Have you been having jaw pain or heard a clicking sound when you open or close your mouth? Have you ever had difficulty or felt pain when chewing? If you are experiencing any of the symptoms, you might be having the temporomandibular joint (TMJ) disorder. TMJ pain could severely affect one’s life well-being, but diagnosing and treating TMJ disorder usually are very complex. There is no single treatment that works for all kinds of TMJ disorders and each person responds differently to treatments. In this article, Dr Lisa Chong, who has more than 25 years of clinical experience in treating TMJ will go through some of the common methods to treat TMJ dysfunctions, analyse their differences, and compare their strengths and weaknesses. We also provide a TMJ diagnostic chart at the end of this article to allow you to better understand your current situation.
TMJ Physiotherapy
Physiotherapy is a common and effective way of treating TMJ pain. TMJ physiotherapists may utilize a range of treatments, including:
Hands-on manual therapy: it could help the patient restore a pain-free range of motion at the TMJ, off-load the irritated TMJ disc and enable proper joint gliding.
Training in jaw and posture: physiotherapists will provide training to help release excessive tension of the tight chewing muscles or to address any postural issues that may increase strain on the jaw.
Take-home exercise: you may also receive a take-home exercise to address the imbalances or tension of your jaw muscles and to correct the faulty motor patterning.
Neck and back treatment: Joint restrictions found in these areas could severely affect the jaw position and movement patterns.
Pros
Physiotherapy can treat TMJ disorder in a non-invasive way and it is usually a very effective method to help reduce the TMJ pain and discomfort and improve one’s functionality. The physiotherapy is also customizable which means each individual will receive tailored treatments to address the specific needs and symptoms.
Cons
However, it takes time to see the effects of physiotherapy and the effectiveness highly depends on the skills and experiences of the physiotherapist. In addition, for severe TMJ dysfunction cases, Physiotherapy alone might not be sufficient to resolve the issue.
Osteopathy
The osteopath will first conduct a thorough assessment of all the areas of your body that could be related to TMJ dysfunction, which usually include the jaw, head, neck, shoulders and mid-back. You will also be asked a series of questions about your sleeping conditions and stress level, as well as your job and hobbies to identify where your TMJ issues stem from. While both Osteopathy and physiotherapy include hands-on techniques to remove pain and improve functionality, unlike physiotherapy targets a certain body part with specific exercise, osteopathy usually uses a broader range of techniques and treats the body as a unified whole. Osteopaths usually utilise:
Holistic approach: Osteopaths consider the entire body in their treatment approach, not just the jaw. They may treat other parts of the body, like the neck, spine, and shoulders, that could be contributing to TMJ symptoms.
Soft Tissue Techniques: Osteopaths may use soft tissue techniques, such as myofascial release and trigger point therapy, to address muscle knots and tension around the TMJ. This can help reduce pain and improve jaw function.
Improve body circulation: Techniques used can help to improve blood circulation and lymphatic drainage around the jaw and facial area, which may help reduce inflammation and accelerate healing.
Lifestyle advice: The Osteopath will also provide lifestyle advice to reduce teeth grinding manage stress and prevent future TMJ issues.
Pros
As osteopathy treats the body as a whole, it could help improve overall health and well-being in addition to the problem area. The techniques that are used are usually very gentle and suitable for a wide range of patients. It is also particularly recognised as managing chronic conditions.
Cons
Just as physiotherapy, it takes time to see the effect and the effectiveness highly depends on the Practitioner’s skill. Currently, there is only limited evidence supporting osteopathy and the availability of it could be lower than physiotherapy.
Chiropractic Treatment
A TMJ Chiropractor focuses on correcting imbalances in the function of the TMJ joints and the muscles around them, enabling a more symmetrical movement during mouth opening and closing. Tight muscles often lead to uneven jaw movements, which can also result in symptoms affecting the face and head. Therefore, treatment targets these areas to alleviate such issues.
Below is the list of common techniques that are used in Chiropractic treatment. Even though the techniques look similar to some of the treatments we mentioned before, but they all have different focuses and underlying philosophies. Chiropractic treatment usually focuses on adjusting the spine and improving nerve function. It also performs specific adjustments to the haw to improve alignment and function.
Manual adjustment: Utilizing mild pressure on the jaw and adjacent regions to enhance alignment and movement.
Soft tissue therapy: Methods like massage and myofascial release are employed to soothe and elongate the muscles of the jaw. Occasionally, dry needling of the targeted muscles is also performed to provide relief.
Exercise and advice: Recommendations for specific jaw exercises and lifestyle modifications to aid in managing symptoms associated with TMJ.
Pros
One of the most significant benefits of treating TMJ disorder with Chiropractic is that it helps improve the overall alignment and this can be effective if the pain is caused by the misalignment of the body. It is a comprehensive method as it takes care of areas that could be contributing to TMJ symptoms.
Cons
As chiropractic treatment mainly targets improving alignment, its effectiveness can vary widely among individuals depending on their specific condition, and some may not respond to the treatment. It is also a less common practice than physiotherapy and therefore needs more empirical evidence to support its effectiveness.
TENS Treatment
TENS treatment is a type of neuromuscular therapy that utilizes low-frequency electrical currents, targeting areas of pain in the body. Electrodes are applied to these painful spots to activate nerve pathways, producing a tingling and massaging effect that helps soothe pain.
Relieve the tension: the electrodes of a TENS unit will be attached to the pain points, such as the jaw joint or the neck, and the low voltage electrical current encourages your jaw muscles to relax.
Block pain signal: the TENS unit operates by obstructing pain signals sent to your brain. Rather than experiencing pain, you'll notice a tingling and massaging sensation resulting from the electrical stimulation.
Pros
TENS treatment is a generally safe and convenient way to treat TMJ as it can be done at home. But please make sure to speak to a healthcare provider before start using the TENS unit.
Cons
The TENS machine is usually safe, but caution is needed in certain cases. Avoid using it on damaged skin, areas with altered sensation, swollen spots, near tumours or clots, recently radiated areas, and around major neck arteries. Side effects can also occur, such as skin irritation and unusual sensations around the treatment area.
Botox
Botox is one of the top non-surgical options for TMJ discomfort, which can ease muscle tension for several months at a time. It works by blocking the nerve signals that cause muscles to contract. When injected into the muscles involved with jaw movement, it reduces muscle activity, thus easing tension and pain
Pros
Botox is one of the top non-surgical options for TMJ discomfort, which can ease muscle tension for several months at a time. It works by blocking the nerve signals that cause muscles to contract. When injected into the muscles involved with jaw movement, it reduces muscle activity, thus easing tension and pain.
Cons
However, using botox to treat TMJ is just a temporary solution and only typically lasts for 3 to 6 months. Repeated treatments are required to maintain the effectiveness. In addition, it is not a comprehensive solution and it causes potential side effects, such as pain, bruising and unintended muscle weakness in some rare cases.
If you have tried all the treatments above and still not have had the TMJ disorder treated, you may have other complex underlying TMJ issues and need a careful diagnosis from an experienced TMJ expert. Dr Lisa Chong, with over 25 years of experience in treating TMJ and is regarded as the expert in the field will be happy to help you. You can read through the TMJ diagnostic chart below to get a better understanding of your condition before you make a consultation.
TMJ Diagnostic Chart
General Question
Have you ever had a severe blow to the head or jaw
Any whiplash neck injuries
Have you ever been involved in any serious accidents
Jaw Joint Symptoms
Does your jaw feel tired after a big meal
Are there any foods you avoid eating?
Do you ever get dizzy?
Do you ever feel fainty?
Do you feel nauseated？
Is there a family history of TMJ problems or headaches?
Do you ever hear or feel clicking, popping, or cracking sound from your jaw joints?
Did you have jaw locked where you were unable to open or close your mouth?
Do you have difficulty in opening your mouth wide or yawning?
Have you ever had pain in either jaw joints?
Ear and eye symptoms
Do you have itchiness or stuffiness in either ear?
Do you get pain in, around or behind either ear?
Do you suffer from loss of hearing?
Do you hear ringing , buzzing or hissing sounds?
Do you hear granting noise?
Do you wear glasses or contacts?
Arethere times when your eye sight blurs?
Do you find yourself adjusting your glasses time and again?
Breathing
Do you have allergies?
Do you have sinus problems?
Do you snore at night?
Is your nose stuffed even when you don’t have cold or flu?
Pain symptoms
Do you suffer from any of the following?
Tension headache
Migraines
Headache R or L temple
Headaches back of the head
Stiff neck/neck pain
Trouble sleeping
Sore teeth upon waking up
Jaw ache while chewing
Ear pain
Chronic shoulder/back pain
Grind teeth
Tired jaws after sleep