HOW TO GET RELIEF FROM TMJ PAIN WITHOUT DRUGS OR SURGERY
If you suffer from jaw pain, clicking or locking – now there is hope!
Do You Have Any of the Following Conditions?
Pain and muscle spasm in the jaw
Headaches into the temples or behind the eyes
Headaches that are worse in the morning or with stress
Grinding or clenching your teeth
Ringing in the ears
Recurrent neck pain or undiagnosed vertigo
If so, we may be able to help you!
Problems with the TMJ or tempomandibular joint vary widely in their presentation and can be difficult to diagnose and treat. Generally called TMD (Temporomandibular Disorders), these complaints are often misdiagnosed because symptoms such as headaches are not always associated with popping or clicking in the jaw.
We frequently find that TMD is not frequently relieved with the wearing of night splints or guards. In fact, the vast majority of patients wesee with jaw or head pain already have one or more oral splints.
What We Do for TMD
To understand how we treat TMD, it is important to understand how TMD problems develop. There are a number of reasons why people develop TMD. The most common include stress, trauma such as whiplash, poor posture and having dental or tooth pain that alters the bite. Stress is probably the most common cause of TMD problems. People with abnormal amounts of stress in their lives tend to “hold” their stress in the muscles of both the neck and jaw. Over a period of time this abnormal muscle contraction irritates and inflames the delicate nerves in the joints resulting in a neurological reflex in which the body contracts the muscle involuntarily. Even if the patient takes muscle relaxers, this abnormal neurological pattern will return because of the dysfunction in the joints. Not until normal function to the muscles and joints is restored and any inflammation is brought under control will the condition resolve. This is why TMD problems can become so chronic as medications are just a temporary fix.
Whiplash injuries commonly damage both the neck and the jaw, especially rear-enders and also from striking the airbag with the chin and face. Symptoms usually do not present at the time of injury and are not evaluated initially in the emergency room due to concern about ruling out cervical spine injury (It’s good to rule out a broken neck first!). It is usually discovered diagnostically months or even years later when the patient complains of persistent headaches in the temples or behind the eyes.
Poor posture leads to TMD problems when people sit or stand with their heads perched forward. This causes abnormal stresses to the shoulders, upper neck and jaw resulting in irritation to both the muscles and joints. Over a period of time these structures adapt in an unnatural way resulting in what we call “Muscle and Joint Dysfunction.” It is the neurological disturbance from this dysfunction that causes most patients’ symptoms. We have found that correcting this mechanical problem and trying to eliminate the original cause (in this case poor posture), we can often totally eliminate TMD symptoms.
A similar phenomena occurs when someone alters his or her bite from a sore tooth. The body will adapt by contracting muscles in an asymmetrical manner and this feedback to the nerves in the joint will cause the body to keep this altered pattern of motion even though the original tooth pain is gone. We see an identical occurrence with patients who develop low back pain weeks or months after limping on a bad knee or hip. Once the body accommodates to the asymmetrical motion neurologically it is stuck in this pattern until some type of manual therapy can be performed. The principle underlying our treatment approach is “Find the cause, Find the cure.” Our typical TMD patient already has a splint and is typically on 2-3 medications for their ongoing pain. Obviously this approach isn’t curing much! We find that if we can reduce any inflammation and correct the nerve irritation using manual therapies then home exercise and splint therapies can effectively keep TMD symptoms at bay.
Finding Permanent Solutions
Because of the complex nature of TMD, a comprehensive treatment approach produces the best results. The most effective treatment we use is manual therapy to both the muscles and joints. This includes gentle stretching procedures to the muscles or mobilization to the joint itself. This is combined with low force or instrument adjusting, which has an immediate effect on reducing both pain and muscle spasms. Another very helpful treatment is intra-oral massage. This is a procedure requiring advanced training in which very specific contacts are made within the mouth (using gloves of course!) to reduce involuntary muscle spasm. By reducing spasm and improving normal function in the joint we can often achieve rapid improvement.
Laser Can Help
Low Level or Cold Laser is an advanced modality that reduces pain and inflammation. It also accelerates healing at the cellular level. A number of research studies have shown that low level laser helps both TMD and osteoarthritis.
What About the Neck?
An often overlooked aspect of treating TMD disorders is the neck or cervical spine. There is an intimate anatomical and mechanical relationship between the joints of the upper neck and the TMJ itself. Quite simply, when one goes bad, the other often follows. This is because the nerves, muscles and joints of this region are interconnected and work together mechanically. For instance, many of the muscles that open the mouth connect directly to this region of the neck.
It has been our experience that if you do not correct the upper cervical dysfunction, the TMJ problem will not resolve. As an example of the interconnectedness of these structures, a recent study showed that patients with TMJ problems had improved opening of their mouth and less pain in their TMJ muscles after receiving joint therapy exclusively to their upper neck (and not their TMJ)! For patients who have undergone unsuccessful dental treatment for TMD, this is one of the first things we check.
Why We Have to Work with Dentists
Nothing will undo our treatment results quicker than an intrinsic problem with the teeth that alters a person’s bite. This will affect both the joint capsule and the muscles and will cause the symptoms to return in short order. This is why we work closely with patient’s dentists to get longer lasting results. We have also found that patients who uncontrollably grind and clench their teeth (bruxism) at night can benefit from a night splint and that this can help “hold” the treatment gains we often deliver. Ironically however, the vast majority of our TMD patients have already seen their dentists for their symptoms and many already have a night guard splint.
Why See Us?
We have worked for over 25 years at Spinal and Sports Care Clinic in Spokane, WA, to develop our treatment program for TMD. By integrating techniques from the fields of Chiropractic, Physical Therapy and Massage we often get rapid and long lasting pain relief. We work closely with dentist, oral surgeons and family practice medical physicians to produce superior results.