This can be termed TMJ syndrome or dysfunction. At Chirolink we look at this as the ‘bitten off more than you can chew’ condition and we’ll explain why.
It is brought on by stress – mechanical stress of actually biting off more than you can chew (trauma) or overall systemic stress causing grinding or clenching (bitten off more than you can chew with life in general). When you have it, you know about it, and no matter the cause, it shouldn’t be left alone – seeking treatment is the best thing you can do for yourself.
For example, just two weeks ago Sarah came to Chirolink with TMJ syndrome. She arrived, eyes tearing. Her jaw was in excruciating pain, and she was tired. It started a few days prior but came to a peak that day. She came to the clinic on the advice of a friend.
Where do we begin?
Firstly, Sarah was stressed. She had a lot on her plate between having 4 children, running between different schools and extracurricular activities, and having her sickly mother to take care of – this was the last thing she needed! Sarah was struggling to not only eat but talk too. The one side of her jaw was incredibly sore and almost felt swollen and it was making a large clunking sound. She had some ringing in her ear and a headache creeping up with some neck stiffness.
So what was going on?
The reality is that TMJ syndrome is an exceptionally prevalent condition, but it can vary from mild to severe. Most people only seek some form of treatment when it starts to affect their daily lives more than they are used to. Anything that disturbs the normal biomechanics of this joint can result in a series of reactions or changes but to fully understand this, we have to understand the normal structure and movement of the joint.
The TMJ is a joint that is made of small complex pieces that work together to create an effective and high-functioning hinge joint. It needs to be stable, resilient, and adaptable to efficiently handle being used so much, and it needs to work fluidly in conjunction with the same joint on the opposite side. Like most joints, there is cartilage on each surface to provide fluid motion, but the TMJ is special because it has a fibrous disc that sits between these surfaces to accommodate complex movement. This is important to note because it is heavily involved with TMJ syndrome. When we open and close our mouths the disc slides forward and back respectively and at the back of the disc, there is highly sensitive and vascularized tissue that can get irritated if the disc is sitting out of normal alignment during these movements.
Most of us have seen the dentist a few times, had a tooth pulled here and there, or had a filling done. Many of us have had a fall or a knock to the jaw or chewed something a bit strange and strenuous. And many of us have experienced stress. These are precursors to an irritated jaw. It’s all physics – either a sudden or steady consistent pull on such small, intricate structures by some of the strongest muscles in the body, and in an abnormal direction, creates havoc with normal biomechanics. The muscles’ abnormal pull on the disc shifts it out of place resulting in compression of that highly sensitive tissue discussed above. Any clicking or catching that comes with this is the bony surface pushing up against the bunching disc and slipping over it. The extent of the compression will determine the amount of pain and inflammation. At its worst, the disc gets fully dislocated, resulting in a locked and extremely painful jaw. Painless clicking and popping occur among most people and occur when the sensitive disc tissue is not compromised but the normal disc movement is.
What are the symptoms of TMJ syndrome?
Jaw pain and stiffness with possible clenching or grinding, clicking, or catching in the jaw made worse with movement, possible fullness and ringing in the ear, sore neck, and headaches. Patients with TMJ syndrome can even present with nausea, fatigue, a sense of feeling overwhelmed, and sensitivity to sound or light.
So what can we do about it and how did we help Sarah at Chirolink?
As Chiropractors, we treat dysfunctional joints. We ensure that it is moving properly so the joint can settle back into normality along with the soft tissue surrounding it too. When the structure and conditions are complex, so is treatment. The muscles of the jaw are extremely strong, and treatment is highly effective but as with anything good consistency is key.
We bring normal movement back into the joint, treat the muscle spasms associated (some even inside the mouth), and stretch the appropriate soft tissues. Very importantly we consider the biomechanical chain of the neck and ear and finally, we tap into the toolbox of applied kinesiology and stimulate the vagus nerve (the TMJ and vagus nerve have a strong link).
Homework includes reducing the stressful load (eating softer, less strenuous foods and talking less), massage, and gentle stretching with the application of some heat to ease the solid tension. The vagus nerve stimulation homework described in our Chirolink Applied Kinesiology blog post along with stress management is key. Mindfulness (doing self ‘check ins’) with regards to jaw tension is extremely helpful. A sneaky tip – when you notice tension in the jaw (especially before you go to sleep), simply place your tongue on the roof of your mouth. Please also remember that if this is chronic, a grind plate may be necessary to protect those teeth!
Always remember that there is light at the end of the tunnel! TMJ syndrome is not a walk in the park, and we are here to help you recover seamlessly.