TMJ dysfunction refers to problems involving the temporomandibular joint. This is the joint that holds the lower jaw to the skull, and it is used in activities such as speaking and chewing. The jaw is a very unique joint, allowing the mouth to open and close but also allowing the lower jaw to slide from side to side.
As a result, there are a number of unique issues that can occur at the TMJ. When a problem occurs here, it can cause pain that radiates toward the ear and/or neck as well as a popping or clicking sound when the mouth is opened and shut. It may also affect sleep depending on the underlying cause. While some people experience TMJ pain for a limited time and it resolves on its own, at other times the condition can become chronic and require intervention.
Today, we’re going to look into the symptoms of TMJ disorders, potential causes of this problem, common treatments and home remedies, and a natural alternative that has been beneficial for some including 5 patients in a unique case study.
What Is TMJ Dysfunction?
Temporomandibular disorders (TMD) include the full scope of conditions that affect the jaw. TMD is often associated with other pain conditions such as fibromyalgia, chronic fatigue syndrome, headaches, migraines, neck pain, lower back pain, and IBS (irritable bowel syndrome).
According to estimates by the TMJA (TMJ Association), TMD affects about 12% of people or about 35 million adults in the US alone. What are some of the symptoms of TMJ disorders and what causes them to occur?
TMD Causes and Symptoms
No single cause is attributed to the onset of all cases of TMD. Instead, jaw problems may begin due to a wide variety of causes. Some of these include:
- Trauma to the head, neck, or jaw
- Autoimmune conditions
- Dental procedures that require prolonged opening of the mouth
- Surgery that involves insertion of a breathing tube
There are also various factors that may predispose a person toward developing a TMJ problem such as genetics, hormones, or certain environmental factors. This may explain why TMD is more common for women of childbearing years and among people with habits like gum chewing or holding a phone between shoulder and ear.
Symptoms of TMD vary depending on the cause of the disorder, but some of the most common symptoms include:
- Jaw pain that may become chronic
- Neck and shoulder pain
- Chronic headaches
- Reduced range of motion in the jaw
- Ear pain and tinnitus (ringing in the ear)
- A clicking or popping sound that accompanies jaw pain
- Vision problems
It is important to note than an occasional jaw click may be completely normal, especially if it is not accompanied by pain, so there is no need to run to the doctor any time the jaw pops while chewing or speaking.
Medical Treatments for TMJ Disorders
First of all, know that there is no such thing as a “TMJ specialist.” There simply isn’t an established standard of care or program for a doctor to go through to gain such a title. As a result, most people just go to their primary care physician or a dentist when TMJ problems arise. What treatment can be expected?
4 common categories of TMJ care include:
- Medication – If the pain is chronic, a doctor may prescribe a painkiller, but over-the-counter drugs such as NSAIDs will be recommended first. Of course, this only relieves pain and doesn’t actually correct the underlying problem. It’s often used as a stop-gap to relieve a patient’s pain while the underlying cause of the problem is identified and corrected.
- Splints – This is an oral appliance provided by a dentist. Stabilization splints (also called a bite guard) are used temporarily. For example, if a person suffers from bruxism (grinding of the teeth), this can prevent grinding and relieve the jaw. Other splints are designed for long-term use and may reposition the jaw to correct a bite problem.
- Surgery – This is a very controversial way of caring for TMJ problems. The TMJA recommends avoiding surgery and reminds patients that more aggressive treatments are not always the right option when traditional methods fail.
- Everything Else – There is a laundry list of other forms of care that may be recommended. Not all of these are considered treatments, and the effectiveness of each depends on the underlying cause of the pain. Some of these therapies include steroid injections, Botox, and orthodontics to improve bite alignment.
Home Remedies for TMJ Pain
The good news is that many TMJ problems are temporary in nature. Here are a few things you can do at home to correct the problem without the need for intervention by a doctor.
- Ice – Jaw pain is often due to inflammation. Ice reduces inflammation and is especially beneficial the first day or two following an injury. Remember not to have the ice directly on your skin and to use ice for no more than 20 minutes at a time.
- Dietary Changes – Eating soft foods may give your jaw time to heal from minor injuries on its own. Sometimes the jaw problem is no big deal, but overuse aggravates the condition until it becomes chronic. You may have to trade in that bagel in the morning for some scrambled eggs for a few days, but you should be back to harder foods soon enough.
- Resting the Jaw – Eating isn’t the only time the jaw gets overused. Try to avoid things that overwork the jaw or stretch the mouth wide like yawning, chewing gum, singing loudly, or yelling.
- Maintain Proper Posture – Misalignments of the upper neck can affect jaw position and lead to pain. Again, watch out for habits like holding a phone with your shoulder as this type of posture can lead to increased pain.
- Destress – Sometimes jaw pain is the result of subconsciously clenching the jaw over and over throughout the day. This is usually stress related, so reducing stress can be a big factor in reducing jaw pain.
How TMJ Problems May Affect Sleep
We mentioned earlier in our discussion that TMJ issues can affect sleep. A number of sleep problems have been connected to TMJ dysfunction through various studies. Here are a few examples:
Sleep Apnea – Sleep apnea is often connected to jaw problems such as a jaw that is misaligned. In fact, researchers are unsure of whether TMJ issues may actually be to blame for some cases of sleep apnea or if the cause is the other way around.
Teeth Grinding – Bruxism (teeth grinding) is sometimes a symptom of a TMJ problem. When the jaw is misaligned, one may begin to grind the teeth subconsciously, often while sleeping. This only serves to make jaw problems worse. But again, which of the two problems is causing the other is often unknown.
Headaches – When TMJ pain radiates down toward the neck and up toward the ear around the back of the head, it can actually mimic migraine pain. When this is combined with oxygen deprivation due to sleep apnea, the result can be frequent headaches.
How to Find Relief from TMJ Problems Naturally
A mild case of TMJ pain may respond to things such as a change in diet to softer foods and gentle massage of the jaw. However, the problems described above reveal a more serious problem with the joint and surrounding nerves and soft tissue. Some further recommendations include gently stretching the neck and working at improving posture. What does the neck have to do with the jaw?
When a misalignment occurs in the atlas (top bone in the neck), it can affect both the jaw and the ears because of its close proximity. As the muscles and soft tissue move to keep the head straight, a misaligned jaw is just one of many possibilities. Therefore, correcting the atlas misalignment that set all of the problems in motion can allow the body to heal naturally.
Are there any case studies to back up the idea that correcting upper cervical alignment could help to relieve chronic TMJ pain?
A Case Study Involving Upper Cervical Chiropractic and Chronic TMJ Pain
A case study was performed based on the premise that atlas subluxation can lead to problems with the TMJ. Each of the five patients involved in the study had been suffering from TMJ pain for over a year and had not responded to treatment from the dentists they were referred to.
Each patient (four women and one man) underwent a physical examination that revealed differences in leg length, a telltale sign of atlas misalignment. Diagnostic imaging techniques confirmed that each subject suffered from a misaligned atlas. As a result, upper cervical chiropractic was used to provide personalized care to each patient over the course of eight weeks. However, each patient received only one adjustment during that time period because the adjustments held and produced the desired results.
The visual analog scale (VAS) was used to measure each patient’s pain level on a scale of 0 (no pain) to 10 (worst possible pain). At the start of the study, the patients averaged a TMJ pain level of 5.9. At the end of eight weeks, the patients averaged a mere 0.9 with the patient still experiencing the worst pain level at 2.0. While the researchers acknowledge that the study was limited by just having five patients and all of them seeing the same practitioner, the results still displayed the short-term benefits of a properly aligned atlas on correcting TMJ pain over the course of an eight-week period.
Upper Cervical Chiropractic and TMJ Pain Relief
The results of the study make sense in the light of an understanding of how upper cervical chiropractic works. When a precise and gentle adjustment is used to restore the proper alignment to the top bones of the neck, this can relieve problems with the TMJ.
Upper cervical misalignments can result in shifts throughout the body and cause the shoulders to be lopsided. The hips then follow suit, as do the leg lengths. That’s why the leg length check was able to reveal the subluxation in the patients of the study before imaging was used to confirm the problem. When the upper cervical misalignment is corrected, these shifts can return to normal. The same is true with jaw shifts related to the proximity of the atlas.
It’s no wonder then that neck and shoulder pain is so common along with the other symptoms of TMJ dysfunction. The ear pain and symptoms can also be the result of this alignment issue since the ears are in close proximity to both the atlas and TMJ.
Upper cervical chiropractic care focuses on finding and correcting this specific misalignment of the atlas. As a result, one may find relief from TMJ pain, neck pain, headaches, and the many other symptoms that are associated with TMD. Thus, if a person is experiencing TMJ pain on a chronic basis, it makes sense to seek the help of an upper cervical chiropractor, especially if you can remember a head or neck injury that may have caused the subluxation. The injury did not have to be severe to lead to a subluxation, but even if no such injury has taken place, postural problems and normal wear and tear could still have caused the misalignment. This is a common problem faced by office workers and others who sit all day for work.
It is important to be examined by an upper cervical chiropractor to know for sure if such a misalignment exists, especially if other therapies have proved ineffective for relieving the pain. Contact an upper cervical chiropractor near you to learn more about the importance of a properly aligned atlas and to schedule a consultation. A gentle adjustment may be the first step on the path to reduced or eliminated TMJ pain.
Woodfield, Charles H. Dickholtz Sr., Marshall. Subluxation Based National Upper Cervical Chiropractic Association (NUCCA) Care for Temporomandibular (TMJ) Pain. Journal of Philosophy, Principles & Practice of Chiropractic. 31 December 2012. Pages 75-77. Accessed online 19 June 2017. http://www.mccoypress.net/dialogues/docs/2012-1258_iraps2012.pdf