Lisa Marie Foreman, B.Sc., M.OMSc. - Osteopathic Manual Practitioner
Temporomandibular joint disorders (TMJ) involve the major jaw structures in the head that are responsible for motion, most specifically the lower and upper parts of the jaw. Symptoms of temporomandibular joint disorders involve: pain in the jaw, aches and pains in and around the ear, a locking jaw and difficulty chewing. All of which can make this form of joint disorder debilitating.
TMJ can come about when:
The joint’s cartilage becomes damaged, most commonly by arthritis
The disk erodes or moves out of its proper position
There is a muscle spasm. This can be a result of jaw clenching, teeth grinding and sleeping disorders
The joint is damaged by trauma or impact
Signs and symptoms of TMJ disorders may include:
Neck pain and/or stiffness
Shoulder pain
Earaches or fullness in your ear
Headaches
Jaw locking or clicking of one or both lower jaw joints (TMJ), with or without pain
Limited jaw opening
Clicking or popping of the jaw when you open or close your mouth
Pain in the jaw area (directly in front of the ears) when opening or closing your mouth
Pain when yawning, biting, or chewing
Facial asymmetry with one side puffier than the other
A protruded lower jaw. This compromises the airway so the head is held forward (the forward head posture strains the cervical vertebrae – the thoracic and lumbar vertebrae must compensate, and now either one shoulder or hip is lower than the other)
The jaw and headache pain are the result of chronic compression of one or both jaw joints. The joint becomes displaced posteriorly and affects the circulation of the external carotid artery.
The muscles and ligaments supporting the joints attempt to protect the compressed joint by splinting or restricting the movement (similar to limping after spraining an ankle). If the compression is chronic, the muscles ultimately fatigue and pain occurs.
The joints may become compressed from a variety of causes:
Accidents that tear or stretch the ligaments and muscles supporting the joints
Untreated misaligned teeth or jaw size discrepancies, which prevent symmetrical closure of the jaws. (Ultimately, one jaw becomes compressed because of the uneven pull of the muscles which close the jaw).
Orthodontic treatment with a headgear to correct an overbite, in conjunction with removing the upper premolars (not lower premolars). This creates an upper jaw smaller in circumference than the lower jaw. The arc of closure of the lower jaw is now restricted, resulting in compression of one or both joints.
Grinding or clenching in the night
Stress/Anxiety
Motor vehicle accident injuries
Poor posture and body mechanics
How can Osteopathy help with jaw pain:
In 1874, Dr. Andrew Taylor Still founded a new profession and named it Osteopathy. The word “Osteopathy” is derived from the words “osteo,” meaning bone, and “pathos,” meaning disease or suffering.
The jaw is an incredibly complex joint and whilst there are a wide range of issues that fall under the umbrella term of ‘temporomandibular joint disorders’, it is most often the inter-articular disc that is the bane of most sufferers’ pain. An osteopath understands the construction of the jaw and can help address the symptoms of TMJ.
An osteopath will study and work with the structure of the jaw, as well as the head, neck, back and shoulders. Their treatment will involve reflex relaxation of the jaw, which ultimately aims to reduce the symptoms associated with TMJ. Osteopaths are also professionally equipped to treat muscles that may be suffering from regular spasms.
Treatment is essentially directed at decompressing the joints and allowing the ligaments and membranes to relax. This allows the muscles to stop the splinting process, thereby allowing unstrained movement of the TM joints.
Specific assessment and treatment to the neck, jaw and cranio-facial bones will follow. This involves techniques for the soft tissues, including muscles, ligaments and fascia as well as specific techniques to release the tensions at the articulations of the neck, cranial and facial bones, as well as the temporomandibular joints. This may involve the practitioner doing gentle stretches and manipulations inside of the mouth to reach deeper structures. Techniques that temporarily “gap” or separate the two joint surfaces between the condyle of the mandible and the base of the skull. This gapping allows the joint to reset itself comfortably and may include some movement that may have been lost due to excess tension on the restricted side.
Self-Care
Whilst TMJ certainly requires treatment from a medical professional, there are steps that you can take at home to help alleviate some of your symptoms. These include:
Heat treatment when muscles spasm (such as a heat pack applied to the neck for 30 minutes)
Self-massaging of the jaw
Stretching of the jaw, as well as the connected structures (such as your neck and back)
Meditation and other steps toward reducing stress
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