Many people have jaw pain, also called TMJ pain, and/or clicking but they often don’t know where to turn for help in alleviating it. Many physiotherapists do not have adequate training in dealing with jaw pain and a multidisciplinary approach is needed to deal with possible structural problems in the teeth or jaw (orthodontist and dentist), stress (psychologist or counselor) and muscle tension and strength (physiotherapist).
When the muscles of the jaw are at rest, the teeth should be slightly apart with the lips still together but if you have problems with your jaw you may find that you often clench your teeth. If you clench your jaw due to feeling stressed during the day or clench/grind your teeth at night subconsciously, the muscles of the jaw such as masseter, temporalis, medial and lateral pterygoid become dysfunctional and can develop trigger points. This is painful and can lead to the jaw being pulled off centre, causing more pain. Tension in these muscles can also contribute to problems with the disc in the temporomandibular joint which you may feel or hear as a click when opening and/or closing your jaw.
Your head and neck position can also influence tension in the jaw. If your head is forwards of your centre of gravity, there is more tension placed on the jaw. You can test this by poking your chin forwards as far as you can and trying to open your jaw. It is harder to open your jaw in this position compared to keeping your head over your shoulders. With increased sitting you may develop this posture which can increase jaw pain.
So what can be done to improve TMJ/jaw pain? First, your teeth need to be aligned correctly, or it can be difficult to get the muscles of the jaw to relax. A visit to your dentist or orthodontist can assess if there are problems with the alignment of your teeth that may be affecting your pain. Second, being aware of the tension you hold in your jaw and your head posture can help to reduce the severity of your symptoms. A physiotherapist can help address these issues. Third, myofascial release, trigger point release, joint mobilisation and acupuncture/dry needling with a physiotherapist trained in dealing with jaw problems can relieve the tension that has built up in your jaw muscles and help your jaw align more evenly. Forth, if you are feeling stressed or going through a stressful period in your life, some form of counseling may help you to manage this stress that is leading to physical tension in your muscles and jaw. Fifth, if you clench or grind your teeth at night there are specific mouth appliances that are designed to help you stop clenching. One example of this is the NTI TSS splint. There is information about this splint available online and only certain dentists can provide these splints.
It can take some time to respond to treatment and to overcome clenching and grinding your teeth but there is no need to feel helpless with your pain. Consult a physiotherapist with training in treating jaw pain and the TMJ such as Nicholas Evans at e-physiotherapy and start feeling better.
