Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition?
What Not To Do Temporomandibular Joint Disorder
Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check.
Chewing Gum
Gum chewing is not recommended for individuals with TMJ.
The jaw is one of the most used joints in the body.
Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
Resting sore muscles and joints is the first step in injury recovery.
Eating Chewy and Hard Foods
Chewy and hard foods make the jaw have to work overtime.
Avoid eating hard foods like chewy candies, hard and chewy breads, vegetables like corn on the cob, and fruits like apples.
These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.
Chewing Only On One Side
Many individuals chew their food on only one side of the mouth.
This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
Stay aware of chewing habits and make sure to utilize both sides of the mouth.
Individuals with dental issues or tooth pain are recommended to see a dentist.
Non-Functional Jaw Activities
Going through each day, individuals tend to do things unconsciously or out of habit.
For example, individuals:
Reading or writing might chew on a pen or pencil.
Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
These activities can place stress on the joint, worsen the condition, and extend the healing process.
Resting on The Chin
Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
This position can be comfortable, but it can affect the jaw.
This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
Breaking the chin resting habit can allow the joint to relax and heal correctly.
Teeth Clenching
Bruxism is the medical term for clenching the teeth.
This can occur during the day or during sleep.
Teeth clenching is often brought on by stress and can place incredible pressure on the jaw’s muscles and worsen TMJ.
A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)
Slouching
The function of the jaw is closely related to body posture.
The jaw operates optimally when the head is above the cervical spine and the posture is upright.
Slouching can change how the jaw muscles work and the way the jaw opens and closes.
Part of physical therapy for TMJ is working on posture adjustments and training.
This can involve strengthening the back and shoulder muscles and setting up posture reminders.
Sitting and standing correctly can keep the jaw operating properly.
Postponing Treatment
Many with musculoskeletal issues and symptoms wait for the pain to go away.
Individuals having problems with their jaw should not wait to get treatment.
TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)
Treatment
Treatment can involve:
Initial treatment focuses on pain relief and jaw function opens and closes improvement.
A guard can help with night teeth grinding/bruxism.
Anti-inflammatory treatments.
In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
Follow recommendations on what not to do and avoid certain activities.
Quick Patient Initiation
References
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. https://doi.org/10.11607/jop.1151
Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. https://doi.org/10.1371/journal.pone.0059980
Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. https://doi.org/10.2147/JMDH.S178507
Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon’s perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. https://doi.org/10.1111/adj.12593
Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477
Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. https://doi.org/10.5125/jkaoms.2018.44.2.43
Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. https://doi.org/10.11607/jomi.te20
The temporomandibular (tem-puh-roe-man-dib-u-lur) joint TMJ acts as a sliding hinge that connects the jawbone to the skull. There is one joint on each side of the jaw. TMJ jaw disorders are also known as temporomandibular disorders – TMD. These disorders affect the connecting point between the jaw and the skull that causes swelling and pain in the joint and the muscles that control movement. The disorder can be caused by a combination of factors, like stress, genetics, arthritis, or injury. The symptoms, pain, and discomfort are often temporary and can be relieved with self-care and nonsurgical treatment like chiropractic.
Jaw Disorders
If the jaw is not moving correctly or becomes imbalanced, it can stress the temporomandibular joint. If this happens, the jaw muscles and the neck and shoulder muscles can tense up and over time become fatigued as they overwork to compensate and keep the jaw balanced. The bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disc to maintain smooth movement. Jaw disorders can happen if:
The disc erodes or moves out of alignment.
The joint’s cartilage is damaged by arthritis.
The joint is damaged by impact trauma like hitting the head from a fall or sports accident.
Individuals that have been in an automobile accident.
Other factors include:
Tension or stress can cause individuals to grind or clench their teeth, known as bruxism.
Symptoms of TMJ vary from case to case. These symptoms might include:
Problems with opening or closing the mouth
Difficulty or pain while chewing
Pain or tenderness of the jaw
Pain in one or both of the temporomandibular joints
Aching facial pain
Neck and shoulder pain
Headaches
Aching pain in and around the ear
Dizziness
Locking of the joint
Clicking sound
Grating sensation
Chiropractic Relief
Chiropractors can help with TMJ by alleviating tension and dysfunction in the shoulder, neck, and jaw. Once the dysfunction is relieved, it reduces the pressure on various nerves. Treatment includes:
Manipulation of the jaw joint so it can move easily
Not all carbs are equal, with some having a more significant effect on insulin levels than others. For individuals with diabetes or insulin resistance, this is important. A food’s Glycemic Index – ranging from 0 to 100 – indicates how a particular carbohydrate will affect blood sugar and insulin levels.
Foods that digest quickly are high on the index.
Foods that digest slowly are lower on the index.
Foods high on the GI scale, include potatoes and white bread, are quickly broken down. This is what happens when going through a sugar rush that comes crashing down minutes later. Foods low on the GI scale, include sweet potatoes and whole oats, are digested gradually. This results in a steady rise in blood sugar levels. The following factors may influence the GI scale:
Food processing
The more processed the food, the higher the GI.
Fat and acid content
Foods high in fat, acid, or carbs eaten with fat or acid tend to have a lower GI.
Fiber content
Fiber slows down the rate of digestion, leading to a gradual, healthy rise in blood sugar levels.
Ripeness
Ripened fruits tend to have a higher GI than unripened fruit.
References
Alcantara, Joel et al. “Chiropractic care of a patient with temporomandibular disorder and atlas subluxation.” Journal of manipulative and physiological therapeutics vol. 25,1 (2002): 63-70. doi:10.1067/mmt.2002.120415
DeVocht, James W et al. “A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder.” Journal of the American Dental Association (1939) vol. 144,10 (2013): 1154-63. doi:10.14219/jada.archive.2013.0034
Pavia, Steven et al. “Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series.” Journal of chiropractic medicine vol. 14,4 (2015): 279-84. doi:10.1016/j.jcm.2015.08.005
Rubis, Lisa M et al. “A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report.” Journal of chiropractic medicine vol. 13,1 (2014): 55-61. doi:10.1016/j.jcm.2013.10.003
Jaw pain can make chewing, yawning, and talking a painful experience. This is a syndrome known as Temporomandibular Joint syndrome or disorder or TMJ and TMD. What happens is the temporomandibular joint that connects the jaw to the skull becomes inflamed. It is part of the musculoskeletal system, which means that chiropractors can treat the syndrome with various chiropractic techniques that include soft tissue work and temporomandibular joint adjustments. Chiropractic can bring lasting relief from Temporomandibular Joint Syndrome/Disorder.
How to Tell if TMJ Is Present
Jaw pain is the most common symptom but there are other factors that can cause pain. To help determine if it is TMJ, here is a list of additional symptoms:
Difficulty or pain moving the mouth such as when chewing
Popping sensation sound when opening/closing the jaw
Cracking sensation sound when opening or closing the jaw
If it is TMJ should an individual see a dentist or a chiropractor? This depends on the situation and individual.
If TMJ is caused by teeth grinding while sleeping, or there is pain/problems with the teeth then seeing a dentist is recommended.
If TMJ pain is accompanied by joint or muscle pain, or there is neck and/or back pain, then chiropractic is recommended.
Certain cases could require dental treatment and a chiropractor for the joint issues.
Chiropractic TMJ Treatment
Jaw Adjustment
One way chiropractic treats TMJ is through jaw adjustment/s. This varies from patient to patient. An example assessment and adjustment for TMJ.
The chiropractor will utilize the most beneficial technique/s for each individual.
The chiropractor will have the individual open and close their jaw while feeling each side.
They will determine which side opens first and widest, and which opens last and not as wide.
Then they will perform a jaw adjustment through gentle pressure applied to both sides of the jaw.
Soft Tissue Treatment
A contributor to jaw pain can be attributed to the muscles that are used to open and close. In this case, the chiropractor will perform soft tissue manipulation to loosen them up. This releases the jaw so it evens out. This also helps with headaches associated with TMJ. The focus is on three muscles:
Masseter
Pterygoid
Temporalis
A chiropractor will mobilize these muscles applying pressure repeatedly as the individual opens and closes their mouth.
Jaw Exercise Therapy
The chiropractor will recommend exercises to help quicken the healing process and strengthen the muscles. These are simple exercises that can be done at home or work to help relieve any discomfort or pain and for prevention.
Mouth Opening
Place one thumb under the chin
Open the mouth and gently push against it with the thumb
Hold for 5 to 8 seconds then close mouth
Repeat a few times every day
Mouth Closing
Open the mouth holding the chin with the index finger and thumb from both hands
Close jaw with gentle resistance with the fingers
Hold for 5 to 8 seconds
Repeat a few times every day
A chiropractor may collaborate with a dentist to provide the best treatment plan.
Body Composition
Body Dehydration
Dehydration happens when the body loses more water than it can replace. This can come from frequent:
Diarrhea episodes
Vomiting episodes
Too much alcohol the night before
Excessive sweating
Excessive urination
When dehydration sets in a wide range of symptoms can present. Early signs/symptoms include:
Dizziness
Headaches
Dry mouth
Cool skin
If dehydration is not addressed in the early stages, it can lead to not having the urge/need to urinate. There is potential for long-term health issues like high blood pressure. High blood pressure is common for individuals that are chronically dehydrated. When the body’s cells lack water, the brain sends a signal to secrete vasopressin, which is a chemical that constricts the blood vessels. This causes blood pressure to rise. This could eventually lead to heart failure. If the blood vessels continue to progressively narrow, oxygen, and blood circulation to the brain decreases. This results in migraine headaches and decreased ability to concentrate.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG*
email: [email protected]
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Ibi, Miho. “Inflammation and Temporomandibular Joint Derangement.” Biological & pharmaceutical bulletin vol. 42,4 (2019): 538-542. doi:10.1248/bpb.b18-00442
Blum, Charles L. “Chiropractic and dentistry in the 21st Century.” Cranio: the journal of craniomandibular practice vol. 22,1 (2004): 1-3. doi:10.1179/crn.2004.001
Brantingham, James W et al. “Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review.” Journal of manipulative and physiological therapeutics vol. 36,3 (2013): 143-201. doi:10.1016/j.jmpt.2013.04.001
https://www.nidcr.nih.gov/health-info/tmj
Asking questions is the best way to learn, of course, and chiropractic patients often ask questions about some of the health issues they face. Some chiropractic patients are curious about back problems, for example, because chiropractors are well known for being extremely knowledgeable when it comes to spine health and the musculoskeletal system. A few chiropractic patients want to know about TMJ disorders.
Here are a few of the most common things chiropractic patients want to know about TMJ disorders.
The Most Frequently Asked Questions about TMJ Disorders
�TMJ disorder?
A TMJ disorder affects the temporomandibular joint (TMJ), which is the joint where the jawbone connects to the head, just in front of the ear. The bones and muscles of the TMJ allow the jaw to move up and down, and side to side, enabling a person to talk, chew and yawn.
TMJ disorders (TMDs) can cause pain in the jaw joint and in the muscles that control the movement of the jaw.
How common is it?
About 12 percent of the population experiences symptoms of TMJ at any given time, according to the TMJ Association.
The Causes?
There are several known causes of TMJ disorders, including:
Dental procedures, especially those that require the mouth be open for a long time
Insertion of a breathing tube prior to surgery
Arthritis
Misalignments of the jaw
Grinding teeth, known as bruxism, may cause TMJ disorders but not everyone who grinds their teeth develops a TMD.
Medical professionals may not be able to determine the underlying cause of TMJ disorders in many cases but chiropractors can treat TMJ disorders even if the cause cannot be determined.
The Symptoms of TMJ disorder?
Many people with TMD describe their symptoms as a dull, aching pain that comes and goes in their jaw joint and in nearby areas. Some people with TMJ disorders do not experience pain but have trouble moving their jaws.
Other common symptoms of TMJ disorders include:
Pain or stiffness in the jaw muscles
Chronic headaches
Neck, shoulder pain
Clicking, popping or grating of the jaw joint when the individual opens or closes his or her mouth
Limited movement of the jaw
�Locking� of the jaw
Tinnitus, which includes ear pain, fullness, pressure, and ringing in the ears
Dizziness, vision problems
A bite that feels �off� when the person closes his or her mouth
Treatment for TMJ disorders?
The best way to treat TMJ disorders is to eat soft foods, ice the affected area with ice packs to ease pain and try to avoid extreme jaw movements, such as chewing gum or yawning.
Does Chiropractic treat TMJ disorders?
Yes, chiropractic safely and effective treats TMJ disorders. A chiropractor will perform a full evaluation of the patient�s temporomandibular joint and surrounding bones, muscles, tendons and ligaments to assess the full scope of the TMJ problem and determine its underlying causes. The chiropractor can then suggest a range of treatment that can include stretches and exercises that alleviate pain and melt stiffness in the jaw joint. The chiropractor can also detect and address any misalignments that may be contributing to TMJ pain.
For more information about the temporomandibular joint, TMJ disorders and chiropractic for TMJ problems, contact a chiropractor with experience in diagnosing and treating TMJ problems.
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Over-the-counter insoles do cost less, but they only support one arch in the foot. When only one arch is supported, the structure can collapse, and that’s when problems can begin in other parts of the body. Over-support of one arch can cause pain and symptoms, instead of relieving them.
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Radiculopathy is associated with some of the most significant causes of chronic or acute low back pain. However, it is important to note that the condition itself does not cause pain. Instead, elements of radiculopathy, such as disc herniation, nerve root impingement, and facet arthropathy are actually what causes the pain.
Radiculopathy is a condition of the spine that occurs when a nerve is compressed, causing pain, weakness, tingling, or numbness along the nerve�s course. In the lower back, that course is in the leg. While it is most common in the lower back, radiculopathy can occur in the cervical or thoracic regions of the spine as well.
NCBI Resources
The�temporomandibular joints, TMJ, are the lower jaw hinges that sit on either side of the head in front of each ear. They are responsible for the lower jaw opening, closing, sliding, and rotating. The TMJs are the most body�s most complex joints. The typical person uses them more than 5,000 times a day by talking, laughing, yawning, chewing, eating, smiling, and swallowing.
Temporomandibular Joint Disorder, or TMJ, is a common condition that affects the jaw. It can be extremely painful and many people are turning to methods other than medication or surgery to relieve that pain. While lifestyle changes such as diet may help, chiropractic care has been cited as a viable treatment for TMJ pain.
At first, this may seem counter-intuitive simply because it is widely believed that chiropractors only treat the spine and neck. This commonly held belief is not entirely accurate. Chiropractors treat all joints, including the spine and neck. A chiropractor may treat ankles, wrists, knees, and, yes, even the jaw. Sometimes the neck and spine can be contributing factors and they can be treated with chiropractic care as well.
What Is Temporomandibular Joint Disorder?
The joint that connects your jaw to your skull and allows you to open and close your mouth is the temporomandibular joint. When you have problems with the muscles or joint in that area it is called TMJ, or more accurately temporomandibular disorders, or TMD.
This disorder is characterized by pain and stiffness on one or both sides of the jaw. The jaw may also lock or get stuck in either a closed or open position. Patients may also notice a popping, clicking, or grating sound in the jaw when chewing, yawning, or when closing or opening their mouth. They may also have trouble chewing and even experience swelling.
Doctors don�t know what causes TMJ. It seems to be linked to trauma to the neck, such as with whiplash, but it also can be caused by:
Arthritis in the jaw
Grinding the teeth
Stress that causes clenching of the jaw
Movement of the disc, or soft cushion, that lies between the socket and ball of the jaw
Diagnosis & Treatment For Temporomandibular Joint Disorder
Many conditions can mimic the symptoms of TMD. After taking a medical history, your doctor will check the joints in the jaw for popping, clicking, or grating sounds. He will also assess the patient�s pain or tenderness level and check for any stiffness. During the exam, the doctor will assess the job and its ability to function properly. X-rays may also be a part of the examination.
If the doctor can pinpoint the probable cause of the TMJ, he may prescribe certain treatments or make recommendations that will help. Medication is one option, mainly stress or anti-anxiety medication to help the patient relax. A night guard or splint is another option. It helps to put the patient�s teeth in the correct position. A splint is worn all the time and a night guard is worn only at night. Dental work is another option and in come more serious cases, surgery.
Chiropractic Care For Temporomandibular Joint Disorder
Chiropractic for TMJ is not only common, but very effective. The chiropractor may perform neck or spine adjustment as well as adjustments to the jaw. This means that the patient may experience pressure on their skull, jaw, upper spine, or neck as the chiropractor treat the condition. There are also soft tissue treatments that the chiropractor may perform during the course of treatment for TMJ.
The chiropractor will often recommend lifestyle and diet changes to patients. This offers the patient the opportunity to treat the whole body as opposed to just one area. They may apply cold packs or heat packs to the area, recommend supplements, and teach the exercises designed to lessen the pain and encourage healing. Chiropractic is a safe, effective, and non-invasive treatment for TMJ.
So if you or a loved one have been diagnosed with TMD and/or are experiencing TMJ pain, give us a call. Our Doctor of Chiropractic is here to help!
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This disorder is characterized by pain and stiffness on one or both sides of the jaw. The jaw may also lock or get stuck in either a closed or open position. Patients may also notice a popping, clicking, or grating sound in the jaw when chewing, yawning, or when closing or opening their mouth. They may also have trouble chewing and even experience swelling.
