This blog post was written by Justin Scherff, a Core Physical Therapy PT who specializes in TMJ pain and disorders.
The Temoromandibular Joint (TMJ) might seem like a simple ball and socket joint but its nothing short of the complexity of the nerves, blood vessels, muscle control, take a look at this picture:
Source: Netter, FH. Atlas of Human Anatomy, 5th Edition. Saunders Publishing, 2011.
Dysfunction of the TMJ is probably the most undiagnosed cause of chronic pain in this country. Estimates of just how many people may actually be afflicted with TM, to some extent, range from 52 to as high as 80%. (Source: Temporomandibular Joint Syndrome notes from Cranial Technique Part 1 Course Manual. Michigan State University, College of Osteopathic Medicine. Pages 104-108)
When your teeth come together (occlusion), there can be up to 400 psi of pressure at the TMJ. Just for reference, your tire pressure on your vehicle is recommended to be between 30-35 psi, so there is 10x or more pressure in your mouth when you chew than when your car travels over the road… talk about pressure!
So, how does one develop TMJ symptoms?
Untreated/incorrectly treated bite problems
If your teeth don’t touch together when you bite, that is a primary cause of TMJ pain.
Traumatic injuries to the face, head, neck
Getting hit in the head with objects, concussions, chronic wearing of glasses, bumps, are a few things in this category. These issues, even way back in the past, can be some of the underlying reasons why the jaw symptoms start.
Car accidents, falls that cause a rapid head movement can changes tension in the head/neck and face region. If left untreated, then asymmetries develop and over-time can lead to pain/limitation.
Unsuccessful compensation for body balance issues
Our body position matters. Here’s a quick test. Sitting in a chair, tip your body to the right and gently close your teeth together. Now to the same with tipping to the right. Now do it with sitting up straight. And again slouching.
Chances are when you pay attention to how your teeth touch (occlude), it will change, sometimes subtly and other times you won’t be able to feel teeth touching at all on one side. That shows you how your posture can impact your bite. Now, add 400lbs of pressure in an off-balance bite and it makes sense why pain could show up without being supported.
Here’s what one of our patients said:
“When I brought my teeth together, they would touch on the L and not at all on the R. It was really painful on the L side and people could tell and hear my teeth coming together. I had to miss work because when the TMJ was so severe I would get migraines and have to go home, sometimes multiple times each week. Since coming to PT I’ve not had a migraine that caused me to miss work.After PT, my teeth touch evenly at the same time now, I can even eat some of my favorite food without pain.”
If you are chewing on this information (pun intended), and wondering if your TMJ could be impacting you, check out some of these other associated symptoms that could be related to a sub-optimal TMJ:
- Chronic, recurring headache
- Dizziness/ringing in ears
- Painful jaw use/ motions
- Clicking/popping / locking of the jaw
- Pain in eyes, visual disturbances
- Face pain
- Neck pain
- Shoulder pain
- Upper Back pain
- Chronic fatigue/digestive stress
Now you know how “it’s all connected,” what do we do about it? Enter in physical therapy at Core Physical Therapy.
We listen to you, to your story, to get clarity on your background and your specific case versus just treating everyone the same because of the same symptom. After your first visit you will be heard, guaranteed.
We do a full-body evaluation to uncover any musculoskeletal components that may be contributing to the TMJ pain. Example: A house over time can have a foundation that starts to settle. This can cause a leak in the roof, or cracking in the drywall. Instead of just filling the cracks, we look for any foundational issues in your body.
We consider all parts of the body. Bottled up stress can cause TMJ, nutritional imbalances can cause TMJ, emotional issues can impact TMJ. We want to ensure we dig deep!
We provide care like no one else. What we mean by that is the style of approach we use is very unique in its combination as physical therapists and we are committed to delivering the BEST quality in each visit.
We help foster independence. We don’t want you to need us for the rest of your life. We give you simple exercises at home that you will feel confident performing to retrain your body after each visit to build the new foundation for long-lasting change. Then you also have a tool-kit which empowers you for self-care should something come up in the future.
We work closely with your dentist as needed. We can coordinate our findings and work as a team FOR YOU. As your posture improves of the head/neck/shoulders/jaw for a balanced and painless bite, your dentist can do their amazing work to fix any remaining bite issues for long-term relief.
If a future without TMJ symptoms is something that you’re starting to dream about, we’re here to help make it happen. We are committed to do everything we can to help you achieve your best life. We are honored and excited to work with you.
Learn more about Justin Scherff here and book an appointment today.