TEMPOROMANDIBULAR JOINT

The temporomandibular joint, or TMJ, is the joint formed at the top by the jaw and the temporal bone by the skull. This bone acts as a sliding hinge and can sometimes present problems due to the complexity of the movements it performs. Temporomandibular joint disorders can cause pain in the jaw joint and in the muscles that control jaw movement.

The temporomandibular joint combines rotation with sliding movements. The parts of the bones that interact in the joint are covered with cartilage, capsule, and are separated by a small disk that absorbs shock and accompanies movement.
 

TYPES OF TMJ DISORDERS

- Muscle pain that controls the movements of the jaw.
- Internal asymmetry caused by a displaced disc, by the subluxated jaw or by injuries of the condyle.
- Degenerative and inflammatory disorders of the TMJ.

Temporomandibular disk

 

THE SYMPTOMS

The following symptoms may indicate that you have a temporomandibular joint disorder:

- Jaw, face or neck pain, sensitivity to touch.
- Pain in one side of the head, which increases when teeth are clenched.
- Limited movement or blockage of the joint, making it difficult to open or close the jaw mouth.
- Pain and stiffness in the jaw muscles.
- Difficulty chewing. Ex: eat a sandwich, yawn, bite an apple.
- Ear pain in or around it and / or ringing or tinnitus.
- Pain when getting up in the morning that decreases throughout the day and that sometimes increases in the afternoon.

If you have answered “Yes” to any of these symptoms, we recommend that you go to physiotherapists specialized in Orofacial Pain and Craniomandibular Dysfunction, so that they can help you improve your quality of life.
 

Temporomandibular pain

CAUSES OF ATM DISORDERS

The exact cause of a person's TMJ disorder is often difficult to determine. Pain can be due to a combination of factors, such as genetics, arthritis, fractures, or an injury to the jaw.

However, the most frequent causes that can cause TMJ disorders are:

- Bruxism.
- Stress or anxiety.
- An injury to the jaw or TMJ.
- Certain wear on the disc or cartilage of the TMJ.
- A condition due to rheumatoid arthritis or gout.
- Other diseases that cause inflammation in the jaw.
 

Bruxism

RISK FACTOR'S

Some factors that can increase the risk of developing temporomandibular disorders are the following:

- Different types of arthritis, such as rheumatoid arthritis or osteoarthritis.
- Injury of the jaw.
- Long-term grinding or clenching of teeth (chronic).
- Bad postural habits: chewing gum, biting your nails, making strange gestures with your face, etc.
- Certain connective tissue diseases that cause problems that can affect the temporomandibular joint
 

PHYSIOTHERAPY AND TMJ

Physical therapy can help you restore natural jaw movement and reduce pain. Physiotherapy treatments for TMJ dysfunction may include:

- Active exercises and manual mobilizations (manual therapy): alone or in combination, they may be effective in the short term for increasing total vertical opening in patients with TMJ dysfunctions, resulting from acute disc displacement, acute arthritis, or acute or chronic myofascial syndrome. Often included in the treatment protocol is an exercise program to perform at home.

- Postural education: an advanced posture of the head when sitting can indicate that the cervical musculature is being put on tension, increasing the stress on the temporomandibular joint. As a consequence, the jaw muscles may be overworking at the closure of the mouth.

- Special treatments for pain: In addition to manual therapy, if the pain is severe, your physical therapist may decide to use treatments to reduce pain such as: transcutaneous electrical nerve stimulation (TENS), ultrasound, heat or cold in painful areas or tense.

- Radiofrequency: deeply relieves nerve endings and relaxes the muscles as far as our hands cannot reach.

- Acupuncture or dry needling of the masticatory and / or cervical muscles.

In most cases, the pain and discomfort associated with TMJ disorders are temporary and can be alleviated with non-surgical treatments. Surgery is usually the last resort after conservative measures have failed, but some people with TMJ disorders may benefit from surgical treatments.

Temporomandibular disorders can also cause a clicking or squeaking sensation when opening the mouth or chewing. But if there is no pain or limitation of movement associated with a snapping jaw, you probably don't need treatment for a temporomandibular disorder.
 

Temporomandibular physiotherapy

MULTIDISCIPLINARY

The treatment of disorders in the TMJ is multidisciplinary, since several health professionals may intervene. If the TMJ dysfunction is caused by tooth alignment problems, the physical therapist may refer you to a dentist or maxillofacial.

The swallowing or lingual movement also plays a fundamental role and it is necessary to refer it to the speech therapist.
 

PREVENTION OF ATM DYSFUNCTIONS

The general tips to decrease the probability of having temporomandibular pain are:

- Avoid stressful situations
- Avoid bad habits: nail biting, chewing gum, excess coffee and tea.
- Soft food.
- Do not clench your teeth.
- Perform some daily physical exercise.