TMJ and Facial Pain

What is a Temporomandibular Disorder (TMD)?

Temporomandibular disorders (TMD) comprise a large number of pathologies related to the masticatory muscles and/or temporomandibular joint (TMJ), as well as contributory surrounding structures such as the cervical spine. TMD is the second most common cause of chronic pain in the human musculoskeletal system, after chronic low back pain! 

Characteristic symptoms of these disorders are:

1. pain of the temporomandibular joints (TMJ) and masticatory muscles, which may be acute or chronic
2. functional disorders of TMJ e.g. limitation of movement, jaw’s deviation during mouth opening
3. crepitation and clicking sounds of TMJ.

TMD is a multi-factorial condition that is caused by both physical and psychological factors.  One of the main physical reasons that we treat is hyperactivity of masticatory muscles and TMJ overload.  These factors can contribute to the start of symptoms, which leads to compensation strategies and ultimately failure to take this capacity any further leading to pain and dysfunction. 

What are treatment options for TMD?

Current indications for treatment for TMD follow a conservative approach that includes information, reassurance, control of functional excesses, physiotherapy rehabilitation, application of physical therapies, administration of drugs, and intraoral devices. The contemporary interdisciplinary approach to the problems of temporomandibular joint dysfunctions includes: dental treatment, orthodontic treatment, rehabilitation, pharmacotherapy and patient’s education.

For many people, a splint provided by your dental team and physical therapy services are enough to manage symptoms.  We find that it a low-cost, personalized treatment with physical therapy services should complement your splint therapy (i.e. mouth guard) and be the first step prior to more costly and invasive procedures. 

What does Physical Therapy do to help my TMD?

We examine your symptoms through a mechanical assessment of the jaw and neck. We can effectively determine how much influence your jaw and neck has on your symptoms, as well as determine if your symptoms are mostly due to the joint (arthrogenic) or muscles (myogenic). In many cases, you may have influence from all of the above that is collectively causing your pain.

Treatment is personalized to each person’s unique needs and focuses on the use of manual therapy techniques that restore optimal function while relieving pain and symptoms as quickly as possible. Our goal is to maximize each individual’s progress toward an active pain-free lifestyle.

As physical therapists with special interest in TMJ related conditions, neck pain and headaches, we understand that an effective approach to managing TMJ disorder and face pain must include a multi-faceted approach including:

• Treating the structures of the jaw and neck responsible for symptom production
• Prescription of specific exercises to stretch tight muscles and strengthen others to help normalise TMJ and neck function.
• Addressing lifestyle postures and other factors that may be placing strain on these injured structures resulting in symptoms persisting or recurring episodically.
• Assisting to reduce fascial and nervous system involvement through manual therapies to the cranio-fascial and cervical spine.
• Working in conjunction with your referring dentist or specialist to coordinate any other treatment you may be receiving such as the use of an oral (mouth) splint to protect your teeth from grinding and to help break the cycle of clenching / grinding.
• Referral to other specialists with a special interest in TMJ disorder for further assessment / investigation and treatment where necessary.

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Learn more with our articles on TMJ!