Osteopathy For Jaw Pain &
TMJ Dysfunction

What is the TMJ?

The temporomandibular joint (TMJ) is a complex joint that connects the jawbone to the skull. It is located just in front of the ear on either side of the head and facilitates movements essential for everyday functions, like speaking, chewing, and opening and closing the mouth. The TMJ consists of cartilage and a small disc that cushions the joint, enabling smooth motion. The action of the joint is enabled by the muscles of mastication, the temporalis, masseter, lateral pterygoid, and medial pterygoid muscles as well as other supportive muscles.
Due to its pivotal role in oral and facial functions, any dysfunction or disorder of the TMJ can lead to pain, discomfort, or difficulties in jaw movement, significantly affecting quality of life.

What is TMD?

Temporomandibular dysfunction (TMD) is a group of conditions affecting the jaw joint and the surrounding muscles. It can cause pain and discomfort in the jaw, face, neck, and even the ears. People with TMD might experience difficulty in chewing, clicking or popping sounds when moving their jaw, and stiffness in the jaw muscles. Stress, teeth grinding, or jaw clenching often contribute to this condition. While TMD can be uncomfortable and sometimes painful, it is usually manageable with treatments like physical therapy, stress management, or dental appliances. Understanding TMD is crucial because it can affect daily activities like eating and speaking, impacting overall quality of life. With proper care, many individuals can relieve their symptoms and return to their normal routines.

Some common symptoms of TMD?

• Pain or tenderness in the joint

• Pain or tenderness in the jaw

• Face pain or tenderness

• Ear pain where no infection or other pathology is present

• Pain with chewing or yawning

• Pain or difficulty swallowing

• Headaches, especially temple headaches

• Limited mouth opening or difficulty opening and closing the mouth

• Popping or clicking sounds in the joint in addition to pain or dysfunction

• Crunching sounds in the joint

• Jaw locking

• Neck and shoulder pain and tension

Potential causes or drivers of TMD?

Causes of TMD are often multifactorial and complex and there is still a lot of uncertainty of what truly causes TMD. However the following are some things usually associated with people who experience TMD.

• Bruxism - clenching or grinding the teeth

• Stress which may acerbate bruxism

• Trauma to the face, head or neck, e.g. whiplash

• Dental issues e.g. malocclusion, poor fitting splints/appliances

• Excessive chewing of gum

TMD is known to be more prevalent in women than men by up to 4 times. The hypothesis is due to the presence of oestrogen receptors in the TMJ. Some research has also shown a correlation between TMD and sleep apnoea and also acid reflux in some cases (1, 2, 3).

How may osteopathy help?

The role of osteopathic treatment is to help reduce your pain and improve the function of the joint. This will involve assessing and treating the TMJ, neck and shoulders. A holistic approach is taken at the clinic and where indicated other areas that may be a contributing factor may also be assessed and treated. For example, if you also have reflux, the diaphragm and viscera would be considered to improve overall outcomes. Advice on self-care and exercise to help manage and prevent future episodes will also be given.

Different techniques are used; soft-tissue massage, joint mobilisation, and gentle release, including intraoral techniques. A range of treatment applications are available and only those you are comfortable with will be used.

it may also be suggested that your see your dentist or GP.

Self-help tips for TMD

• Apply a warm compress or an ice pack to the jaw area

• Avoid chewing hard foods like apples and nuts

• Avoid chewing gum, your pens and biting your nails

• Avoid placing your hand under your chin or sleeping with your hand under your face

• Be aware of when you are grinding or clenching

• Find ways to manage your stress

• Self-massage for the jaw muscles

• Neck stretches

• TMJ exercises can be helpful in later stages when you are in less pain. Resting the jaw in the initial stages is best.

References

1. Wang, Y. P., Wei, H. X., Hu, Y. Y., & Niu, Y. M. (2024). Causal Relationship Between Obstructive Sleep Apnea and Temporomandibular Disorders: A Bidirectional Mendelian Randomization Analysis. Nature and Science of Sleep, 16, 1045–1052. https://doi.org/10.2147/NSS.S476277

2. Wu, J.-H.; Lee, K.-T.; Kuo, C.-Y.; Cheng, C.-H.; Chiu, J.-Y.; Hung, J.-Y.; Hsu, C.-Y.; Tsai, M.-J. The Association between Temporomandibular Disorder and Sleep Apnea—A Nationwide Population-Based Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 6311. https://doi.org/10.3390/ijerph17176311

3. Bartley J. R. (2019). Gastroesophageal reflux disease, temporomandibular disorders and dysfunctional breathing. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 191(45), E1255. https://doi.org/10.1503/cmaj.73545

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