Head & Neck

Jaw pain can disrupt your life, especially when talking and chewing. This type of pain ranges from moderate to severe, and the cause is often hard to determine. One of the most common causes of jaw pain is temporomandibular joint (TMJ) dysfunction. Management of this disorder ranges from home solutions to medical treatments.

TMJ dysfunction can be treated in some cases for a full recovery, while the dysfunction is lifelong in other instances. No matter what the cause is, you can manage and reduce the pain to prevent it from interfering with your life.

Here is all you need to know about managing TMJ dysfunction at home or with the help of medical professionals.

What Is TMJ Dysfunction?

The temporomandibular joint is the joint that connects your jaw to your skull and contains a complex system of ligaments and muscles. This system works together to enable you to open and close your mouth, yawn, and chew food.

Problems with the joint can arise from various instances such as an overuse injury, grinding your teeth, chewing hard or tough foods too often, or a structural injury. When the joint doesn’t function properly, it causes jaw pain, headaches, neck pain, clicking sounds, and other symptoms.

These symptoms can range from minor discomfort to debilitating pain, but usually, a sufferer will experience moderate pain and symptoms depending on the cause of the dysfunction. While the cause of the dysfunction will guide treatment, the following are the most recommended home management solutions and possible medical interventions.

7 Best Practices to Manage TMJD at Home

Try these home management solutions to relieve the pain and discomfort caused by TMJ dysfunction. Any treatment method should be guided after a session with a medical professional to determine the best way forward for your specific case.

However, these solutions will help you manage the pain until you have an in-person appointment and can be used as a guide after an official diagnosis.

1. Rest Your Jaw

Rest your jaw as often as possible to give the joint time to heal while remaining in a position that puts little or no strain on the jaw, muscles, and ligaments. Ways of resting the jaw include avoiding foods that require a lot of effort to chew (e.g. biltong, nuts, gum); and practice relaxing your jaw.

To find the relaxed position of your jaw, rest your tongue on your palate and leave about 2 mm of space between your top and bottom teeth. While this may not feel natural, try to maintain it for as long as possible at intervals throughout the day. Set a few alarms throughout the day to remind yourself. The more you consciously relax your jaw, the more likely it will become a habit.

2. Use Dental Plates

Bruxism is an occurrence where you fall into a habit of grinding or clenching your teeth. When this happens, you will grind your teeth during the day or while sleeping. If you often wake up with a sore jaw or a locked jaw, this could be the culprit of your TMJ dysfunction.

Bruxism is usually caused by stress and anxiety or sleeping problems. The constant straining of your jaw when grinding and clenching overworks the joint and muscles. To fix this problem, you should consider the underlying issues and work on solving those issues. While you work to sort out your sleeping problems, stress, or anxiety, you can wear a dental plate.

Your dentist will prescribe and make a fitted plate or mouth guard for you to wear while you sleep. These protective guards will prevent your teeth from touching during the night, preventing grinding. The guard will also keep your jaw in the correct position to relax the joints and muscles.

3. Improve Your Posture

You’re probably wondering, ‘what does posture have to do with my jaw?!’. Poor sitting posture or slouched sitting places strain on the neck and shoulder muscles, the poor positioning has an effect on whether or not a joint is within its neutral zone, often not. When a joint is not within the neutral zone, the muscles surrounding the joint often have to compensate to support the joint, causing muscle tightness and strain.

If you are often sitting in a position for too long, especially positions that strain specific muscles, your jaw pain will intensify. Focus on improving your posture by setting up an ergonomic workstation at home, if you work from home often.

Make sure you have a chair with good back support and plant your feet flat on the ground while working. Taking breaks every 20 or 40 minutes is essential to stretch out different muscle groups.

4. Stress Management

Since stress can cause TMJ dysfunction, learning to manage your stress with relaxation techniques will help ease the discomfort. Stress usually leads to clenching and grinding of your teeth and with time the habit is formed, a clenched jaw is now your ‘new normal’.

In cases where your stress and anxiety are high, undergoing cognitive behavioural therapy with the help of a psychologist will help you manage these conditions. This type of therapy, in turn, will help reduce the discomfort caused by TMJD.

With the help of physiotherapists, other effective relaxation techniques include breathing and exercise to manage stress and anxiety, if done correctly.

5. Apply Heat and Ice

Depending on what works for you, a heat or ice pack can help ease the pain. Whether you need to apply heat, ice, or a combination will depend on what provides most relief. There is no right or wrong way when it comes to heat or ice, both methods improve circulation, which essentially eases the pain. Speak to your physiotherapist to find out which application method is best suited for you. Take care not to burn your skin by wrapping the heat or ice pack in a small towel.

6. Jaw Exercises

Jaw exercises will help maintain a good balance between muscle length and strength. These exercises are beneficial for people who play instruments that require use of their mouth and jaw, such as biting down on a mouthpiece when playing brass or wind instruments. These exercises will also help in other cases where the jaw is overused, for instance, if you often eat tough foods like biltong.

Ask your physiotherapist to explain which exercises will help your jaw region and how often to do the exercises.

7. Massage Techniques

Professional massage techniques are often used to relieve the tension in the jaw region. A qualified physiotherapist should do these massage techniques to ensure that the correct methods are used.

A few other considerations to take note of when managing TMJD at home include:

• Eat softer foods or eat less of the tough foods you enjoy
• Reduce habits that can cause it, such as chewing gum or always eating on one side of your mouth
• Use over the counter medication sparingly to minimise pain

Medical Treatments for TMJD

In most cases of TMJ, medical intervention will be necessary to treat TMJD. These interventions are usually non-invasive and can be prescribed by your doctor, dentist, or physiotherapist.

• Physical therapy to improve jaw range of motion, reduce pain and inflammation, and promote relaxation.
• Resistance exercises and stretches prescribed by your physiotherapist to establish muscular balance.
• Cognitive behavioural therapy with a psychologist to reduce stress and anxiety.
• Dry needling carried out by a trained physiotherapist.
• Prescription medication for relief of pain and inflammation. In more severe cases, botox injections may be recommended.

Other Treatment Options for TMJD

Less conventional methods that can improve TMJD symptoms can be considered in extreme cases when none of the above interventions offers any improvement. Only consider these options after the above options and with the guidance of your doctor or physiotherapist.

• Corticosteroid injections
• Botox injection

Final Thoughts

TMJ dysfunction can cause a lot of pain, discomfort, and stress when left untreated. While the condition is rarely a sign of an underlying issue, early treatment of the condition will produce the best recovery results. In some cases, although it is uncommon, TMJD can be a lifelong problem that some individuals will have to deal with periodically.

Proper management can significantly reduce pain and discomfort. Contact me today if you think you may have TMJ dysfunction.

Pain and discomfort in your face and jaw can be disruptive to your daily life, especially while eating, drinking, and talking. The discomfort you are experiencing could be caused by Temporomandibular Joint (TMJ) dysfunction. Understanding the causes and symptoms will guide you in deciding which treatment may best suit your needs.

TMJ is usually not a serious condition but can sometimes be caused by underlying issues. The condition affects the joints of the jaw as well as the surrounding ligaments and muscular tissues. This condition generally causes discomfort and pain but is preventable and treatable.

What Is TMJ?

TMJ is often incorrectly used as the term to describe the condition that causes jaw discomfort. However, TMJ is just the jaw joint itself. TMJ stands for Temporomandibular Joint and is the joint that connects your skull and mandible (jaw), completing your facial and head structure.

The joint is found on both sides of your face, just in front of your ears, and allows you to open and close your mouth and move the jaw from side to side. If you place your finger in the spot just next to your earlobes while opening and closing your jaw, you can feel movement under your fingers. This is roughly where your TMJ is situated.

While TMJ is commonly used as the term for the multiple disorders that can affect these joints, it is more correct to refer to the conditions as TMD or TMJD.

What Is TMD?

TMD is the term used to class all the disorders that affect the Temporomandibular Joint and the surrounding structures. TMD can be used to describe any problem that interrupts the normal functioning of the complex systems in the facial region including the joints, bones, and muscles. The issues can be caused by disorders or by a dysfunction of the joints or other structures.

The common disorders that arise and cause dysfunction in this region are:

• Myofascial pain is the most common type of TMD which results in general pain or discomfort in the connective tissue and the muscles in the jaw, shoulders, and neck. Myofascial pain has many causes and underlying issues that should be addressed to alleviate pain and discomfort.
• Degenerative joint disease is caused by the natural ageing of the joints found in the facial region.
• Internal derangement of the joint occurs after a displaced disk between the jaw bone and the skull, a dislocated jaw, or an injury to the jaw bone.

The Causes of TMD

Many issues can cause TMD and it’s often hard to determine the exact cause. Any form of strain or injury to the jaw area as well as underlying illnesses can cause dysfunction of these structures.

Possible causes of TMD include:

• Jaw injuries — direct trauma to the jaw, neck, or shoulder
• Stress — results in unconscious clenching of the jaw, causing muscle tightness
• Bruxism — the habit of clenching and/or grinding of the teeth
• An improper bite — an over- or under-bite
• Dental procedures
• Eating food that requires chewing effort — foods like biltong, nuts or chewing gum
• Chewing on one side of the mouth more than the other
• Dislocation of the ball and socket joint — on account of traumatic injury or hypermobility syndrome
• Conditions causing paralysis or weakness of facial muscles – Bell’s Palsy or Stroke
• Structural jaw issues
• Arthritis

Common Symptoms of TMD

Depending on the cause of TMD and the length of time that the dysfunction has been present, there are various signs and symptoms. You may experience one or more of these symptoms and they can often be mistaken for other medical conditions.

These common symptoms of TMD could signify the need to consult your doctor or physio if the pain or discomfort is interrupting your daily life.

• Jaw and facial pain or tenderness
• Headaches or migraines
• Ear aches
• Tinnitus – ringing in the ears
• Toothache
• Pain or discomfort while chewing; talking or yawning
• Locking of the jaw with opening or closing your mouth
• Popping or clicking sounds when opening and closing your mouth
• Limited range of motion when opening your mouth – you should be able to fit 3-4 fingers vertically in your mouth
• Facial swelling
• Neck and shoulder pain

When to Seek Medical Attention

If you experience one or more of the symptoms above you should consult a medical professional to diagnose the problem. This is especially important if the symptoms are affecting your quality of life and making it difficult to eat regularly.

While minor symptoms are not usually a cause for concern, it’s better to seek medical attention earlier rather than later. Early treatment and prevention is better than cure.

You can speak to your general practitioner, dentist, or physiotherapist about your symptoms and they will be able to give a diagnosis or refer you to a specialist if necessary.

How Is TMD Diagnosed?

TMD can be difficult to diagnose due to the high number of probable causes and the wide range of symptoms that can indicate other problems.

However, medical professionals such as your doctor or physiotherapist are equipped to diagnose you based on your symptoms and medical history. Your dentist may even pick up TMJ problems during a routine dental check-up or when carrying out a dental procedure.

In some cases, radiological findings can help to diagnose TMJ when there is a structural underlying cause. These procedures usually pick up TMJ when used for other reasons, such as when getting braces. It is rarely the case that a doctor will recommend a radiological scan solely for TMJ symptoms.

Treatment Options for TMD

Treatment options for TMJ dysfunction will depend on the cause of the pain and discomfort and the type of symptoms you are experiencing. There are several options for home management or medical management of TMD. Discuss treatment options with your doctor, physio, or dentist to determine the best TMJ dysfunction management for you.

Risk Factors for TMD

TMJ dysfunction can happen to anyone at any stage of their life, although there are instances that create a higher risk of developing this condition. Take note of the following risk factors to minimize your chances of developing TMJ if possible.

• A traumatic jaw injury, in the case of contact sports, can increase the risk of developing TMD. Wear the correct protective gear during contact sports to reduce the risk.
• Inflammatory conditions including types of arthritis can lead to TMD and should be treated as soon as possible under the guidance of a medical professional.
• Grinding and clenching your teeth will stress the muscles and the joint. This can be prevented by wearing a dental plate, in addition to reducing stress.
• Improper posture should be avoided to prevent TMD as well as back, neck, and shoulder problems.
• Playing brass or wind instruments that require you to bite down on a mouthpiece can cause an overuse injury. Exercising and stretching the jaw muscles and resting the jaw enough will help prevent TMD.
• People who are hypermobile from birth are at higher risk of developing TMD.

Frequently Asked Questions About TMD

Can TMD go away on its own?

In certain cases, TMJ dysfunction will clear up on its own depending on the severity of the dysfunction and the underlying cause. In cases where TMD is caused by teeth clenching and stress, patients may experience flare-ups from time to time. Certain causes of TMD will require treatment to cure the condition.

Is TMD a permanent condition?

In most cases, TMD is not a permanent condition and can be resolved with the correct treatment method. Certain causes of TMD may lead to a chronic condition and some will require regular treatment to manage the condition to prevent prolonged pain and discomfort.

What will happen if TMD is left untreated?

TMD is not a life-threatening condition, however, it does affect your quality of life and the severity of the condition will determine how much of a disruption it can be. Consult a physiotherapist or doctor for a proper diagnosis and explore treatment options as you may need a combined approach.

Final Thoughts

TMJ dysfunction is not a condition that you need to suffer with alone, it can be treated. Contact Pegram Physiotherapy today and see how we can help you restore your quality of life.

Whiplash is often thought of after a minor car accident when one’s head is whipped back and forth suddenly from the impact. However, whiplash can occur from several other incidents including contact sports, physical abuse, and severe falls. Furthermore, whiplash associated disorder (WAD) can develop years after the initial impact.

WAD can cause a lot of pain and discomfort and disrupt your daily life in many ways. The good news is that it is a manageable condition with the right help from a medical professional. 

Here is all you need to know about this condition and the steps you can take to prevent problems later on or to ease the discomfort or pain you are currently experiencing.

What Is Whiplash?

Whiplash happens when the neck and head are suddenly forced backwards and then forwards. This sudden, severe movement causes the muscles and ligaments in your neck to extend beyond their usual range of motion. 

The sudden force out of the usual realm of motion places extreme stress on the soft tissues in the neck. The soft tissues also stretch and sometimes tear from the sudden force.

Whiplash most commonly happens when you are in a car accident where the car behind rear-ends you. However, this condition can also occur from other incidents. The effects of whiplash can occur suddenly and you will feel pain in your neck and head. 

In other cases, the effects of whiplash can appear years later, which is known as whiplash associated disorder. This disorder can cause pain and discomfort in many ways.

What Causes Whiplash?

Whiplash can be caused by many different incidents and the severity of the incident will determine how severe the effects are. The common causes of whiplash include the following.

• Car accidents: Whiplash is most commonly caused by a car accident in which a car rear-ends your car. The excessive force from behind causes a sudden neck and head movement that hurts your soft tissues in this region.
• Contact sports: Sports that involve excessive contact such as rugby, boxing, or MMA can cause whiplash from a heavy tackle or blow to the head. Any movement that causes the sudden whipping of your head in these sports can result in whiplash.
• Blows to the head: Any type of blow to the head can cause whiplash, especially when the knock is unexpected. These unexpected knocks hurt the neck and head because you don’t have time to prepare yourself.
• Physical abuse or assault: Physical abuse can result in a knock to the head as above. However, physical abuse can also involve violent shaking which creates the whiplash effect. Abuse can also result in dangerous falls.
• Falls: When you experience a sudden fall where your head jerks back violently, you may experience whiplash from the movement.

The Symptoms of Whiplash

The symptoms of whiplash may be acute, in which case you will experience a sudden onset of symptoms immediately following the incident. More often the symptoms appear later on, within 24 hours of when the incident occurred. In other cases, symptoms can appear two years or more after the incident, and this is when it becomes a disorder.

Common symptoms of whiplash that occur anytime after the incident including years later are:

• Headaches — often at the base of the skull
• Neck pain and stiffness
• Loss of range in neck motions
• Tiredness
• Dizziness
• Fatigue
• Blurred vision
• Inability to sleep well
• Memory problems
• Ringing in the ears (tinnitus)
• Irritability

When to Seek Urgent Medical Attention

It is recommended that you always seek medical attention immediately following an incident or suspected incident of whiplash. However, it is especially important to seek urgent medical attention if you experience the following.

• Severe neck pain
• Localized weakness in a leg or arm
• Loss of bladder or bowel control
• Numbness or tingling in your shoulders, arms, or legs
• Stiffness in the neck that goes away and then comes back

Possible Long-Term Complications

Long-term complications include the possibility of developing a whiplash associated disorder. This happens when the symptoms of whiplash present later on after two years following the incident.

WAD can be acute where patients fully recover from the injury, or it can progress to a chronic condition later on with long-term pain or disability. The chronic disorder is highly complex and can occur for multiple reasons and should be diagnosed by a medical professional.

Symptoms and treatment of WAD are the same as whiplash and the only difference is that the symptoms usually appear years after the incident. Treatment should be conducted by a medical professional and early treatment after a whiplash incident is important to prevent or minimise the long-term effects.

Treatment for Whiplash

Any type of whiplash should be treated as soon as possible, even if no symptoms are immediately present following the incident. Avoiding early treatment increases the likelihood of developing a disorder later on. 

All treatment for whiplash should be overseen by a medical professional to determine the severity and the correct treatment methods.

Medical Treatment

Medical treatment will be prescribed by your doctor and includes the following medications:

• Over-the-counter (OTC) medication
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants

Non-pharmaceutical Methods

Depending on the severity of the whiplash, a medical professional may suggest certain non-pharmaceutical methods to ease the pain and discomfort. These methods are important to lessen the chance of experiencing whiplash associated disorder later on.

A physiotherapist can assist in the following treatment solutions:

• Apply ice and/or heat
• Improve your posture
• Head and neck exercises
• Massage therapy
• Relaxation techniques
• Movement within tolerable range — this must be advised by a medical professional 
• Neck collar — in severe cases this can be recommended for short term use

Long-term use of a neck collar may result in dependency on the collar which essentially weakens your neck muscles. In the case of short-term use of a neck collar, you will need to be weaned off the support apparatus.

How to Prevent Whiplash

Whiplash is difficult to prevent because of the unexpected nature in which whiplash usually occurs. However, general safety protective gear should be worn in certain situations, such as when playing contact sport.

It is also possible to strengthen your neck muscles to better prepare them for sudden whiplash. This is usually only necessary when you are often in high-risk situations such as competitive racing or playing contact sports professionally.

Final Thoughts

Whiplash can happen to anyone and it is hard to prevent this occurrence. However, following the right treatment plan, especially the non-pharmaceutical interventions with the help of a physiotherapist will reduce the chances of experiencing long-term effects.

Whether you suspect you have recently experienced whiplash or are feeling symptoms of WAD years after the impact, contact your healthcare provider today to find out possible treatment options for you.