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  • David Wadsworth

Jaw Pain or TMJ

Updated: Mar 23

Pain in the region of your jaw, or temporomandibular joint (TMJ), is common, with between 4-5% of people suffering this problem*.


There are multiple causes of jaw pain, and the term given to all of these causes is TMD or Temporomandibular Disorders. In simple terms jaw pain can be caused by:


1. Muscles

2. The joint itself (TMJ)

3. Or Headache which is attributable to the jaw muscles / jaw movement


MUSCULAR JAW PAIN:

By far the most common cause of jaw pain are the jaw muscles, which are prone developing myofascial trigger points which refer pain into the region of your jaw, ear or head (ie a headache). A trigger point is a taut band of spasm in your muscle which becomes painful and refers pain further away from the trigger point itself (see the picture below). Trigger points in your jaw are typically caused by repeated or chronic muscle overload (often from clenching your teeth in response to stress or grinding your teeth at night), but can also arise following trauma (eg a fall or impact where you hit your jaw or head).


Masseter muscle trigger points typically refer pain into one or more of the red shaded areas.

The good news is that muscular jaw pain is fairly simple to treat and produces very good results. It requires very skilled trigger point therapy and addressing any perpetuating factors such as jaw clenching when stressed, or eliminating the issues in the neck or cranium following trauma that perpetuate tight muscles. The key part of the treatment for repetitive / chronic muscle overload patients is often learning to manage stress and anxiety to prevent recurrence.


JOINT PAIN / TMJ PAIN:

Pain arising from the TMJ is the next most common cause of jaw pain. The jaw is a rather unique joint as it involves two paired joints for the one bone (the mandible). Each TMJ has a disc which normally moves as you open and close your mouth. Some types of joint problem involve issues with the disc, with the joint capsule / ligaments, or the joint surfaces (eg arthritis). There are several recognised types of joint disorder including:


1. Disc disorders

2. Osteoarthritis (OA)

3. Rheumatoid arthritis (RA)

4. Instability

5. Fibrosis (stiffening & contracture of the joint capsule making it difficult to open your mouth)


Joint disorders can be associated with:

· Clicking noises when opening or closing;

· Locking (the jaw gets stuck), and

· Pain when using your jaw (eg chewing or biting).


A physiotherapist skilled in this area can diagnose the difference between joint and muscular causes of jaw pain, and manage the both types of disorder effectively.



HEADACHES & FACIAL PAIN ATTRIBUTABLE TO A JAW DISORDER

Some people experience headaches associated with their jaw disorder. Usually these headaches are caused by trigger points in the jaw and neck muscles which can refer pain into the head and feel exactly like a headache, a tooth ache or jaw pain. The differential diagnosis for a patient complaining of a headache should include examination of the jaw structures to ensure that they are not the cause.


It’s also important to note that most (83%) patients with jaw pain also have other disorders present as well*. That’s right, only 17% or people who get jaw pain have ONLY jaw pain! About 50% have neck pain or headaches in addition to their jaw complaint, 64% have back pain, and 59% of people with a jaw condition have at least 2 other conditions occurring at the same time. So managing these other conditions at the same time is often beneficial.

Fortunately at Pain Solutions Queensland David is skilled and highly experienced in managing not only jaw conditions but most other types of musculoskeletal pain. He routinely treats patients who have multiple problems at once.



*Plesh O et al (2011): Temporomandibular joint and muscle disorder-type pain and comorbid pain in a national US sample. J Orofacial Pain 25:190-198.

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