Physical Therapy for Temporomandibular Joint Dysfunction, aka 'TMJ' or 'Jaw Pain'
Jaw Pain. TMJ. TMD.
All are ways of describing the same thing -- pain associated with the Temporomandibular joint. It is estimated that about 15% of the American population suffers from some kind of cranio-facial pain which can be in the form of Temporomandibular joint pain, facial pain, headaches, and even ear aches.
Interesting enough, this condition affects women twice as often as men, and is the most frequent non-dental cause of chronic facial pain. Symptoms may result from an injury such as car accident, direct blow to the jaw, or collision during a sporting event, or it can come on without history of trauma.
Patients with TMD often describe a variety of symptoms: local pain at the TM joint itself, clicking when opening or closing mouth, pain or joint noise when eating hard or chewy foods or yawning, headaches, ear aches, ringing in the ear, difficulty opening their mouth wide, deviations or shifting of the mandible when opening/closing their mouth, and pain or stiffness with waking which is often attributed to them 'grinding their teeth.'
How Can Physical Therapy Help TMD?
Good question. And one I generally get immediately after telling someone that physical therapy can help their TMD. There are a number of variables that may contribute to or effect the TM joints. As with anything, we start first with a thorough evaluation. We are not just looking at the TM joints alone as the site of pain -- we want to get to the source of it. What is causing the TM joint or joints to be painful? A thorough evaluation would have the following components:
1. Postural assessment: Looking at the entire body, how is the individuals sitting and standing posture.
What is the orientation of the cranium on the cervical spine, cervical on thoracic, scapula on thoracic,
2. Examination of the jaw: A local examination of the TM joints is done to assess ROM, joint mobility,
and motor control.
3. Examination of the cervical spine, with particular emphasis on upper cervical region.
4. Examination & screening of motor control and movement patterns.
From here, we should have a good idea of what is contributing to the presentation of TMD. Especially in cases where there is not mechanism of injury, odds are compensations or changes in the system over time have lead to the restrictions in joint mobility, motor control, and postural organization that are seen during the evaluation.
Okay, so we confirm what the patient said coming in "I have jaw pain!" Hopefully we have an indication of what we need to work on to get the patient out of pain and back to their normal life routine, so now what?
There are a number of treatment options that we utilize in the quest for a successful outcome. Treatment options include:
1. Education: Educating the patient serves a number of invaluable purposes. First, we attempt to
decrease the perception of threat and intervene to minimize the persistence of pain. Second, we get
the patient to become aware of things that provoke symptoms, thing that relieve symptoms, and how
the move and carry their body on a daily basis. Third, we teach them how to avoid provocative
maneuvers, perform things that provide relief, and improve their sense of control over their health
and outcome. A fourth benefit that hopefully ensues for the first three is increased patient buy-in and
compliance with the treatment plan, which will help yield a positive outcome.
2. Manual Therapy: Manual therapy can be performed to improve soft tissue and joint mobility, and
can be aimed at restrictions found during the evaluation. Often times patients will present with limited
OA and upper cervical motion, restrictions in posterior soft tissues such as suboccipitals, and may
have limitation in thoracic motion and scapular stability.
3. Exercise: Exercise is utilized to help improve motor control, restore joint mobility and improve
postural organization, and provide a positive movement experience where the patient is able to move
with little to no pain and/or achieve pain relief through exercise.
4. Dry Needling: Dry needling is a very effective way to manage headaches and tissue tension, and
manage pain. This is a modality that I am using more often and much earlier in treatment of TMD,
and so far has been quite beneficial in making change quickly.
If you or someone you know living in Las Vegas or Henderson is experiencing symptoms of TMD, or you have been diagnosed with TMD but have seen a physical therapist, then I encourage you to contact our office and schedule your initial physical therapy evaluation. Let's see what we can do to get you out of pain and back to your normal routine!
Contact us today at (702) 930-8155 or BOOK YOUR APPOINTMENT ONLINE HERE!
Athletes Physiotherapy - Las Vegas, NV
Sports Physical Therapy, Performance Enhancement, and Athlete Development for Las Vegas & Henderson, Nevada
Thank you for stopping by the Athletes Physiotherapy Blog! Kristopher Bosch founded Athletes Physiotherapy in Las Vegas, NV. He is a Father, physical therapist, athletic trainer, pilates teacher, & perpetual student!
EDGE Mobility System
John Rusin - StrengthDoc
Sue Falsone - S&F
Systemic Dry Needling