The TMJ acts as a sliding hinge joint that is connected on each side of the skull. It is important in opening and closing the mouth. There are numerous muscles that connect to the joint in aiding mouth opening/closing. Within the joint is a small disc, which keeps jaw movement smooth and consistent.
TMJ disorders tend to develop from long-term grinding of teeth, arthritis (rheumatoid or osteoarthritis), jaw trauma or connective tissue diseases. These issues can cause joint damage or the joint to move out of proper alignment. Symptoms include tenderness in the jaw, pain in one or both temporomandibular joints, pain around the ear, difficulty or pain while chewing, facial pain and locking of the temporomandibular joint. It is very common to have clicking or popping without pain when opening or closing the mouth. In this case treatment is not necessary.
There are a variety of different options when it comes to treatment of temporomandibular joint dysfunction. Medications include pain relievers, anti-inflammatories or muscle relaxants. Nondrug therapies include mouth guards to avoid teeth grinding, physical therapy to strengthen/stretch jaw muscles, ultrasound to loosen jaw musculature and chiropractic care.
When it comes to TMJ treatment in my office, I focus on both jaw position and tight musculature surrounding the temporomandibular joint. A lot of times a patent’s jaw is higher on one side or the other due to the tight muscles around the TMJ. These muscles need to be calmed down first. I do this by loosening muscles surrounding the joint including the masseter (helps with chewing), lateral pterygoid, medial pterygoid and temporalis muscle (on side of skull above ears). Once these muscles are more relaxed, I can adjust the jaw to a better position. The third aspect of treatment involves the cervical spine. Studies show that adjusting the cervical spine, specifically the C2 area (Axis) can help relieve TMJ symptoms. In many cases TMJ and cervical spine dysfunction tend to be opposite one another. For example, if a patient has left TMJ dysfunction they usually have right sided cervical C2 dysfunction. This is a tendency I have noticed from past TMJ cases. If TMJ dysfunction persists after drug and non-drug therapies, surgeries or injections of the jaw may be necessary to acquire full relief.
Below are jaw stretches that I instruct patients to do at home to keep the TMJ as loose as possible. If you are having TMJ issues give these a try!
Trapezius self traction stretch
Sitting tall, grasp the back edge of chair with hand of side to be stretched. Turn head toward same side and lean head and body away to feel a stretch in the side of the neck. To increase intensity, use free hand to gently pull head in direction of stretch.
Occipital Lifts
Put the bottom of your hands on each mastoid process. Pull up and lift head with one hand while pulling down on the other. Perform for 3 minutes.
Chin Tucks
Take a deep breath in. While breathing out tuck chin into chest. Repeat 10-15 times.
Platysma Stretch
Press down on chest with one hand. Raise head to the sky while relaxing shoulders and bringing chest forward. Hold for 30 seconds. Perform 5 times.
Resistance open and close
Put one hand under chin. While opening mouth push against it with hand. Reversely, while closing mouth try to resist the action with hand. Perform back and forth for 3 minutes.
Mouth stretch
Open your mouth as wide as you can while pushing tongue to the floor. Hold for 20 seconds. Repeat 5 times.
Tongue and eye movements
Move tongue and eyes as far as you can in opposite directions for 30 second intervals. Repeat 5 times.
AEIOU’s
Open your mouth as wide as you can and say AEIOU. Do this 5 times for one set. Perform 3 sets.
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