Temporomandibular Joint Dyfunction
Did you know there are over 300 muscles that attach to the jaw, skull and neck?
298 of these muscles do only one thing...they close the jaw, squeezing it into the skull bone. Any misalignment problems, or deficiencies, cause compression and dysfunction in the joint, skull bone, and brain.
What is Temporomandibular Joint Dyfunction?
TMJ/ MSD is a dysfunction of a group of associated muscles, ligaments, nerves and supportive structures that are associated with the temporomandibular joint. Unfortunately, TMJ identifies a multifaceted multi etiologic group of problems that involve bothmedical as well as dental conditions involving the temporomandibular joint, muscles of mastication
(chewing/eating), the teeth/occlusion as well as the central nervous system. TMJ is more appropriately called TMD (Temporomandibular Joint Disorder or Dysfunction). TMJ/ TMD is one of the most misdiagnosed of the medical/ dental conditions. There are two aspects that contributes to this sad phenomenon of misdiagnosis.
Common problems that can occur with the temporomandibular joint are disc disorders or internal derangments of the disc, disc locations, tearing of the lateral and medial collateral ligaments due to traumatic injuries, inflammatory disorders as synovitis/capsulities, inflammatory arthritis, capsular fibrosis, subluxations, spontaneous dislocations, chronic (recurrent disclocations) contributing to clicks and audible popping sounds. Common misdiagnosis' are fibromyalgia, migraine headaches, neuralgias of the masticatory system as well as cervical/neck/ shoulder and back pain.
Common Symptoms
- Facial pain
- Jaw joint pain
- Back, Neck, cervical pain
- Postural problems (forward head posture)
- Pain in the face
- Limited opening of the mouth
- Headaches (tension type)
- Pain in the muscles surrounding the temporomandibular joints
- Pain in the occipital (back), temporal (side), frontal (front), or sub-orbital (below the eyes) region of the skull
- Pain behind the eyes - dagger and ice pick feelings
- Multiple bites that feels uncomfortable or "off" and continually changing
- Clenching/grinding
- Tender sensitive teeth to cold
- Deviation of the jaw to one side
- The jaw locking open or closed
- Ringing in the ears, ear pain, and ear congestion feelings
- Sinus like symptoms
- Dizziness or vertigo
- Visual Disturbances
- Tingling in fingers and hands
- Insomnia - difficulty sleeping
Areas of pain referral
Structure and Function of the TMJ
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The Temporomandibular Joints are the only two joints that function together as a single unit unlike any other joint in the body in that they must coordinate with the coming together of the upper and lower teeth (accompanied by the surrounding periodontal ligamentous attachments, nerves and surrounding bones and gum tissue, during opening and closing cycles of chewing, swallowing, breathing, talking, whistling, kissing, sucking and resting modes.
The Temporomandibular Joint is the joint connecting the jaw (mandible) to the skull (temporal bone).
The two bones are held together and function via a complex group of muscles, ligaments and other soft tissue. The temporal bone has a concavity call the glenoid fossa in which the head of the jawbone (the condyle)sits. A cartilage disc call the articular disc separates the two bones. The articular disc slides in conjunction with the mandible to provide smooth quiet movement and acts as a cushion against heavy forces generated by the strong jaw muscles. The right and left TMJ joints do not act as a separate joints, but must move in coordination with one another.
The TMJ joints are considered the most complex joints in the human body because they must provide for rotational movements, sliding movements and an infinite range of combined movements and functions, unlike any other joint in the body.
The lower jaw (Mandible) has a relationship to the upper jaw (Maxilla). If this relationship is altered, the muscles of mastication (chewing muscles) go into spasm. This causes the muscles that have the same nerve intervention to also go into spasm and myofascial trigger points can develop. The resulting stresses may radiate throughout the head, neck, and even involve the back. The pain may be constant or intermittent, lasting minutes, hours, days, or even years. Many patients
Myofascial Trigger Points (MTrP)
A Myofascial trigger point is an area of elevated neurological activity located in muscle/ fascia (connective tissue) that may refer pain in a localized or peripheral manner.
The trigger points feel like lumps in the muscle or connective tissue that are extremely sensitive to pressure. Trigger points often become self perpetuating once they have taken hold. Releasing trigger points typically requires active treatment.
Each specific trigger point on the body has a referred pain or other symptom pattern. Myofascial TrPs can entrap the nerves, blood, and lymph vessels, causing a variety of symptoms that confuse doctors and patients alike. Therapy includes direct manipulative techniques externally and internally that will improve abnormal musculoskeletal physiology.
Specific exercises to stretch or strengthen certain muscles or muscle groups may be advised and taught.