In a survey of people who have used complimentary and alternative medicine for TMJ disorders, the people most satisfied with the results were those using the “hands-on” therapies of chiropractic, massage, and acupuncture. (J Am Dent Assoc. 133(9):1189-1196)

One single-patient study examined a person who experienced TMJ clicking, teeth grinding, pain chewing, inability to open the mouth as wide as usual (“reduced jaw opening”), and headaches for 3 years. After just 3 weeks of two 30-minute sessions per week of “Western massage techniques combined with strain-counterstrain techniques”, “TMJ-related pain decreased and maximal jaw opening increased by almost a third. Jaw clicking decreased fourfold to once monthly.” (Journal of Bodywork and Movement Therapies 11 (3):223-230)

Common problems we see in our office involving the TMJ include: TMJ Syndrome (cervical involvement), myofascial, postural, subluxation-related dysfunction, dental abnormalities or pathologies, synovitis, capsulitis, disc inury, tendinitis, and arthritis.

When you come in for your appointment, the doctor will review your medical history and perform a physical exam. This along with some basic orthopedic and neurologic testing will usually provide enough information for a diagnosis. Sometimes, however, X-rays, CT scan, or MRIs may also be needed, primarily for those who are in severe pain and in cases where a patient does not respond to treatment. 

Once the doctor determines the cause of your condition, he will create a custom treatment plan to decrease your symptoms and correct the problem that caused them. This may include an adjustment, if there is cervical or TMJ subluxation-related joint dysfunction. It may include physical therapy in the form of ice, heat, ultrasound, or interferential electric stimulation.  In some cases, acupuncture or massage therapy may also be recommended.

Many TMJ disorders have been shown to benefit from acupuncture. In a study of 45 people suffering long-term “facial pain or headache of muscular origin”, it was found that “both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs.” (Acta Odontologica. 1991, 6; 49(3):153-158)

Three of the five extra-articular TMJ disorders listed above respond well to chiropractic care, those being TMJ Syndrome (with cervical involvement), postural involvement, and myofascial involvement.

If there is myofascial involvement, then massage therapy, especially certain techniques like myofascial release, may be beneficial. “Massage…is a simple and efficient method that can be recommended for patients presenting with temporomandibular joint dysfunction syndrome.” (Rev Stomatol Chir Maxilofac. 2009, 4; 110(2): 77-80)

For those extra-articluar causes of TMJ that are related to dental abnormalities, the doctor can even integrate a patient’s care plan with their dental care plan, working in conjunction with a recommended dentist, or the patient’s own dental health care provider.

As for intra-articular TMJ disorders, the following is a brief rundown on a few of the most common, along with their causes and recommended treatments:

Capsulitis is caused by overstretching, yawning, keeping the mouth opened wide for prolonged periods (such as in some dental procedures), and microtraumas caused by poor chewing habits or by occlusional problems. In the early stages ice and rest are usually the only intervention required.

Synovitis is usually caused by direct trauma (such as a sports injury), chronic disc injury, or a spasming temporalis or pterygoid muscle, though excessive gum chewing may also be a cause. Joint manipulation and relaxation of the mastication muscles are often helpful in relieving the symptoms and correcting the causes of synovitis. Besides joint manipulation, certain massage techniques (including trigger point therapy and myofascial release) and ultrasound can help free up movement of the joint caused by restrictive adhesions.

Disc Derangement can also benefit from joint manipulation to help to stabilize the joint when adhesions are present. In a single-patient study examining the effect of chiropractic on TMJ disorder involving disc derangement, after 9 1/2 weeks of 2 chiropractic sessions per week, the patient’s pain and clicking went away completely, and their ability to open their mouth wide returned to normal. (J Orofac Pain. 2003 Summer;17(3):224-36)

In chronic cases of disc derangement, chiropractic care, physiotherapy, massage therapy, and acupuncture techniques are all integrated with dental approaches (like splints and stabilizing appliances) for maximum healing. Sometimes in these chronic cases, surgery (such as discoplasty or discectomy) may be recommended.

Whatever your care plan, after your symptoms of pain have diminished you may be given TMJ exercises and stretches to do at home to strengthen the joint and supporting muscles.

What is TMJ?

While the term TMJ is commonly misused to refer to TMJ disorders, the TMJ itself is actually a part of the human anatomy, specifically a part of the jaw known as the temporomandibular joint.

The TMJ is the joint, or pair of joints, on the side of the head, one on each side, in front of the ears where the lower jawbone (or mandible) attaches to the bone that makes up the side skull (the temporal bone). Together, these two joints are the “hinges” that allow us to yawn, chew, and even talk.

As a reminder, a joint between two bones consists of soft cartilage covering the attachment points of each bone with a gel-like disk between them acting as a shock absorber. As the TMJ makes two motions in one – a sliding or gliding motion in addition to a hinging action – it is one of the more complex joints in the body, and especially when you consider how often it is used, also one of the joints most prone to damage.

The National Institute of Dental and Craniofacial Research a division of the National Institutes of Health estimates that TMJ disorders affect over 10 million Americans (or 5-15%).
TMJ disorders (sometimes seen written as TMD) generally involve problems with the TMJ itself, the larger jaw, or the surrounding facial muscles. Both  joints or only one may be affected in a TMJ disorder. A TMJ disorder can be the result of the disc in the joint eroding or slipping out of alignment, or the cartilage on the ends of the bone getting damaged by impact or disease, or any number of activities that overwork or overexert the muscles responsible for stabilizing the joint.

Other terms used to refer to TMJ disorders include: myofascial pain dysfunction syndrome, tempromandibular dysfunction, orofascial pain, and internal derangement.

There are many different types of TMJ disorders, mostly based on the specific cause. Some TMJ disorders have their cause inside or directly involving the temporomandibular joint, such as direct injury to the joint. These are called intra-articular causes of TMJ disorders, and include: synovitis, capsultitis, tendonitis, and arthritis. 

But there are also extra-articular TMJ disorders, or those caused by something other than the actual joint itself. An injury to some other part of the jaw or related muscles of the head and neck (such as whiplash), for example, would be an extra-articular cause. As would TMJ Syndrome (with cervical involvement), postural involvement, myofascial involvement, subluxation-related dysfunction, and dental abnormalities. 

Other possible causes of TMJ disorders include:

• stress manifested as a tightness in the face and jaw muscles
• clenching and grinding the teeth
• a slipped disc
• osteoarthritis and rheumatoid arthritis

The symptoms of a TMJ disorder are as follows:

• a clicking sound or a grating sensation when opening and closing your mouth
• a locking of the joint making it hard to open and close your mouth; not being able to open your mouth as wide as usual
• tenderness or an aching pain around the jaw or other parts of the face, which can then radiate to the neck and ears
• discomfort or difficulty chewing; an uncomfortable or uneven bite
• headaches, toothaches, earaches (and hearing problems)
• neck pain
• dizziness
• a feeling of tiredness in the face
• swelling around the side of the face

TMJ disorders can impact a person's ability to eat (including chewing and swallowing), to speak, or make facial expressions. And in extreme cases, they can impede on one’s ability to breathe.  At Ravenswood Chiropractic & Wellness Center we understand the impact TMJ disorders can have on your day to day activities.  We accommodate same day appointments for jaw pain.  Expert team members  can be reached at 773.878.7330 Monday through Saturday to schedule an examination for you.