By Gita Mikal
Chris has been experiencing headache and jaw pain in the right side of his face for the past three months. After seeing his doctor and having a series of tests done, he finally saw his dentist thinking it had something to do with his teeth.
A set of X-rays, some more tests and nothing wrong was found. Sound familiar?
Like many other people with chronic facial pain, Chris’s symptoms could be related to tempromandibular/jaw joint (TMJ) dysfunction. The tempromandibular joint is one of the most complicated joints in your body. TMJs are located on either side of your face, just in front of your ears where the lower jaw bone and your skull connects.
Like any other joint, your TMJ may develop osteoarthritis, rheumatoid arthritis and other inflammatory conditions and in rare cases tumours.
Excessive gum chewing, forceful biting as well as clenching or grinding the teeth or if the mouth is forced to open widely during dental procedures can affect the smooth and coordinated movement of TMJs. When the movement becomes imbalanced, the ligaments and muscles supporting the joint are strained and can cause jaw pain, headache, neck pain, popping, clicking or even locking.
TMJ pain often is a result of excessive muscular strain rather than an issue with the actual joint. Muscle tension due to psychological stress, anatomical problems and injuries such as whiplash are among the most common causes of TMJ pain and dysfunction.
What can I do to manage jaw pain?
For most people, TMJ pain is not serious and requires little or no treatment and can simply be managed by:
- Avoiding hard, crunchy or chewy foods to help reduce the pain.
- Reducing stress, a common trigger for TMJ dysfunction and often causes clenching or grinding teeth. Practice self-awareness and relaxation techniques. You may even require muscle relaxants.
- Taking over-the-counter medications such as ibuprofen (Advil or Motrin), naproxen (Aleve) and acetaminophen (Tylenol) to relieve TMJ pain and reduce inflammation. Your primary care physician or dentist may prescribe other medications to relieve jaw pain such as muscle relaxants, non-steroidal-anti-inflammatory drugs, opiates and anti-depressants.
Always take medications as prescribed, and contact your doctor or pharmacist if you have any questions.
- Applying heat or cold compresses to reduce jaw pain. Experiment with both and find what works best for you.
Untreated TMJ dysfunction can result in impaired concentration, inability to chew food (leading to poor nutrition), difficulty sleeping and psychological distress.
In more severe cases, TMJ dysfunction requires a visit to a dentist or orthodontist or pain specialist. A dentist can evaluate TMJ problems and may recommend a dental appliance such as a mouth guard or dental work. In many cases, a referral to a physiotherapist to address associated neck pain and headache is necessary.
Manual techniques to restore normal movement of TMJ, in combination with strengthening, stretching and relaxation techniques prescribed by the physiotherapist will help reduce pain and improve function. In addition, acupuncture and massage therapy are proven treatment options to address referred pain caused by trigger points.
Inserting acupuncture needles and applying massage techniques can release this trigger points and increase blood flow to tight muscles.
So don’t live with pain; apply self-management techniques, see your dentist and consider other pain treatment options.
If still in pain, ask for a referral to a TMJ or pain specialist.
Note: This information should not be used as a substitute for necessary consultations with a qualified health care professional. Always consult a medically trained professional with questions and concerns you have regarding your medical condition.
Gita Mikal is the founder of Pain Management & Fibromyalgia Centre and Physiotherapy at Don Mills. Gita is a practicing physiotherapist with post-graduate training in pain management. She incorporates a variety of therapeutic techniques such as manual therapy, acupuncture and pain education in her treatments. Visit www.physioatdonmills.com, or call 416-444-4800.