The Importance of Treatment for Temporomandibular Joint (TMJ), Headaches & Neck Pain
An estimated 75% of the U.S. population has experienced signs or symptoms associated with disorders involving the TMJ. Temporomandibular disorder (TMD) is a more accurate term that describes the two types of TMJ disorders, including conditions caused by the muscles surrounding the TMJ or from changes in the temporo-mandibular joint. Many areas of the body affect the TMJ and a comprehensive evaluation will help identify the root of the problem.
A loss of spinal alignment can contribute to the development of TMD and our physical therapists can help identify the causes and reverse the effects of poor posture. For many people, sedentary computer work accelerates the loss of spinal alignment, and we encourage you to schedule an evaluation. Our treatment plan will include simple exercises to help you regain and maintain alignment to address your pain, typically in just a few weeks. Failure to address these issues with early intervention can contributed to degenerative disc/joint disease of the cervical spine, poor posture, chronic clenching, tooth fractures (need for extensive dental work) from grinding (bruxism), TMJ arthritis, poor sleep, painful chewing, limited mouth range of motion, and poor breathing patterns.
What Are Typical Symptoms of TMJ Disorders or TMJ Dysfunction (TMD)?
TMJ or TMD symptoms consist of tension in the ear, face, jaw joint, facial muscles and neck and may be caused suddenly, such as when biting into something hard and straining the joint. Symptoms may fluctuate in intensity and frequency over months to sometimes years. There may be joint sounds, such as grinding, grating, clicking or popping of the joint when moving the jaw during daily activities, such as talking or eating. Locking may occur which may be an indicator that there is a temporomandibular disc displacement problem. At times, there may be a deflection or deviation to one side when opening the mouth. Headaches are also very common with TMJ disorders, along with difficulty eating due to pain or limited opening.
What does TMJ, Headache and Neck Pain Treatment Consist of?
Your physical therapist will complete a thorough examination of your spine and work restore alignment of the head and neck. Slouching can promote loss of alignment and development of a “straight neck” or “inverted cervical lordosis”. Cervical lordosis promotes healthy neck joints and use of the neck with the least amount of load or compression. Loss of cervical lordosis can promote lower cervical degenerative changes such as osteophytes, bone spurs, degenerative disc disease, herniated discs and more. Restoring proper posture promotes improved neck range of motion, normal lordotic curvature of the neck, restoration of cranio-vertebral angle, decreased facial and shoulder tension and more.
What Should I Expect During the Head, Jaw, and Neck Evaluation?
A licensed physical therapist will evaluate the following:
- Review of detailed history and causes of jaw, neck and headache symptoms, including prior history of dental work, questions about work, work-related positions, depression, anxiety, diet and family, as well as pattern of any headache can help the therapist develop a treatment plan.
- Evaluation of spinal alignment with assessment of muscle tension in the surrounding areas
- Evaluation of gait or walking pattern to see if ankle, knee or hip limitations are affecting the biomechanics of your head, neck and TMJ
- Evaluation of joint mobility of the spine and neck and influence the functioning of the TMJ, as well as identify abnormalities or asymmetries
- Assessment of the TMJ and neck to determine the cause of clicking, headaches, and neck pain
- Full evaluation of the muscles and soft tissues of the neck, shoulder and face for tenderness and activity level
- A comprehensive assessment of the problem and recommended treatment will be explained to the patient. A home exercise program will be developed to address all aspects of the problem and with the goal of immediately reducing TMJ symptoms
- Review of the manual therapy or hands-on treatment plan to address TMJ problem. If problem is muscular-based, we will teach you how to reduce facial and neck tension through exercise, posture and also apply manual therapy techniques. If an internal joint problem is present, we will explain treatment options to minimize joint noise.
What Should I Expect During Treatment of the Head, Neck and TMJ?
- Specialized Manual Therapy: To restore full range of motion, joint mobility and decrease pain of the jaw, neck and upper back
- Soft Tissue Mobilization: To decrease your facial swelling and pain
- Dry Needling: May be recommended to address active trigger points of the head and neck muscles
- Education: To decrease chronic headache and jaw pain through exercises and postural correction. We may not realize the daily habits that are actually hurting us and overloading our joints and soft tissues
- Postural Screening and Re-education: To decrease pressure in the jaw, face, neck and shoulders
- Exercises: To decrease tension in the face, head, neck and upper body
- Breathing Exercises: To restore nasal diaphragmatic breathing patterns to reduce neck tension and chest or mouth breathing
- Gait Training: To improve and optimize our alignment during gait to reduce head and neck tension
How Do I Learn to Manage My TMD Problem?
Many TMDs require ongoing self-management as these problems do not typically resolve with a "quick fix." Learning why symptoms are occurring and how to minimize the cause is key to success. You may need a few daily exercises to reduce tension in the area and promote better alignment of the neck and jaw. We may recommend a reduction in hard or crunchy foods to reduce the compressive forces of the joint, which is particularly important with degenerative changes of the joint or a disc displacement. At times, collaboration with mental health professionals can decrease the stress and overwhelming feelings that life or the symptoms may be creating. We collaborate with multiple health care practitioners to address all aspects of the TMJ problem.
How Is My Treatment Affected By Dental Appliances, Night Guards or Splints?
Your physical therapist may collaborate with your dentist to provide night splints to help reduce muscle tension at night. TMJ splints or appliances protect the teeth and may help decompress the joint. At times, splints can initially contribute to increased pain, but our hands-on manual therapy techniques can help improve tolerance. If you have been recommended to wear a splint, we can collaborate with your dentist to optimize your ability to adapt to and tolerate your new appliance.
Please call (773) 665-9950 for more information or schedule an onsite or virtual appointment.