What you should know about TMJ and TMD
with advice from Renee Bailey, PTA
and Pressure Positive
Temporomandibular joint disorders or dysfunction, often referred to as TMJ or TMD, cover a wide variety of problems, most commonly pain and muscular tightness in the jaw. You’ve no doubt heard of this problem, but did you know that physical therapy is one of the solutions?
TMD can be a result of a variety of causes, explains Renee Bailey, a physical therapist assistant at Conshohocken Physical Therapy, a Physiquality member in Pennsylvania. “Symptoms can arise from something as simple as bad posture habits, or it can be a result of trauma to the joint, like a direct hit or impact, a whiplash injury, or even clenching or grinding your teeth,” she says.
The most widely reported symptom of TMD is pain, which can range from the jaw to the neck, ears and shoulders and can also present as a headache. Other symptoms noted by the National Institute of Dental and Craniofacial Research include stiffness in the jaw muscles and joint; limited movement or locking of the jaw; clicking, popping or grating in the jaw joint when opening/closing the mouth and while chewing; difficulty swallowing; and changes in how the upper and lower teeth fit together. Renee has also seen patients that experienced ringing in the ears (tinnitus) and dizziness.
||The NIDCR breaks down these disorders into three general categories, although some patients can have TMD that fits into more than one:
- Myofascial pain, which relates to the muscles, bones and connective tissue in the joint — for example, stiff muscles in the joint, or a strain to the fascia or connective tissue within the joint
- Internal derangement, caused by displaced or dislocated bones in the joint
- Arthritis, caused by wear and tear to the joint
If the pain is mild or has recently begun, the NIDCR advocates trying a few things at home to reduce the pain and irritation. You can relieve pressure on the joint by avoiding extreme movements (including yawning) and eating soft foods that don’t require a great deal of chewing. Ice packs can reduce swelling in the joint and minimize pain. You can also try to reduce stress and relax, which might help the muscles to relax or unclench.
If the problem is ongoing or the pain is severe, a physical therapist can help in several ways, says Renee. After an initial evaluation, PTs can determine possible causes of the pain and develop a treatment plan accordingly. For some patients, poor posture can contribute to pain in the upper body, including the jaw. A physical therapist can teach patients how to improve their posture and reduce strain on their neck, head and jaw.
Renee explains that physical therapists can also help to improve motion in the jaw muscles and joint; they have a variety of methods to do so. Manual therapy can stretch the jaw and increase motion throughout the joint while also stretching and releasing the mandibular muscles. Some patients may also benefit from a variety of strengthening exercises that don’t put strain on the jaw but help to strengthen the muscles of mastication and reduce pain.
Your physical therapist or other healthcare provider may also suggest tools that you can use on your own. Some may suggest a mouth guard (worn at night) or a bite splint (worn all the time) to avoid grinding your teeth and to possibly improve your alignment. They may also suggest a way to massage your muscles at home by using a product like the MyoFree® Solution from Physiquality partner Pressure Positive. According to Pressure Positive, the MyoFree® Solution gives patients a tool to massage their mandibular muscles from the inside of their mouth, targeting the trigger points that are most likely to be causing pain.
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||Renee Bailey, PTA, is a physical therapist assistant at Conshohocken Physical Therapy, a Physiquality member in Pennsylvania. Her bachelor’s degree in psychology, combined with her licensure as a PTA, gives her a unique perspective for helping patients, in particular children and adolescents.
For further reading, look through our selection of articles on injury prevention and treatment, in addition to the below links:
TMJ disorders. National Institute for Dental and Craniofacial Research, August 2013.
Tinnitus. Mayo Clinic, February 5, 2013.
Stand up straight! Physiquality, December 2, 2011.
Gray, Henry. Anatomy of the Human Body. 1918.