What is the Medical Term for Jaw Pain?
The anatomical name for your jaw is the Temporomandibular joint or TMJ for short. Temporomandibular joint disorders are a group of conditions that cause pain and dysfunction in your jaw and the surrounding muscles.
Usually pain in the jaw is not a sign of a serious problem. Jaw pain is usually temporary, although it may reoccur. The condition is more common in women than men, and the pain will often resolve on its own or with simple treatments. However, some people develop significant and long term pain.
The TMJ connects the lower jaw, called the mandible, to the bone at the side of the head called the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joint move.
Your jaw can move up and down and side to side, enabling you to talk, chew, yawn and yell insults at referees on weekends (please don’t do that…). The muscles that attach to and around your jaw control its movement.
When you open your mouth, the rounded ends of the lower jaw, called condyles, roll and glide forwards in the socket of the temporal bone. The condyles slide back to their original position when you close your mouth. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the jaw joint from chewing and other movements.
The temporomandibular joint’s combination of hinge and sliding motions makes it unique among other joint in the body.
What are TMJ Disorders (Jaw Pain)?
We can broadly group TMJ disorders into three main categories:
- Myofascial pain (Muscle related) – involves discomfort or pain in the muscles that control jaw function.
- Internal derangement of the joint (Joint related) – involves a displaced disc, dislocated jaw, or injury to the condyle.
- Arthritis – refers to a group of degenerative/ inflammatory joint disorders that can affect the temporomandibular joint.
You can have more than one of these conditions at a time. Other health problems can commonly co-exist with TMJ disorders, such as chronic fatigue syndrome, sleep disturbances or fibromyalgia. This may suggest that some jaw pain is due to pain sensitivity problems and not necessarily one of the 3 categories above.
These disorders share some common symptoms, which suggests that they may share similar underlying mechanisms of disease. However, we don’t yet know whether they have a common cause.
Rheumatic disease, such as arthritis, may also affect the TMJ as a secondary condition. Rheumatic diseases refer to a large group of disorders that cause pain, inflammation, and stiffness in the joints, muscles, and bone.
However, most people have relatively mild forms of the disorder. Symptoms usually improve significantly, or disappear on their own within weeks or months. For others, the condition causes long-term, persistent, and debilitating pain.
What Causes TMJ Disorders (Jaw Pain)?
Trauma to the jaw or temoromandibular joint plays a role in some TMJ disorders. But for most TMJ problems we’re not sure of the exact cause. Because the condition is more common in women than in men, researchers are exploring a possible link between female hormones and TMJ disorders.
For many people, symptoms seem to start without obvious reason. The current evidence does not support the idea that a poor bite or orthodontic braces can trigger TMJ disorders. There is no proof that sounds, such as clicking in the jaw will lead to serious problems either. In fact, jaw sounds are common in the general population.
Jaw noises alone, without pain or limited jaw movement, do not indicate a TMJ disorder and do not warrant treatment.
What are the signs and symptoms of TMJ?
TMJ disorders can have a variety of symptoms. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom.
Other common symptoms include:
- radiating pain in the face, jaw, or neck
- jaw muscle stiffness, limited movement or locking of the jaw
- painful clicking, popping or grating in the jaw joint when opening or closing the mouth
- a change in the way the upper and lower teeth fit together
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How are TMJ disorders diagnosed?
No one test can accurately diagnose TMJ disorders. Because the exact causes and symptoms are not clear, identifying these disorders can be tricky.
Currently, your physiotherapist or GP will note your description of symptoms, take a detailed history, and examine problem areas, including the head, neck, face, and jaw. Imaging studies may also be recommended but are often not necessary.
You may want to consult your doctor to rule out other known causes of pain. Facial pain can be a symptom of many conditions, such as sinus or ear infections, various types of headaches, and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.
What Happens in a Physical Examination?
During your TMJ examination, we will assess your:
- Jaw range of motion
- Neck range of motion
- Muscle tension / tightness
- TMJ co-ordination and movement pattern.
- TMJ stiffness or hypermobility (excessive movement)
Irreversible treatments such as orthodontics to change your bite, have not been proven to effectively treat TMJ pain.
How are TMJ disorders treated?
The most conservative treatment should always be considered first. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need invasive types of treatment.
Self management such as eating softer foods, avoiding end-range jaw movements (such as yawning, loud singing, or eating a large burger), not chewing gum, or resting your jaw on your hands at a table, can help. Techniques for relaxing and reducing stress are also helpful.
Often we will recommend exercises to help with the range of motion in your jaw and neck, your posture, and co-ordination exercises for the muscles of the jaw
Short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may provide temporary relief from jaw pain. When necessary, your doctor can prescribe stronger pain medications.
Occasionally your dentist may recommend a night splint or bite guard, which is a plastic guard that fits over the upper or lower teeth. If a splint is recommended, it should be used only for a short time and should not cause permanent changes to your teeth.
Irreversible treatments such as orthodontics to change your bite, have not been proven to effectively treat TMJ pain. Surgical procedures are controversial and often irreversible, and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there any standards to identify people who would most likely benefit from surgery. Failure to respond to conservative treatments does not automatically mean that surgery is necessary. If surgery is recommended to you, be sure to have your doctor explain to you the reason for the treatment, the risks involved, and other types of treatment options that may be available.
For most people the pain and discomfort from TMJ disorders will eventually go away on its own. Simple self management strategies are often effective in easing symptoms. If treatment is needed, it should be based on a thorough assessment and diagnosis, be conservative, and personalised to you. Avoid treatments that can cause permanent changes in your bite or jaw. If irreversible treatments are recommended, be sure to get a reliable, independent second opinion.
Some physiotherapists will specialise or take a special interest in TMJ disorders. If you have chronic TMJ pain you should seek the advise and treatment from a physiotherapist. Especially prior to considering any invasive treatments.