The jaw joint is located just in front of the ear canal, and it joins the jaw bone (mandible) to the skull near to the temple. The jaw joint is also called the temporomandibular joint (TMJ). Problems affecting this joint are usually known as TMJ disorders. However, there are various other medical terms for for this condition – for example, TMJ dysfunction, TMJ pain and myofascial pain disorder.
A joint is where two bones meet. Joints allow movement and flexibility between two bones. The jaw joint allows movement between the jawbone (mandible) and the skull. Muscles attached to the skull and jawbone cause the jawbone to move as the mouth is opened and closed.
Inside the jaw joint, there is a smooth material called cartilage, covering part of the bones. There is also a cartilage disc within the joint. The joint is lubricated by fluid called synovial fluid.
What are the symptoms of temporomandibular joint disorders?
- Pain in the joint area or nearby. The pain is usually located just in front of the ear, and it may spread to the cheek, the ear itself, and to the temple.
- Jaw movements may be reduced. This may be a general tight feeling or a sensation of the jaw getting stuck. Very rarely, the jaw may get ‘locked’, causing difficulty in opening or closing the mouth.
- Clicks or noises can sometimes be heard coming from the jaw joint when you chew or move your mouth. These noises can be normal, so they are only relevant if you have other symptoms in the joint, such as pain or reduced movement.
- Because the ear is very close to the jaw joint, some people get ear symptoms such as noise in the ear, sensitivity to sound or dizziness (vertigo).
- Headaches – the muscles around the jaw can radiate pain into the head.
What causes temporomandibular joint disorders?
In general, TMJ disorders are thought to have a ‘multifactorial’ cause, meaning that there are usually a number of factors contributing to the cause. These factors can be grouped into two types: problems linked to the muscles working the joint, and problems inside the joint itself. The muscle problems are the most common type, particularly for younger people.
Problems with the muscles may be caused by:
- Overactivity of the jaw muscles. This can occur if you clench your jaw a lot during sleep, which is quite common. Rarely, other conditions make the jaw muscles overactive. For example, there are some rare kinds of movement disorders (called orofacial dystonias) which cause excessive jaw clenching.
- Increased sensitivity to pain. We don’t know why this happens, but it may be linked to stress, or to some other process which affects pain sensitivity. Some doctors call this type of problem a pain syndrome because the exact cause of the pain is not known.
Muscular causes can be associated with stress, anxiety, clenching, bruxism; secondary component to all other forms of TMD; palpable muscle tenderness; often bilateral; provoked by activity (clenching, chewing, bruxism); confirmed by muscular management techniques and patient education regarding stress and other contributing factors.
Problems in the joint may be caused by:
- Wear and tear to the inside of the joint – for example, wear and tear to the cartilage. Sometimes this is due to osteoarthritis. This problem tends to affect older rather than younger people.
- Injury to the TMJ or to its cartilage disc can cause TMJ pain.
You may feel pain along the joint, joint pain with movement, clicking of the joint, pain on clenching your teeth, odd movement of the joint – not a smooth movement when you open or close your jaw or notice that you can’t open your mouth fully.
What can we do to help?
We will check how you move your jaw; how you bite; muscle tension; how you open your jaw; how it closes; neck mobility. Generally neck pain is present in all TMD cases; presence of upper cervical spine or head pain; accessory movement restrictions; unilateral or bilateral; multiple levels may be involved; confirmed with joint interventions.
Approaching jaw problems from many angles has been shown to be effective at reducing symptoms of TMD.
This may include:
Soft tissue mobilisation
Exercises against resistance
Guided opening and closing
Manual joint distraction
Yoga – see www.aerodynamicyoga.com