Temporomandibular Joint Disorders (TMJ)
This term includes both jaw pain and pain referring elsewhere from the jaw and jaw dysfunction- where the ability of the jaw to open, close or perform its usual functions is limited.
Your dentist may have spoken to you about your jaw pain and suggested physiotherapy, you may have found our website through the Association of Chartered Physiotherapists in Temporomandibular Disorders or perhaps we came recommended.
Most commonly, pain and dysfunction are linked to a change in the muscle mechanics around the jaw, sometimes related to stress and tooth grinding (bruxism).
Sometimes pain and dysfunction are related to changes in the temporomandibular joint itself as a result of degenerative change, arthritis and sometimes injury.
In rare instances, jaw pain can be a sign of something serious such as temporal arteritis and giant cell arteritis
Commonly symptoms include
- Sudden onset severe headaches
- Pain and tenderness a the side of the head- brushing the hair is too painful
- Jaw or tongue pain worsened by speaking or eating
- Visual problems such as double vision or loss of visioning one or both eyes
These conditions are more likely if you have already had a condition called Polymyalgia Rheumatica.
If you think you have Temporal arteritis or giant cell arteritis, please follow the guidance from
https://www.nhs.uk/conditions/temporal-arteritis/
What to expect at your assessment
Assessment of the jaw is a thorough process involving a detailed discussion about your symptoms and the problems they cause, your medical history and some information about your work life and social life. It is helpful if you can provide us with an accurate list of your medications. We may ask about how you manage your stress and any emotional factors that might drive the pain.
We will look at your upper body with you in sitting and lying down.
We will look at how your jaw moves as well as what might limit it or what might be causing pain.
We will take measurements and test the muscles and joints of the jaw.
Please note that we will need to look inside the mouth and also feel inside the mouth to find the problem and give appropriate treatment.
Advice and Treatment
Trying to be aware of when you might be clenching your jaw and finding the rest position- “Say Emma”
Chewing equally on both sides, trying to notice and avoid resting your chin on your hand, eating softer foods for a period of time, avoiding prolonged sitting with a slumped or forward head position by checking your desk set up and using a lumbar roll or sitting to the back of your chair.
You may also find mindful apps such as Headspace to be helpful, looking at your stress factors and those emotional factors that might drive your symptoms to feel worse.
Physiotherapy treatment might include massage and stretching. It is likely to include proprioception exercises- that work on your coordination and strength exercises. There are acupuncture protocols that can be very helpful.
Commonly we would advise seeing you every 2-4 weeks for follow-up dependent on your symptoms until you feel you reach your therapy goals- such as eating out in a restaurant, being able to eat chewy food, being able to yawn, laugh and talk without pain or clicking or are able to manage your symptoms independently long term. If you opt to trial acupuncture as an adjunct to treatment, sessions would be advised to happen weekly for three sessions before review.
I look forward to meeting you and helping you get your smile back!