Wait… Do I have TMJ or TMD?
What is TMJ?
Here’s What We Have to Say About the TMJ
You may hear people say that they have TMJ when referring to popping, clicking, tightness, or pain in their jaw joint. The term TMJ, however, actually stands for temporomandibular joint, the hinged joint located in front of each ear where the jaw bone attaches to the skull.
What people usually mean to say is that they have TMD (temporomandibular dysfunction) or TMJD (temporomandibular joint dysfunction), the name of the condition affecting the inside or the outside of the TMJ that causes these symptoms.
Despite its relatively small size, the TMJ has some really important jobs to do and those suffering from TMD know that these joints can cause a whole lot of suffering when they aren’t working optimally.
WHAT AND WHERE IS THE TMJ?
The temporomandibular joint is located in front of the ear on each side of the face. It is the connection between the mandible or jaw bone and the temporal bone of the skull. The joint is a bit unique in that it acts a little like a hinge joint and a little like a ball-and-socket joint. This allows for movements of the jaw in many directions. The jaw can open and close, protrude (slide forward) or retrude (pull back), and move side to side. The two joint surfaces are separated by an articular disc and surrounded by fibrocartilage. Several ligaments stretch between the skull and the jaw bone to stabilize the TMJ. Muscles of the face allow movement of the jaw in its many directions.
Without the TMJ you would find a long list of things you could no longer do. The multiplanar movements of the jaw, facilitated by the TMJ, are necessary for chewing, sucking, talking, swallowing, breathing, facial expressions, and opening and closing the mouth to eat and drink. When loss of optimal function occurs in this joint we call it TMD or TMJD and now that you know how important the TMJ is, you can see why addressing this condition is so important.
LET’S TALK ABOUT TMD
Problems both within the joint itself and outside of the joint may fall under the umbrella of TMD. Aside from the functional problems with eating, talking, facial expressions, etc., dysfunction at the TMJ can also cause facial pain, jaw pain or soreness, jaw fatigue, earache or ringing in the ears. Additionally headache, popping of the joint, locking of the jaw, teeth sensitivity without dental issues, limited mouth motions, and changes in the way the teeth fit together can occur. Often these symptoms are more pronounced upon waking up and in the late afternoon. It is important to know that jaw sounds like popping or clicking that are not accompanied by pain or limited jaw movement are not considered a serious problem. The truth is, joints are noisy, even healthy ones can make noise when there are no problems to worry about.
The cause of TMD may originate from problems with the joint such as arthritis or it can originate in the muscles or ligaments that surround it. Often the cause of TMD is thought to be multifactorial. Biological, environmental, emotional, social, and cognitive triggers for TMD exist. The incidence is higher in persons diagnosed with other conditions such as autoimmune conditions, sleep apnea, mental illness, or fibromyalgia. TMD can be the result of arthritis in the TMJ or from displacement of the articular disc. Jaw or facial fractures and surgery of the face or jaw may lead to TMD in some persons. Also problems with teeth alignment (malocclusion) and frequent jaw clenching (bruxism) can trigger TMD. Even poor posture habits can lead to TMD if repeated frequently. We don’t know the exact statistics on TMD but some estimates suggest over 10 million Americans may be living with this condition.
WHAT CAN I DO IF MY JAW IS BOTHERING ME?
If you’ve noticed that you are experiencing any of the symptoms of TMD you may be wondering what you can do about it. If the problem is new and not severe or accompanied by warmth, redness, or swelling of the joint, chest pain or pressure, or fever, you can probably start with some at-home treatments to see if this helps. Here are some things you can try:
Set a timer when you are working to check in every 15-30 min and see if you are clenching your jaw. Practice separating your teeth and relaxing your muscles
Apply a cold or warm (not hot) compress to the area for 10-15 min. The cold can help reduce inflammation while the warmth will increase blood flow and help relax muscles. Be sure to set yourself a timer to remind you to take it off and don’t fall asleep with either of these on
Practice meditation or breathing techniques to help relax you and relieve stress. Jaw clenching and teeth grinding often increase when we are stressed
Work on your posture. Poor postural habits can exacerbate TMD. Try changing positions throughout the day if you tend to sit in one place to work, for example, for hours at a time
Get a good night’s sleep and use a pillow that is supportive and allows your neck and jaw to relax
WHEN TO CALL THE DOCTOR…OR DENTIST
If you’ve tried these home remedies for a couple of weeks and aren’t seeing improvements in your symptoms it is a good time to reach out to a professional. Because several other health conditions can cause symptoms that mimic TMD it is important to have a qualified healthcare professional examine you if you aren’t improving quickly or if you have any symptoms that suggest a more acute problem. A visit to your physician or dentist is a good first step. Sinus infections, certain types of headaches, dental issues like a tooth abscess, and a nerve condition called trigeminal neuralgia can also present as jaw symptoms but need to be treated differently than TMD.
The most concerning cause of jaw pain or discomfort is cardiac ischemia or lack of blood flow to the heart. This can occur during a heart attack but also can occur as a warning side of an impending cardiac event. Nausea, vomiting, chest pain or pressure, pain in the left hand, arm or shoulder, or even teeth pain that accompanies the jaw symptoms could indicate a cardiac origin and needs immediate medical attention.
WHAT ABOUT PHYSICAL THERAPY?
Physical therapy is an excellent form of conservative treatment for TMD. Because of the multifactorial nature of these conditions, a physical therapist that takes a holistic approach to your care can help you make changes or improvements in several of the areas that could be contributing to your symptoms and teach you how to prevent recurrence.
Here is a sneak peek at some of the treatments your physical therapist may use to address jaw joint dysfunction:
Postural re-education: PT will assess for any postural abnormalities and teach you how to be aware of them and begin to correct them.
Manual Therapy to improve jaw mobility: Restoring the normal motions and mobility of the TMJ and jaw can be done through gentle hands on techniques either outside of the mouth or sometimes from inside the mouth.
Strengthening Exercises: Exercises to strengthen the muscles around the jaw and neck can be very helpful in reducing symptoms of TMD, improving jaw range of motion, and reducing the likelihood of recurrence.
Dry needling, ultrasound, electrical stimulation: Your therapist may choose to apply these modalities to manage your pain and inflammation
Whenever possible a conservative approach is a good first step to addressing symptoms of TMD. If conservative treatments like physical therapy have not been successful, it may be time to talk with your doctor or dentist about treatment options like oral splints or night guards, botox injections, medication management and as a last resort, surgical intervention. If you have been dealing with pain or discomfort in the TMJ this article should help you understand more about your condition and give you an idea of first steps you can take on the road to improving your symptoms.
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About EvolveNY-
Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!
First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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