Chiropractic for Temporomandibular Joint Disorder

Temporomandibular joint (TMJ) is the term for the paired joints between the upper and lower jaws, as well as the term generally used to describe pain or other dysfunction of these same joints. Initial treatment for a temporomandibular joint disorder (TMD) can include applying heat or cold to the jaw area, eating mostly soft foods, taking anti-inflammatory drugs, or wearing a bite guard in the mouth at night. If these methods are unsuccessful, many patients resort to dental treatments to modify the bite or even surgery of the jaw. For those with TMJ symptoms, chiropractic is available as an alternative to those more invasive treatments.

How Can Chiropractic Help the Temporomandibular joint (TMJ)?

Chiropractic care for the temporomandibular joint (TMJ) can ease pain by correcting the misalignment between the spine and nervous system. Chiropractic can be effective at reducing the pain associated with TMJ, either when used alone or as a complement to other treatments. This is because, rather than change the diet or modify the teeth, it relaxes the muscles, adjusts the joint and uses specific trigger points to accurately re-position the jaw. When done successfully, this will not only relieve pain in the short run (as would medications or eating soft foods), but it will help prevent TMJ pain from returning.

Chiropractic treatment of the temporomandibular joint (TMJ) focuses on relieving tension in the muscles around the joints themselves—working both outside and inside the mouth, using massage and trigger point therapy. A trigger point is a very sensitive area made of muscle fibers. Trigger points feel like knots and may cause pain or even a twitching response when pressure is applied to them. A chiropractor can manipulate trigger points in such a way to alleviate the pain associated with them.

Trigger points common to TMJ include:

• Trapezius muscle, located at the base of the neck. Manipulating this trigger point can influence the areas behind the ear, at the temple and at the jaw bone.
• Sternocleidomastoid muscle, located along the neck from the collarbone to the ear. This trigger point can be used to relieve pain in the forehead, front of the jaw and around the eye socket.
• Masseter muscle, located at the back of the jaw. This refers to pain in the upper jaw, ear and above the eye.
• Medial Pterygoid muscle, located behind the molars on the jaw. This trigger point influences pain in the TMJ, as well as in the ear, nose, lower jaw, and the neck.

Adjustments to the joints can also be done by hand, using a technique that causes a tiny stretch inside the joint to release any fibrous attachments made by the body due to previous trauma. The chiropractor may also give the patient home exercises to help strengthen the joint and loosen the tight muscles.

In some cases, misalignment of the jaw that results from improper posture or a back problem can cause temporomandibular joint (TMJ) disorder. An approach to treating TMJ caused by misalignment in the neck and upper back is to perform chiropractic adjustments on the spinal joint in these areas. In addition, a chiropractor may use massage to relieve tight muscles in the back around the spine. This reduces the amount of stress put on the jaw so that other treatments to adjust the jaw will be more effective.

When these treatments are employed, motion of the jaw joint can improve and symptoms such as ear pain, jaw locking, headaches, and neck pain can be reduced.

Why use Chiropractic for Temporomandibular Joint Disorder?

While there are numerous ways to effectively treat temporomandibular joint (TMJ) disorder, scientific studies have shown that chiropractic was helpful in cases of TMJ. In a 2003 study, 15 participants were administered treatments with the Activator Method, which uses a tool that delivers high-frequency, low-impact adjustments. All participants showed improvements in the distance they could open their jaws and in pain measurements. Although this group was not compared to a group receiving traditional treatment, it shows that chiropractic treatments like the Activator Method show promise as an emerging treatment for temporomandibular joint disorder (TMD).

Many report relief and satisfaction with chiropractic care for temporomandibular joint (TMJ) disorder. In a survey of 192 members of a health maintenance organization published in 2003, nearly two-thirds reported using some form of complementary medicine to treat TMJ. Almost everyone surveyed used complementary approaches together with other traditional treatments, and the greatest satisfaction was reported for the hands-on alternative therapies, including chiropractic.
Chiropractic may be used alone or in conjunction with other treatment approaches. Medications can include anti-inflammatories, analgesics (pain killers) and muscle relaxants, as well as local injections of corticosteroids in severe cases. Application of hot and cold compresses also reduces inflammation. When teeth grinding or clenching is an issue, wearing a mouth night guard can help prevent these actions during sleep. Bite plates can help correct misalignment. Stress reduction, relaxation techniques, jaw-stretching exercises, and modifying chewing habits are all behavioral approaches that are proven effective.

More research into chiropractic methods used to treat temporomandibular joint (TMJ) disorder are needed; meanwhile, evidence from existing studies as well as patient testimony suggest that chiropractic therapies are helpful in relieving TMJ symptoms.

What Causes Temporomandibular Joint (TMJ) Disorder?

Temporomandibular joint (TMJ) symptoms can be the result of an injury to the joint, improper alignment of the jaw and teeth, overuse due to excessive or vigorous chewing, or the action of orthodontics. Habitual clenching or grinding of the teeth, especially while sleeping, can cause or aggravate symptoms. Besides pain and difficulty chewing, jaw symptoms can include decreased range of motion, locking, popping, clicking or sudden misalignment of the teeth. TMJ can lead to pain that radiates to the face, head, neck and shoulders. Some chronic sufferers experience headaches, dizziness, earaches and even difficulty hearing.

For individual experiencing symptoms of TMJ, receiving treatment from a qualified chiropractor can help.

References

• Journal of Manipulative and Physiological Therapeutics 2003 Sep;26(7):421-5.
• Journal of Orofacial Pain. 2003 Summer;17(3):224-36.