Time to smile again??
TMJ pain can be excruciating, and it’s even worse when you don’t know what’s causing it. You can experience, constant aching to severe pain, headaches, foggy/stuffy head, nerve pain, neck pain, difficulty eating, talking, and even focussing.
What is TMJ pain?
Also know as Temporomandibular joint pain or TMJ pain for short.
The TMJ is a joint either side of your face in front of your ears, connecting your skull to your jaw. With the help of the joint’s muscles (Maester, pterygoid and temporalis) we can open and close our mouth for talking, eating and to some extent breathing, and most importantly smiling :).
What causes TMJ pain?
TMJ is caused by damage to the joint and can have multiple contributing factors making it a complex condition. Excess tension in the jaw muscles and neck muscles, direct trauma to the jaw (like whiplash), dental problems, stress and sleep are all important cofactors.
Some of the more common causes of TMJ pain are.
- Grinding or clenching your teeth, which puts a lot of pressure on the joint and tightens the jaw muscles – Often associated with stress
- Excess movement of the soft cushion or disc between the ball and socket of the joint.
- Arthritis in the joint itself
- Poor ergonomics,- office workplace set up, looking down at devices.
- Neck and back tension and injuries
- Dental problems including Orthodontic braces
- Constant stress or anxiety
- Poor posture
- Excessive use of chewing gum
- Connective tissue diseases that affect your temporomandibular joint
What are the symptoms of TMJ pain?
- Pain or tenderness in your jaw joint
- Pain in your neck or shoulders
- Tired feeling or pain in your face
- Swelling on the side of your face
- Pain in or around your ear
- Pain while chewing or an uncomfortable bite
- Hearing problems or ringing in the ears (tinnitus)
- Difficulty opening your mouth
- Locked jaw, which makes it difficult to open or close your mouth
- Clicking or grating sensation when opening and closing your mouth
- Nerve pain in your jaw or face
How is TMJ pain diagnosed?
In most cases TMJ is diagnosed by the presenting symptoms. In some cases further investigation such as X-ray, CT scan or MRI can also help rule out other issues and give a full picture of what’s happening in your Jaw.
Is TMJ pain difficult to treat?
The problem is that to help relieve the pain related to TMJ we need to be able to reduce the inflammation. But the inflammation is there because there is stress or damage to the tissue. The tissue needs rest to be able to heal. But because so much of what we do in our day to day lives involves moving our Jaw and face it can be hard to give the appropriate amount of rest to ensure long term pain relief.
The other issue is whenever we feel pain the muscles around the area tighten to protect the area and reduce the amount of movement. However increasing the tension means more stress on the joint and more jaw pain.
How is TMJ pain treated?
There are some things you can do at home to help:
- If severe – Eat soft foods. Load up on non-chewy foods and avoid foods that require wide bites like thick sandwiches. Take an over-the-counter anti-inflammatory medication like ibuprofen or naproxen.
- Practice good posture, minimise time on computer and hand held devices and avoid resting your chin on your hand.
- Avoid extreme or unnecessary jaw movements. Skip the chewing gum, place a hand under your chin when you yawn, and avoid things like singing or yelling that might cause you to open your jaw too wide.
- Position your jaw with your teeth slightly apart as often as possible. Place your tongue between your teeth if you have problems with grinding or clenching your teeth.
- Place moist heat or cold packs on your jaw and the side of your face for about 10 minutes. You can do this several times a day.
- Learn to relax. You’ll need a few stress management techniques in your arsenal to help you relax and loosen your jaw. Here are some articles from our website you might find helpful.
- Massage your neck and jaw muscles. Where appropriate, ask your therapist about gentle stretches you can do at home.
Western Medical treatment of TMJ pain
- Medications such as pain relievers, muscle relaxers, or anti-inflammatory drugs.
- Oral splints or mouth guards. These oral devices can be soft or hard and usually slip over your teeth to help keep your jaw in place.
- Physical therapy. A physical therapist can give you stretches and massage techniques to help strengthen and stretch your jaw. They can also do ultrasounds and an evaluation of behaviors that might be making your TMJ worse.
- Surgical options. When other treatment options can’t relieve your pain, your doctor may suggest surgery or other procedures. Some of these might include open joint surgery, arthrocentesis, injections at the joint, TMJ arthroscopy, or modified condylotomy. These procedures range from non-invasive to traditional surgery.
How can Evolve Natural Medicine help with TMJ pain?
Nutritional supplementation – can be useful for reducing general inflammation of the body. Items such as fish oils, boswellia, turmeric can have powerful anti-inflammatory effects helping to relieve pain.
Chinese Medicine – The use of Chinese herbs has been around for centuries and has treat pain and inflammation. Recent studies (1) have been able to isolate the mechanisms by which this occurs. These mechanisms include reduction of pro-inflammatory pathways or cytokines, Cox-2 inhibition and antimicrobial effect.
Acupuncture – A randomised controlled trial in 2007 (2) of acupuncture showed Acupuncture had a positive influence on the signs and symptoms of TMJ MP. Acupuncture also has a strong anti-inflammatory effect and as such can further assist with pain relief. A meta-analysis conducted in 2017 (3) indicated that conventional acupuncture therapy is effective in reducing the degree of pain in patients with TMD, especially those with myofascial pain symptoms.
Diet – More recent understanding of the gut has shown that poor gut function can significantly increase levels of inflammation and pain in the body. As a result looking at diet and dietary habits may assist to reduce overall inflammation and therefore provide pain relief in issues such as plantar fasciitis.
For more information about how we can help with pain and other conditions contact us
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Author: Adrian Taricani
Registered acupuncturist, Evolve Natural Medicine
More about Adrian
M: 0491 738 260
- Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders A PRISMA-compliant meta-analysis Medicine (Baltimore). 2017 Mar; 96(9): e6064. Published online 2017 Mar 3 doi: 10.1097/MD.0000000000006064
- Rekik A. Muluye, Yuhong Bian, Paulos N. Alemu. Anti-inflammatory and Antimicrobial Effects of Heat-Clearing Chinese Herbs: A Current Review, Journal of Traditional Complementary Medicine 2014 Apr-Jun; 4(2): 93–98.
- The Journal of Dentistry, The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: A randomised controlled trial J Dent. 2007 Mar;35(3):259-67. doi: 10.1016/j.jdent.2006.09.004. Epub 2006 Nov 13.
- Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorder. A PRISMA-compliant meta-analysis Jun-Yi Wu, MD,a,b Chao Zhang, MD,a Yang-Peng Xu, MM,b Ya-Yu Yu, MD,b Le Peng, PhD,b Wei-Dong Leng, PhD,c Yu-Ming Niu, PhD,a,c,∗ and Mo-Hong Deng, PhDd,∗