Exercises Fixes for TMJ
Wednesday, August 25, 2010 at 12:08AMTemporomandibular joint (TMJ) pain is an exceedingly common issue, with as much as 50-75% of the general population exhibiting at least one sign of TMJ dysfunction.[1]
TMJ or the broader group of temporomandibular joint disorders (TMD) involves a wide ranging constellation of symptoms, including such things as: [2]
- Pain
- Joint sounds
- Limitation in jaw movement
- Muscle tenderness
- Joint tenderness
- Otalgia or earache
- Toothache
- Headache
Historically many people considered TMJ disorders to be a very local issue confined to the just the jaw or the craniomandibular system. More recent studies, though, suggest evaluation and treatment of the neck, shoulders, head position and posture in addressing this issue.
A study by Nikolakis et al. in the Journal of Oral Rehabilitation found that exercise therapy for TMJ symptoms reduced pain and improved incisal edge clearance significantly.[3] Related studies have similarly demonstrated:
- Association between abnormal head posture and cervical posture and TMD[4]
- Children with clicking TMJ and limited jaw mobility had marked forward inclination of the head[5]
- Treatment of “the upper quarter” including the cervical spine and shoulder girdle improved outcomes in patients with complex or persistent symptoms in the head and neck region[6]
Exercise therapy is a good fix for musculoskeletal issues of all types. So why not approach TMJ in this broader context of musculoskeletal dysfunction involving not just the jaw but also the neck, shoulder and head. Exercise interventions can reduce pain and muscle spasm, achieve relaxation and improve joint mobility. Why not apply these principles to the TMJ?
Nikolakis et al. attempted to do just this in their study referenced above. The study involved the following interventions:
- Massage of painful muscles
- Muscle stretching
- Gentle isometric tension exercises against resistance
- Guided opening and closing movements
- Manual joint therapy
- Correction of body posture and relaxation techniques
While the sample size for the study was small, and the study has some limitations in its design, the results are noteworthy. “80% of the patients rated jaw pain as excellently or distinctly improved, and 15% experienced a moderate pain reduction.” [7] At 6 months, 94% reported no pain at rest and 39% felt no pain at all.” Not bad.
So to my niece and all those out there with TMJ-related symptoms, there is hope. A broader exercise program including relaxation and neck-related exercises can help. So can acupuncture, but we will leave that for another post.
[1] Journal of Orofacial Pain. 2006. 20(1): 9-23
[2] Journal of Orofacial Pain. 2006. 20(1): 9-23
[3] Journal of Oral Rehabilitation. 2001. 28: 1158-1164
[4] Kinseiologia. 2001. 64: 82-87
[5] Eur J Orthod. 2001. 23:179-192
[6] Journal of Oral Rehabilitation. 1996. 23:742
[7] Journal of Orofacial Pain. 2006. 20(1): 9-23
Reader Comments (1)
Great post! Very informative. It is surprising how many patients come in with TMJ. It can be very painful and discomforting. For treatment of TMJ we suggest avoiding chewing gum or hard, chewy food, taking small bites, and alternating chewing between both sides of the mouth. Good nutrition will also help the joint heal more quickly.