Jaw (TMJ) Pain
Your jaw is one of the most active parts of your body.
It moves as you eat and speak, opening and closing many times daily.
Your jaw (mandible) connects to your temple bones, giving them the name “temporomandibular joints”, or TMJs for short.
TMJ Movements
They’re also the most complex joints in your body.
As your jaw hinges open, the jaw has to glide forward so that it can open fully. As the jaw glides forward it slides along on a small disc, which is held by ligaments.
A complex array of muscles opens, closes, protrudes, retracts and moves your jaw sideways.
If these muscles or ligaments stop functioning together correctly, your jaw can fall off the disc as you open or close your jaw. This is the popping or clicking sound that some people hear.
When most people close their mouth the jaw will return correctly to the disc. If it doesn’t, then the jaw can become locked.
TMDs are the 2nd most prevalent chronic pain condition in the world, 2nd only to low back pain, and the most common orofacial disorder.
Prevalence among women is about 10%, compared to 3% in men.
It typically occurs between 18-44 years of age, and is associated with:
- clenching and grinding the teeth (bruxism)
- stress and depression
- migraines and tension-type headaches (TTH)
- whiplash
- increased neck pain and dysfunction
Most common types of TMD
The most common type of TMD is “myogenic”, which is caused by muscle dysfunction.
The least common is “arthrogenic”, which is caused by joint dysfunction.
The second most common is “mixed”, which is a combination of both.
Type of pain
Your TMJs and their muscles are innervated by the trigeminal nerve. This nerve also innervates your face, teeth, ears, and the meninges around your brain.
Problems with your TMJs can cause pain in your face, ears, neck, a headache, or it can mimic a toothache.
The muscles responsible for moving and stabilising your jaw attach to your head and neck, which is why head or neck injuries, or prolonged postures can cause TMD.
Malocclusion of your teeth can also cause TMD.
TMD can cause headaches, or muscle pain to the temples that mimics a headache.
This muscle pain, called “myalgia”, is not a true headache (it happens outside your skull, whereas headaches involve inflammation of the meninges surrounding your brain, inside your skull).
Myalgia must be differentiated from a headache because the treatment is different.
TMJ Pain Treatment
Research shows that TMD, headaches and neck pain respond well to manual treatments and exercises.
If the cause is dental (such as malocclusion or trauma to the teeth) then a dentist should be consulted.
Chronic TMD, lasting three months or more, is very common. It can also lead to degeneration and osteoarthritis of the TMJs over time.
It is important to treat TMD early to prevent complications or deterioration of the disorder.
Dr Gerard Keown started practice in 1997 as a remedial massage therapist and went on to complete his Bachelor of Health Science as a Naturopath in 2003, before finally completing a Masters Degree in Chiropractic at Macquarie University in 2010. He also has a special interest in headaches and neck pain.