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GThe Low Back, Abdomeb, & PelvisENERAL INFORMATION, SIGNS & SYMPTOMS, OSTEOPATHIC AND SELF MANAGEMENT OF
  Jaw Pain & TMJ Syndrome

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Jaw pain is a painful symptom of what is commonly known as TMJ (Tempero-Mandibular Joint) Syndrome.

Causes
TMJ Syndrome is currently theorised to be a syndrome as the direct cause is still not fully understood. There are three theorised causes:
  1. Muscle Spasm (e.g. as a result of night time jaw clenching, teeth grinding, and psychological stress*, and sleeping disorders**)
  2. Degenerative Joint Disease (arthritis within the joint)
  3. Changes in the jaw joint: there is a small disc within the joint that can change position (e.g. from trauma)
* Depressive mood and perceived stress was found associated with pain sensitivity and was predictive of 2 to 3-fold increases in risk of first-onset temporomandibular disorder [1]
** Sleep problems may mediate the association between enhanced pain perceptions in chronic pain patients and attenuated conditioned pain modulation (one of the mechanisms of central nervous system pain amplification) as it was showed for temporomandibular joint disorder [2]


Symptoms

  • Increasing pain over the course of the day (especially in the jaw muscles)
  • Pain may also felt in the rest of the head, ears, neck and shoulders.
  • Jaw locking or clicking (may also hear ear clicking)
  • Reduced ability to open, close mouth, &/or eat
  • Ringing in ears (tinnitus)

How is it diagnosed

Your osteopath will be able to diagnose TMJ syndrome by taking a full past medical history and physical examination. You may need to be referred for an X-Ray, other imaging or blood testing if further investigation into the cause is required.


Osteopathic Treatment
An Osteopath will aim to provide symptomatic relief of pain in the related structures of the jaw, head, neck, back & shoulders. This may allow for reflex relaxation of the jaw to settle symptoms of jaw pain and may also assist with a better nights sleep. Osteopaths are also trained to treat muscles within the mouth (with gloves) to access muscles directly related to the jaw that may be in spasm.

Your osteopath will also be able to refer you to a specialist should there be further assistance required (for example GP for temporary pain relief or muscle relaxants or a dental/TMJ specialist). A referral to a psychologist may also assist in some cases (e.g. for management of stress or anxiety).


Self management/Other Management tools:
  • Heat may help relax muscles in spasm. Place a heat pack under your neck for 10-30minutes and relax. Perform this 2-3 times per day.
  • Self massage and stretching for the jaw, and related structures (head, neck & back). Click Here for stretches for the head and jaw.
  • Neck Stretches also assist in relaxing the jaw: Click here for neck stretches.
  • Night Guard/Mouth-guard/splint: may assist in reducing teeth grinding and muscle spasm. It is commonly used over a short period. An osteopath may refer you to a dentist for further evaluation and prescription.
  • Cardiovascular exercise and/or Meditation: e.g. for stress reduction
  • Strengthening exercises for mal-alignment. Click here for strengthening exercises.

References
  • (1) G. D. Slade, L. Diatchenko, K. Bhalang et al., “Influence of psychological factors on risk of temporomandibular disorders,” Journal of Dental Research, vol. 86, no. 11, pp. 1120–1125, 2007.
  • (2) M. T. Smith, E. M. Wickwire, E. G. Grace et al., “Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder,” Sleep, vol. 32, no. 6, pp. 779–790, 2009.