by Nik Panagos, RMT
What is Temporomandibular joint (TMJ) dysfunction?
(1) TMJ dysfunction is a disorder of the muscles of mastication (chewing), the temporomandibular joints, and associated structures. This disorder also presents with pain, discomfort, or limitations whilst at rest or movement.
How do I tell if I have issues with my TMJ?
TMJ dysfunction may present with a combination of the following symptoms:
- Pain in the TMJ at rest or with movement
- A clicking feel or sound with pain
- Movements impaired such as chewing/swallowing/opening the mouth/closing the mouth/moving the mouth side to side
- Sinus congestion with pain
- Ear pain
- Poor posture
I have clicking or popping in my jaw when I chew or yawn, is that normal?
Clicking or popping sound in the jaw is normal as long as no pain occurs or no movements of the jaw are impaired. If none of the listed symptoms occur,then it is not TMJ dysfunction.
Are there different types of TMJ Dysfunction?
The three main types of dysfunctions are:
- Internal derangement of the joint: Dislocation, displaced discs, trauma to the lower jaw
- Degenerative joint disease: overuse or aging of joint, osteoarthrosis, rheumatoid arthritis, or perforation (puncture) of disc
- Myofascial Pain: Muscles surrounding the joint in a hypertensive state (high tension). Usually caused from overuse of clenching of the muscles of mastication (chewing muscles)
What are some common representations of TMJ dysfunction?
(2) Up to 70% of TMJ dysfunction patients suffer from pathology or malposition of the TMJ disc (disc displacement).
Normal movement of the jaw function: the lower jaw opens as the disc slides with the lower portion of the jaw (condyle) allowing for normal opening and closing without pain or dysfunction
Anterior disc displacement with reduction (ADDWR): The disc is displaced slightly forward causing a clicking and potentially some pain as the lower portion of the jaw (condyle) slides over the condyle ending in the proper open position
Anterior disc displacement without reduction (ADDWOR): The disc is displaced so far forward it prevents thejaw from opening fully.
How do TMJ dysfunctions occur?
There are many different factors that can lead to TMJ dysfunction. Some common reasons why it occurs include:
- Excessive use of mastication (chewing) muscles (I.e. chewing gum, chewing tobacco)
- Careers with repetitive strain on muscles around the TMJ often due to prolonged seated posture (I.e. call centers, receptionist, instructors)
- Accidents involving neck/upper back/shoulder trauma (I.e. Moter vehicle accident, contact sports)
- Dental issues (I.e. missing teeth, uneven overbite or underbite, deviation of jaw)
- Stress grinding during sleep
How can Massage Therapy help with TMJ dysfunction?
Massage therapy will help with TMJ dysfunction by physically manipulating restricted muscles, ligaments, and joint capsules surrounding the TMJ. Reducing the restricted muscle tissues will allow for movement to resume without pain or limitation. Mobilizing the joint ligaments and stretching will allow for proper function of the joint space to resume. Stretching the joint capsule will reduce pain, improve function, and reduce clicking if present. Manipulation of these structures will also help improve the overall function of the jaw.
What can I do at home to help prevent or reduce symptoms of TMJ dysfunction?
There are many different ways to help with TMJ dysfunction at home; some of the following ways you can help at home are:
- Self-massage to the muscles of mastication (chewing muscles)
- Reducing the use of chewing gum or chewing tobacco products
- Keeping overall dental hygiene in good standing as tooth decay or wear can cause alignment issues that can put extra strain on muscles surrounding the TMJ
- Follow a prescribed home exercise program to improve the strength and motor control of the muscles that influence the TMJ as well as postural strengthening exercises for the neck and upper back.
Do you treat inside the mouth as well? Is this the only way it can be treated?
Due to the nature of where the TMJ is located, treating within the mouth is usually the best way to access the joint itself for manipulation. However, the TMJ can also be treated without internal mouth manipulation.
In summary, the TMJ is an overlooked area for treatment unless it advances to a point of dysfunction or severe pain. Physical manipulation of TMJ dysfunction is an effective method of treatment for the condition.
1 Clinical Massage Therapy, Fiona Rattray, Linda Ludwig, Jan, 2005 Pg 597 (Citation 2021-07-13)
2 Meghan K Murphy, BE, Regina F, MacBarb, BS, Mark E. Wong, DDS, and kyracos A. Athanasiou, PhD, PE. November/December 2013. Temporomandibular joint disorders: A review of etiology, Clinical management, and tissues engineering strategies Volume 28, Issue 6 (Citation 2021-07-13)
1 Depiction of temporomandibular joint and associating structures, (Citation 2021-07-13), motionspecficrelease.com. https://bodytechphysio.files.wordpress.com/2021/11/5a1f7-4a037c_398c46d6c03c45e0bf0fe91839b2fc33mv2.webp2 A schematic representation of the position of the TMJ disc in three different conditions, (Citation 2021-07-13), researchgate.net.