November is TMJ awareness month – a common but not well understood condition.

It’s estimated up to 60-70% of patients will experience some sort of TMJ (temporomandibular joint) issues in their lifetime, with only around 50% of them seeking treatment.

Perhaps you have noticed your jaw clicking every now and again when you eat or yawn. Maybe you are waking up in the morning and finding your jaw and the surrounding areas are sore. These are signs that could indicate TMJ dysfunction.

What is your TMJ?
Your TMJ are two joints located either side of your head, sitting right in front of your ear. These joints consist of the mandible and temporal bone and they are what connect your lower jaw to your skull. This type of joint is called a hinge joint, which means it has sliding and rotational motions.
The TMJ is one of the most complex joints in the body, along with several muscles. It allows your lower jaw to move up and down, side to side as well as forwards and backwards. These actions are crucial in day-to-day life for things like talking, eating, yawning as well as swallowing.

When these structures are not synchronized or working efficiently together, they can lead to several problems.

How do I know if I am suffering from TMJ dysfunction? 
Common signs and symptoms of  TMJ issues are:
-Pain or aching in or around your ear, often mistaken for an ear ache
-Pain or tenderness of your jaw
-Feeling like your teeth aren’t aligning 
-Clicking and grating sounds in your jaw when opening and closing
-Pain/difficulty chewing 
-Headaches located at your temporals, these can commonly be experienced first thing in the morning
-Tinnitus/ ringing in your ears
-In severe cases, you can have locking of your jaw, making it difficult to open or close it

What can go wrong at my TMJ?

Within the TMJ there is an articular disc that sits between the mandible and temporal bone. This allows for smoother motion, as well as avoids any bone on bone contact. However, issues with this disc are a common presentation when it comes to TMJ pain. The disc gets pulled forwards and backwards within the joint depending on what jaw motion you are doing. If the disc doesn’t go back and sit in the right place you can start to get a constant painful clicking that is accompanied with certain mouth movements.

Sometimes clicking can be a result of one side of your jaw having more motion and moving further than it should, or one side of your jaw not having enough motion and forcing the other side to move further than it should to allow for mouth opening.

Issues with muscle imbalances and arthritic changes also commonly occur here.

So what’s the cause of these issues?
The causes of TMJ dysfunction are poorly understood but it is likely to be multifactorial, with the most common causes being:
-Clenching and grinding of your teeth, either at night or during the day
-Chewing on gum, pen lids, nails etc 
–Dental issues
-Abnormal posture
-Stress and anxiety
–Arthritis – typically osteoarthritis and rheumatoid arthritis
-Genetic issues 
-Direct injury to the jaw
-Some studies have also shown a possible link between female hormones and TMJ issues, with women 9 times more likely to suffer from it than men.

What can I do?
When it comes to fixing your jaw pain we need to find the root of the cause. We won’t be able to make much improvement with your pain if the aggravating factor is not addressed. This will consist of a thorough case history and assessment to figure out the cause and what type of dysfunction is occurring as treatment can vary.  

Only 5% of patients with TMJ dysfunction will require surgery. The rest can be managed through manual therapy including hands–on techniques such as soft tissue, dry needling, joint work, intraoral muscle release, as well as an exercise program, medication or even a referral to a dentist for devices or an oral splint if required.

If you have jaw pain, come into the clinic for an assessment with one of our CSSM practitioners.

About the author
CSSM Osteopath Jaimi Schroen enjoys treating a broad rage of injuries, but has a particular interest in treating temporomandibular joint (TMJ) disorders as well as headaches.

Jaimi enjoys educating her patients about their bodies and showing just how connected everything is and how closely structure and function are related.

References 
Murphy, M., MacBarb, R., Wong, M., & Athanasiou, K. (2013). Temporomandibular Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies. The International Journal Of Oral & Maxillofacial Implants, 28(6), e393-e414. doi: 10.11607/jomi.te20

Temporomandibular Disorder (TMD). (2021). Retrieved 16 November 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/temporomandibular-disorder-tmd 

 Wright, E., & North, S. (2009). Management and Treatment of Temporomandibular Disorders: A Clinical Perspective. Journal Of Manual & Manipulative Therapy, 17(4), 247-254. doi: 10.1179/106698109791352184