If you stop and think about it, our jaw’s get a pretty big work-out over the course of a day. Our Oakville Physiotherapy clinic sees all types of TMJ and jaw pain issues. Talking, chewing, yawning and clenching all require that the jaw joint, and the muscles around the joint, are working properly. So what happens if the jaw stops working properly? Read about how our Oakville physiotherapists treat jaw pain below!
The TMJ Joint
The anatomical name for the jaw is the temporomandibular joint. It connects the temporal bone at the side of the head to the mandible (which is the movable part of the jaw). This joint rotates and glides to allow us to open our mouths (which we do hundreds of times every day – some of us much more than others). The two bony surfaces of the jaw are separated by an articular disc. This disc separates the joint into two different compartments. More about TMJ and treatment options.
The Muscles of the Jaw
There are a few important muscles that move the jaw and assist in the process of mastication (aka – chewing). There are the pterygoids – one medial and one lateral. These muscles assist in the movement called protraction and retraction. This is the movement of the jaw forwards and backwards (the movement of creating an over-bite or under bite). The lateral pterygoid is particularly important, because it attaches onto the articular disc within the jaw joint. If this muscle gets too tight and becomes dysfunction, it can affect how the disc moves within the joint as well. When this unit becomes problematic, it can cause clicking and/or locking within the joint.
There are also larger muscles that assist with chewing. The masseter and temporalis muscles can be easily felt when you clench your jaw. The masseter lies at the angle of the jaw, and the temporalis sits higher in the temporal region of the head. These muscles help move the mandible bone (the lower jaw bone that holds your lower set of teeth) up and down.
Movements of the TMJ
There are two basic paired movements of the TMJ. Protraction and retraction, and elevation and depression. The movement of the joint is quite complex!
Protraction and retraction involves the jaw moving forwards and backwards. The movements move the jaw in directions that create overbites and underbites. Elevation and depression movements move the mouth up and down.
When the mouth opens slightly, the joint rotates to allow the opening. The movement is similar to how a hinge opens. When the jaw opens wide, a movement called translation occurs. The joint rolls forward to create a wider opening.
Symptoms of TMJ Disorders
The most common symptom of TMJ disorders our Oakville physiotherapy team encounters is a dull ache in one side of the face. The pain would typically get worse with chewing. Pain may radiate up into the temple region, behind the ear or down into the cheek. TMJ pain can often be mistaken for a headache.
Some TMJ disorders can cause painful grinding or cracking sounds. In other TMJ issues, the jaw can lock in an open or closed position. Some individuals have jaws that are just naturally noisier than others. If you have painless crepitus of the jaw, it is not usually cause for concern.
TMJ Conditions and Treatment in Oakville
As we mentioned earlier, the jaw moves a lot over the course of a day. These muscles can be overworked and get tired. Similar to when we work our muscles too hard in the gym, our jaw muscles can get overworked too! The 4 main muscles discussed above all have typical pain referral patterns. Pain originating from those muscles can feel more widespread.
The small disc that lays within the TMJ helps it move efficiently and provides some cushion to the joint. This disc can also cause trouble. The disc can get stuck in the wrong position and cause clicking or locking of the jaw. Sometimes the disc returns to its rightful position when the jaw moves and therefore movement is not limited. In other cases, the disc does not return to the proper position and mouth opening can become restricted. Our Oakville physiotherapist’s are experts at determining the root cause of jaw clicking and locking, and will be able to help guide treatment based on their exam findings.
Just like other joints in the body, the jaw can develop arthritis. It doesn’t occur as commonly as it does in other joints, but it can happen. The bone can break down and the fluid within the joint can diminish enough to create a very dysfunctional joint. The joint can be noisy, be painful upon opening, create limited opening capacity. Women are affected more than men.
TMJ Physiotherapy Treatment Oakville
Our Oakville physiotherapy clinic treats jaw pain all the time. Treatment will address the joint, muscle spasm and muscle strength. During the initial exam, our physiotherapists will ask questions about family history, history of the pain, aggravating factors for the jaw pain along with other pertinent questions related to your case. They will complete a physical exam to help determine what movements are effected, which muscles are problematic, and any weaknesses within the muscle/joint complex.
There are a number of different techniques the therapists can use to treat TMJ pain. Some of the larger muscles can be addressed from the outside of the jaw, and muscle release techniques can be used to help reduce tension. Some of the smaller jaw muscles need to be addressed from inside the mouth. The therapist can use gloves to treat the jaw muscles intra-orally. This may sound unusual, but treating the muscles from inside the mouth can result in a lot of relief of pain and discomfort.
Any issues within the joint can be addressed through mobilization and traction of the jaw joint. Our physiotherapists will use hands-on techniques to help guide the jaw through different ranges of motion, working to eliminate any restrictions in movement. Healthy jaws should be able to fit three knuckle widths inside the opening, so if any limitation is identified during the initial exam, the therapists will work diligently to restore normal range.
Our Oakville physiotherapists will also guide you through exercises that can help speed up your recovery. These exercises can be completed at home to help ensure all aspects of rehab are being addressed. Home exercises can be one of the most important aspects of a recovery process.
In addition to physiotherapy, acupuncture can be an excellent way to help relieve TMJ pain. Dr. Jenn, our acupuncture provider, will insert 1 or 2 needles on the affected sides of the jaw. These points go directly into the joint itself and into one of the big muscles that is responsible for moving our jaws. The acupuncture point that goes directly into the jaw joint can be particularly beneficial. Acupuncture is one of the only conservative treatments that can get down into the joint. Acupuncture will boost the healing response and can drastically reduce the time it takes to heal. Acupuncture is a great option for the treatment of TMJ pain.