Have you ever heard the acronym “TMJ” thrown around? Maybe you’ve had a friend complaining about “having TMJ”? What they probably mean is that they’re having TMJ pain. In actuality everyone has two Temporomandibular Joints (TMJs)--but some people experience specific issues within those joints.
What is TMJ and why does my jaw hurt?
The Temporomandibular Joint is what attaches the jaw bone (mandible) to the rest of your skull (temporal bone). The chronic pain associated with the TMJ is called temporomandibular joint dysfunction (ironically, it’s a mouthful).
Temporomandibular Joint Dysfunction or TMD is a dysfunction or abnormal function of the joint that makes up your jaw.
A few common symptoms include:
Jaw pain
Headaches
Neck pain
Ear Pain
Difficulty opening mouth fully
What about other types of pain? How does my jaw cause pain elsewhere?
How does pain originating in your jaw present in so many other areas? You can thank a concept called ‘referred pain’. Referred pain occurs when the interconnecting network of nerves in an area sends pain signals to the brain. Sometimes when these signals are sent the brain interprets them and spans them across different anatomy structures adjacent regions from the origin of the pain itself. It’s kind of like when your Amazon package shows up four houses down on your neighbor’s porch: all the right systems were there, it just didn’t quite make it.
That might sound like complex medical jargon but you’re probably already familiar with referred pain. The most common example of referred pain is an individual experiencing a heart attack. The origin of the issue is in the cardiac muscle of the heart, but oftentimes a tell-tale sign is the pain and numbness that goes down the left arm.
While TMD is less life threatening it’s still a very real pain that interferes with everyday life. Pain from your TMJ can orient all around your head, face and neck. Common referred pain sites include forehead, behind or around the eye, at the base of the skull, throughout the neck and even the ear.
Another common and painful issue with the TMJ is the inability to open the jaw fully. Remember when you were a kid and one of your friends would double-dog dare you to try to fit your whole fist in your mouth? Turns out, that’s a pretty good practice for determining mouth range. We use a “three knuckle” test to assess if the range of the opening of your mouth is normal or limited.
How did I get TMD?
In most cases, there’s not a traumatic incident or specific time that your TMD or TMJ- associated pain began. Often, the pain accumulates from habitual patterns overtime. For example, we tend to clench our teeth subconsciously when we’re stressed. Some of us only chew food or gum on one side of our mouth. When we have habits that stress one side more than another the muscles on that side can get tight and locked up just like a shoulder or knee. In some cases the TMJ can even get stuck and lock either in a “closed” or an “open” position.
How do I get rid of it?
Much like your TMD or TMJ related pain didn’t happen due to a single event, there’s not a single “one-size fits-all” solution either. It’s often a combination of several tactics implemented over time that bring you relief.
As a chiropractor, I treat TMJ pain and TMD issues with a range of techniques. These include manual therapy, dry-needling, stretching techniques, and adjustments to the neck and TMJ itself. A large part of treatment will include addressing the behaviors, habits or other factors contributing to the origin of pain. We can treat the pain all day and all year, but if we never address the source of the pain it will continually come back each time you get stressed out at work or have a bad night of sleep and grind your teeth.
On your own, there are a few method and tactics you can implement to break the habits causing your pain:
Try the “Resting Jaw Position”
Lips together (no mouth breathing)
Teeth slightly apart (no clenching)
Tongue gently resting at roof of mouth (this is called digastric activity)
Chew on both sides of your mouth
Next time you’re eating food or chewing gum, consciously think about where you’re chewing. If you’re favoring one side, start actively involving both sides of your mouth.
Consider switching to mints if you’re a gum-chewer.
Avoid oral parafunctional activities (that’s a fancy way of saying “activities other than breathing or chewing)
Avoid chewing on pens, your nails and even gum
Avoid sleeping on your stomach
The position forces your jaw into clenching
Stress management techniques
This could be a whole article within itself but I’ll keep it brief -- if you are in a stressful time because of work, finances, etc, find healthy ways to deal with and manage stress
This could include: dedicating more time to sleep, seeing a therapist or counselor for stress management, exercising regularly, etc.
Create physical reminders
It might seem silly but I recommend putting a post-it note on your computer or workspace that reminds you to “stop clenching.”
You could also set an alarm or reminder for yourself on your phone to prompt you to stop clenching throughout the day
TMD and TMJ pain will not go away overnight. It will take some on-going practice and yes, even some daily reminders-- to consciously stop the habits that develop and exacerbate your pain. Also, if you want to sound like the smartest person in your friend group you can let everyone know that saying “TMJ joint” is like saying “the ATM machine” -- it’s redundant :)