There are many elements to consider when diagnosing and treating disorders of the temporomandibular joint (TMJ), which connects the jawbone to the skull.
As a chiropractic physician, it is important to look both structurally and functionally at the biomechanics of the joint. But there are other things to consider along with diagnosis.
Treatment methods for TMJ pain may include:
- Oral spints – the night guards help with persons afflicted with a bruxism or grinding of the teeth. This can be beneficial at reducing muscle spasm and joint irritation from limited the amount of movement while a person is asleep.
- Massage therapy – muscular spasms and trigger points can be the main pain generators in some cases. Alleviation of these spasms can reduce pain attributing from muscle tension.
- Chiropractic – traditional chiropractic treats will treat the cervical spine. This approach is effective at reducing inflammation of the C1 nerve that directly effects the TMJ. It can also improve the mechanics of the jaw when the spine is moving at full range of motion.
- Drug therapy – medications such as pain relievers, muscle relaxers, and anti-inflammatory drugs have been used to counter-act the intense pain that can be associated with TMJ pain. Sometimes, even anti-depressants may be prescribed to help with loss of sleep and depressive symptoms.
- Surgery – if there is clicking and snapping of the jaw, an MRI may show permanent damage to the cartilage of the temporomandibular joint. Surgical intervention can improve the articulation and motion within the joint, leading to less pain.
A Patient Centered Approach
A cervico-cranial-temporomandibular dysfunction may sound a bit wordy, but this is precisely what practitioners evaluate to find the root cause of most TMJ disorders.
- The Cerivcal spine – Almost every patient that has walked through the doors of a chiropractic office has had one, two, or three joints out in the top of the cervical spine, which include the occiput, the atlas, and the axis. These three joints are responsible for the attachment sites of the suboccipital triangle, often leading to further muscle spasm and potentially referring pain to the TMJ. The trapezius muscle and levator scapula also increase pain referral patterns and in the common desk sitting, cell phone usage, motor vehicle driving, video game posture, or other types of upright functions. These muscles are ALWAYS ON FIRE.
- Cranial – the cranial bones are typically thought of as immovable joints. Once an infant’s soft spot fuses, the frontal bones and temporal bones are thought to be stationary for the remainder of a person’s life. These joints, while unlike most others of the human body, can translate millimeters anteriorly, superiorly, and inferiorly. Many times, this is the underlying reason why most TMJ patients don’t recover if this is never addressed in the examination. Correcting these asymmetries will also positively influence chronic headaches in patients.
- Temporomandibular – In chronic cases, a night guard is the best way to prevent regression during treatment sessions by minimizing the amount of aberrant movements a patient has while sleeping. Addressing the musculature of the surrounding the jaw, specially the masseter, temporalis, pterygoids, sternocleidomastoid, mentalis muscles and to a lesser extent the sternohyoid and omohyoid muscles.
The missing step that is sometimes not being addressed in this complex is the nutritional status of the patient. Chronic stress, depression, and anxiety will lead to chemical imbalances that over time, and may require specific vitamins and minerals. Specifically, if someone grinds their teeth at night, nutritional intervention is needed to lessen the amount of grinding by calming the mind while at rest. If we are able to focus on getting the patient to sleep at night, we can then allow the body to do what it is supposed to do throughout the night, heal.
And while Temporomandibular may be difficult to pronounce, and even more difficult to spell, a combination of proper treatment, nutrition and information can help alleviate or eliminate most of the adverse symptoms that may flare up.
Do you suffer from TMJ Pain? If the answer is yes, please follow my youtube channel at Nexus Chiropractic and on Instagram @nexuschiropractic_ for more tips on how you can rid yourself of your chronic jaw pain.
Yours In Good Health:
Dr. Jordon VanderVeen