patient case history is important and detailed examination is necessary to determine the cause of your symptoms. Sometimes an X ray is required to determine the problem in the jaw and to ensure that other problems are not causing the problems.
Treatment and rehabilitation
Once the cause of the TMJ pain has been established and the patient is considered safe to treat. There are many manual techniques that help to both restore normal function and ease local and referred pain. These techniques involve gentle stretching of surrounding jaw muscles and manipulation of the TMJ in order to increase its range of movement and improve local blood circulation.
Due to the complexity of TMJ disorders and there being many different contributors to the onset of jaw pain and discomfort, osteopathy usually works best in conjunction with other modes of therapy such as dental, medical, psychological and most importantly, self-help treatments.