Ultimate Guide to Treatment of TMJ Disorders

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Written by: Bronwen Thomson, Registered Physiotherapist

Have you been told that you have temporomandibular joint (TMJ) dysfunction? Do you have jaw pain, tightness, or clicking? Do you clench or grind your teeth? Do you experience headaches, tinnitus, or neck pain? TMJ dysfunction (TMD) often presents with a wide range of symptoms, beyond the jaw itself. Considering how often we use our TMJ – talking, eating, smiling, yawning – TMD can be a major source of pain and disability. However, many individuals are unaware of the treatment options available, including physiotherapy.

What is TMJ dysfunction?

The TMJ is the joint that sits in front of the ears and connects your jaw to your skull. The muscles of the TMJ function to allow the jaw to open, close, move side to side, and move forward and back. These muscle span over the jaw and up into the side of the head. There is a disc within the TMJ that provides cushioning to the joint. Dysfunction of any of these structures can lead to TMD. This may include muscle tightness, joint hypermobility, joint hypomobility, or disc displacement (movement of the disc). Symptoms may include jaw or facial pain, tightness, clicking, locking, headaches, and tinnitus to name a few.

Why do you have TMJ dysfunction?

TMD is a common condition, and many people have signs of TMD. Both males and females may experience TMD, however, it is more common in females. The cause is often complex but can be related to underlying dental issues such as missing teeth or over/under bite, teeth clenching and grinding, trauma, poor posture (for example, due to increased computer use), anxiety and stress, ligament laxity, arthritis and hormonal changes.

anatomy of jaw for TMJ pain

How can physiotherapy help with TMJ dysfunction?

Physiotherapy is an effective treatment method for TMD. Physiotherapy can help people with TMJ pain and dysfunction by:

  • Reducing muscle pain and tightness
  • Improving TMJ mobility
  • Addressing and correcting TMJ biomechanics and improving motor control
  • Addressing postural factors involving the neck, shoulder, and upper back
  • Providing education on activity modifications

Your TMD physiotherapist will assess:

  • TMJ range of motion and joint mobility
  • Muscle tension – including an extraoral and intraoral assessment
  • Biomechanics of TMJ during opening and closing
  • Neck, shoulder, and upper back mobility and posture

Physiotherapy Treatment for TMD may include:

  • Exercise prescription (specific to each patient)
  • Joint mobilizations
  • Myofascial release
  • Postural exercises
  • Activity modifications

Here are some specific examples of TMD exercises and activity modifications:

TMD Exercise examples:

  • Mouth opening with tongue on roof of mouth
  • Guided mouth opening with your finger
  • Chin tucks
  • Thoracic mobility exercises

TMD Activity modification examples - Do’s and don’ts for TMD:

Do

  • Be mindful of posture throughout the day
  • Wear your night guard if you have one
  • Try to breathe through your nose at rest with your mouth closed
  • Take smaller bites when eating

Don’t

  • Chew gum
  • Chew/bite nails or lips
  • Sit with poor, slouched posture or with your head resting on your hand
  • Eat foods that cause jaw pain
  • Intentionally cause clicking in the jaw
  • Chew only on one side of the mouth
Bottom line: You don’t need to live with it, physiotherapy can help!

TMD can be painful, distressing, and frustrating while having significant negative impacts on your quality of life. The good news is that you are not alone and that there are treatment options available. Physiotherapy is an effective, holistic, and comprehensive treatment option and can allow you to live your life without the pain, stress, and frustration associated with your TMD. If you have been dealing with TMD and are seeking relief, please don’t hesitate and book in with one of our physiotherapists today!

References: Jam, Bahram. 2020. APTEI: Temporomandibular Joint (TMJ) Management.

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