Temporomandibular Joint (TMJ) Disorder

What is Temporomandibular Joint (TMJ) Disorder

Temporomandibular Joint is the only movable component in the craniomandibular complex. It is a compound joint made up of three parts: the mandibular condylar process, the temporal bone’s glenoid fossa, and an avascular fibrocartilage articular disc of varied thicknes”. It is used for eating, talking, yawning, kissing, and sucking through the movements that are possible at this complex: depression, elevation, lateral deviation (left and right), retrusion, protrusion, and different combinations of these movements

Temporomandibular Joint (TMJ) Physiotherapy, TMJ treatment

A TMJ headache develops when discomfort in the jaw’s temporomandibular joint (TMJ) travels up the jaw’s supporting muscles to the face, cheeks, and head.  TMJ headaches are closely related to migraines and may serve as a migraine trigger in certain people. Pain in the TMJ joint, which connects the jaw to the skull, is the initial symptom of a TMJ headache. This pain may then spread to other areas of the face and head.

TMJ Dysfunction Symptoms

  • Pain that occurs intermittently on one or both sides of the head and face.
  • Pain and difficulty in chewing food.
  • Inability to widely open the mouth or having irregular jaw movements.
  • Clicking, popping sound or locking in the joint of the jaw.
  • Tenderness and soreness of one or both TMJs (the hinges of the jaw)
  • Patient experience tinnitus (ringing or other noises in one or both of your ears). The noises are not caused by an external sound, and other people usually can’t hear it.
  • Throbbing or stabbing headache, usually on one side of the head and/or temples. Throbbing often feels like a pulsing sensation and can come and go quickly. The throbbing in head can also feel like a vibration or mimic a heartbeat.
  • Nausea and Vomiting.

Causes of TMJ Headache

Hypermobility of the tmj characterized by excessive or early TMJ translation. Excessive forward gliding loosens the capsule, ligaments, and temporalis tendon. Overstretching these structures can cause temporalis tendinitis or disk displacement/derangement in one or both jaw joints. Pain, functional loss, and arthritic changes may occur.

Dislocation of the jaw joint (the lower jaw comes out of its normal position).

Bruxism is a condition in which a person grinds, gnashes, or clenches the teeth using the jaw muscles. Bruxism is a tension-related disorder. When bruxism is severe it can cause frequent headaches.

Osteoarthritis is the also one of the most common cause of TMJ headache .It is caused by wear and tear over time, which breaks down bone and soft tissue. Besides pain, osteoarthritis can cause a crunching sound that’s known as crepitus in the joint and limited range of motion, making it hard to “open wide.

Accident or trauma to the joint may cause dislocation of the joint which in turn can cause TMJ headache.

When your teeth are not in proper relation to each other and to your jaw joints, the jaw automatically shifts to a new position in an attempt to compensate for the misalignment of your teeth known as malocclusion. TMJ disorder can affect blood vessels, nerves and muscles, causing severe headache or ear pain.

Diagnosis TMJ Headaches

Physiotherapist will do the following things to confirm the diagnosis-

  • Range of jaw movements
  • Applying pressure to the face in order to localize tender or painful parts of the face
  • Do a physical examination of the temporomandibular joint and the areas around it when opening and closing the mouth.


Management of the TMJ Dysfunction

Treating TMJ headaches can be done in a number of ways. Options range from behavioural modification, use of Over the Counter and prescription drugs to surgical intervention and other treatments.

Some exercises and stretches for the jaw muscles can help make them more mobile and flexible, which can make headaches less painful. There are also exercises you can do at home that can help you relax. Physiotherapist can help you figure out what treatments will work best for you.

Minimizing the jaw movement by limiting chewing gum, or eating foods that require much chewing, yawning, or yelling can help. The teeth should be kept slightly separated as much as possible.

Incorrect posture i.e. the way the head and neck are positioned can also lead to headaches. Having good posture and working to improve it can help prevent them. This implies that awareness of right posture to sit or stand, even at work is important.

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How Physiotherapy can help with TMJ Dysfunction

A study from 2010 that was published in the Journal of Dental Research found that TMJ exercises help people with TMJ disc displacement open their mouth wider than using a mouth guard.

If it is found that a patient has TMJ headache because of a stiff joint, the physiotherapist can use manual treatment techniques to help the joint get better (often due to some prior trauma that caused stiffness). Stretching exercise supervised by physiotherapist can help keep the new range of motion between appointments.

Forward head position has a big effect on some people with TMJ problems. To improve head posture, physiotherapists can teach patients on how to strengthen muscles that support the spine. 

Muscle spasms often get in the way of the TMJ healing process. Using manual therapy techniques to relieve spasms helps improve joint alignment and mobility, which helps with pain. 

The physiotherapy results may depend on the patient’s condition. Most people with TMJ headache start to feel better after a few weeks of treatment. Some, on the other hand, may need more time to benefit from the therapy.