TMJ: Jaw Pain and Clicking
The TMJ stands for the Temporo Mandibular Joint. This is just the technical name for the jaw. The joint itself is just in front of the ear, so clicking can feel very loud to the person affected. However, it can also be surprisingly loud to people nearby too.
The TMJ is an unusual joint, as it is directly affected by the joint on the other side. For this reason, it can sometimes be difficult to work out where the true problem is. Sometimes clickiness or pain in one side is actually caused by a problem that needs resolving on the other.
TMJ Anatomy
The joint itself is unusual, in that it doesn’t behave like a normal hinge joint (like the knee). If you open your mouth as far as you would while speaking, you’ll find that it’s just pivoting like a hinge. But if you open it further, it begins to slide. Often it is at this range that people find their symptoms kick in.
This might be because of the way the disc within moves. Like in the spine, there is a disc of cartilage within the joint. When it works as it should, it lets the bones slide smoothly over it. But sometimes it gets folded, causing clicking, locking, or other unusual symptoms.
Managing Simple Disc Problems
Fortunately, problems with the disc can be really quick to resolve. The disc is directly affected by small, deep muscles in the cheek (the pterygoids). If they become tight, they can pull on the disc and encourage it to fold at certain points in movement. Following this, the body tries to protect itself, tensing the muscles further and exacerbating the problem. The root cause of the problem comes down to why the muscles were tight in the first place- often stress and teeth grinding play a role. But we can help by addressing the tension. Although the muscles are deep in the cheek, they can be reached by external massage techniques. The muscles and joint together may both respond well to resisted techniques too. This involves engaging the muscles on one side to push your chin into your osteopath’s hand. After a few seconds, you are asked to relax, and the jaw is stretched to the other side. For some people, this can immediately resolve a clicky jaw, although the best results come from continuing the technique at home as an exercise
Managing Other TMJ Problems
It is possible for the joint to become arthritic, but this is not the end of the road. Cartilage has a poor blood supply, but it can be supported to heal itself, or at least slow the progression of the condition. Similar to strategies mentioned above, we will work to improve local movement, and provide exercises to keep the joint moving well between sessions. It is important to remember that movement is good for joints, even if they are arthritic. Don’t be afraid to push into discomfort, just avoid movements that are too painful. We can support you in finding your limits, and keeping the whole area moving as well as possible.