Temporomandibular joint disorder is more commonly known as TMJ. It is a health problem linked to changes in the joint that joins the jaw bone to the skull.
TMJ can cause jaw pain and a clicking noise when opening the mouth wide. People with TMJ also have their jaw clench shut every now and then. Here’s what you need to know about this problem and how to treat it.
What Is TMJ?
TMJ is an umbrella term for pain and dysfunction in the jaw joint. This joint is where the jaw bone meets the skull bones.
The temporomandibular joints are in front of each ear. The muscles attached to the jaw allow it to move up and down, side to side, and forward and back. If these muscles are tense, it can interfere with the movement of the jaw.
The National Institute of Dental and Craniofacial Research estimates that up to 12 million adults in the U.S. have TMJ. It is more common in women than men, but doctors don’t know why.
If you think you have TMJ, talk to your primary care doctor or dentist about your symptoms. Depending on your symptom severity, they may refer you to an expert.
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What Causes TMJ?
In most cases, the exact cause of TMJ is unclear. Some risk factors for TMJ are:
- Having a disease where the body’s immune cells attack healthy tissue (an autoimmune disease).
- A previous infection in the jaw area.
- A previous injury to the jaw area.
- Having a dental procedure or another reason for prolonged mouth opening.
- Having a breathing tube inserted before surgery.
- Having arthritis.
- High stress levels.
- Neck pain.
- Postural abnormalities/imbalances.
What Are the Symptoms of TMJ?
Many healthy people experience sounds — like clicking or popping — without pain in the jaw. These sounds, without pain, are harmless and are not TMJ.
People with TMJ have one or more of the following symptoms:
- Pain in the jaw joint or chewing muscles.
- Pain radiating into the face and neck.
- Limited movement or locking of the jaw.
- Painful clicking, popping, or grating in the jaw when you open or close your mouth.
- A change in the way the upper and lower teeth fit together.
- Ringing in the ears.
- Ear fullness.
- Hearing loss.
How Do Doctors Diagnose TMJ?
There is no single test for TMJ. Your doctor will take your medical and dental history and examine your head, face, neck, and jaw. They may order imaging tests, including X-ray, MRI, or CT.
Your doctor will use this information to rule out other causes of facial pain. Those might include sinus or ear infections, headaches, and nerve-related facial pain (facial neuralgias).
What Is TMJ Therapy?
Doctors typically start with the most conservative, reversible treatments for TMJ. These don’t involve changing the structure or position of the jaw or teeth.
The good news is that these are often enough — TMJ usually goes away without invasive treatment. If symptoms persist, start taking steps to care for the condition at home.
You can treat TMJ symptoms at home with these self-care techniques.
- Eating soft foods.
- Taking over-the-counter nonsteroidal anti-inflammatory drugs.
- Applying ice packs and heat to the jaw.
- Avoiding movements where your mouth is wide open (wide yawning, singing, gum chewing).
- Learning relaxation techniques.
- Managing ongoing stress.
Physical therapy for TMJ
If self-care doesn’t help your TMJ, your doctor may prescribe physical therapy. A physical therapist can develop a program to help you regain normal jaw movement.
Physical therapy for TMJ may include the following:
- Jaw exercises to strengthen your muscles and improve your jaw’s flexibility and range of motion.
- Heat therapy to improve blood circulation in the jaw.
- Ice therapy to ease swelling and relieve pain.
- Massage to relieve muscle tension and allow the jaw to move more freely.
- Posture training. Learning better posture to improve the alignment between your facial bones and muscles.
- Relaxation techniques to reduce stress, including meditation and other calming therapies. Your physical therapist can help you learn these techniques.
- Transcutaneous electrical nerve stimulation to relax muscles, improve blood circulation, and relieve pain. For some people, this mild electrical current over the jaw joint brings relief, possibly by interfering with the body’s pain signals.
- Ultrasound therapy to reduce pain and swelling and improve circulation.
- Movement of the jaw joint to release scar tissue. Scar tissue may restrict muscle movement and the jaw’s range of motion. Your physical therapist may be able to move the joint to release the scar tissue.
- Acupuncture to relieve stress. There’s no scientific evidence that acupuncture helps with TMJ, but many people find this complementary treatment relaxing.
Other Treatments for TMJ
If self-care and physical therapy don’t ease your TMJ symptoms, there are a few other options. Your doctor may suggest the following:
- Pain medicine. Some people with TMJ benefit from prescription-strength pain medicine or muscle relaxants.
- Dental splints. These devices, also called nightguards, fit over the teeth. They may ease muscle tension and stabilize the jaw without changing the teeth or bite.
Most doctors suggest avoiding treatments that permanently change your jaw joints, teeth, or bite. That includes surgery and jaw implants.
Surgery is usually the last resort for TMJ treatment. You should only consider it if you have severe pain or difficulty opening your mouth. Your doctor may also suggest surgery if there is damage to the joint that they can’t fix.
One surgical option that may help damaged jaw joints is TMJ implants. Like other surgical treatments, implants are a last resort when other treatments have failed.
These artificial devices replace part of the jaw or the entire joint. Your doctor may suggest an implant if you have an injury or were born with a defect in the jaw bone that needs repair.
To learn more or talk to a specialist about TMJ physical therapy, call 1-888-723-4277 or visit our website.
The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.