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Temporomandibular Joint Dysfunction | Physiotherapy Treatment

What is Temporomandibular Joint

Temporomandibular Joint Dysfunction or TMJ dysfunction or TMJD, are conditions that affect the jawbones, surrounding muscles, and ligaments. It occurs in the synovial joints where the jaws are connected to the skull. TMJ allows you to perform several activities such as yawning, talking, eating, or kissing. Any kind of issue in this joint will result in serious discomfort in the region and hinder the performance of such activities.

The region may be injured due to several reasons such as accidents, arthritis, or even improper chewing. Read on to learn more about the causes, symptoms, and various treatment plans for Temporomandibular joint type dysfunction.

Temporomandibular Joint Dysfunction Causes

There can be several causes of the Temporomandibular joint pain, such as an old injury or trauma that has left an impact on the jaw. This can be a result of physical injuries that occur while playing, accident-related, or any types of falls or collisions that injure it. Some other causes are inflammation in the region, slipped discs of the facial bones, and immobilization of the jaws due to several reasons.

Reasons such as emotional tension, and muscle spasms in the facial muscles can also result in TMJ. Excessive stress on the joints as a result of improper chewing and biting can impact the joints and cause dysfunction. Since it occurs in the jaw region, dental problems can also reduce the mobility of the jaw and its muscles.

Temporomandibular Joint Dysfunction Symptoms

While lack of movement in the jaw region and its muscles are one of the most common symptoms of TMJ, other factors such as disturbed yawning, inability to chew well, sharp [ain in the jaw region, locking of the joints, and muscle spasms can also be markers of the dysfunction.

Other symptoms can include pain in and around the ears, a grating sensation when you open your mouth, and swelling in the joints near the jaw. Pain in the shoulders and the necks near the jaw can also be signs.

Temporomandibular Joint Dysfunction Diagnosis

One of the most common ways of diagnosing it is to go through a dental check-up. This allows the medical professional to ascertain the actual cause of the pain, and to understand if the pain is a result of a dental case. If this is ascertained, the medical procedure can either be performed by a dentist or a doctor who specializes in this particular case.

Simple tasks such as moving the mouth, side to side movement of the jaw, and contact near the region to understand any presence of pain can help understand the severity of TMJ.

In addition to these, radiography such as X-rays, CT scans of the jaw, and dental conditions can help diagnose the cause with ease. MRI scans can also be used to locate various joints and disk conditions to treat the problem better.

Temporomandibular Joint Dysfunction: Conservative Treatment

There are three types of surgical temporomandibular joint pain treatment. They are:

Arthrocentesis is a simple procedure performed where fluids that allow the joint to dislodge and function are injected into it. It also may require the removal of any disc or scar tissue that may be a result of the injury.

Arthroscopy is performed when a tiny incision is made near the ear at the jaw and after inspection of the area of pain, the scar tissue is removed or any kind of repair needed for the disc is performed. It is a less invasive procedure and the healing and recovery time is quicker.

open-joint surgery is performed commonly where larger incisions are performed and the area of the joint is treated as per the need. It is performed when there is large wear and tear of the joint and disc, tumors around the joint, or if there is severe bone chipping.

Besides these, anti-inflammatory medicines can be prescribed along with cold/heat packs for the pain, depending on the severity.

Manual Therapy Techniques for Temporomandibular Joint Dysfunction

Manual Therapy techniques can go a long way in helping improve mobility in the region of the jaw. Here are some that can help.

Kneading or soft movement of the joints can help reduce the tension in the joints and increase blood flow to the area. This can have a relaxing impact on the jaw and reduce the pain

Stretching techniques of the m=facial muscles and the joints can also help reduce the stress on the joints. This can also help increase mobility in the region. It can include steps like opening and closing of the jaws, and sideways stretching of the jaw.

Myofascial release can help in relieving pain. It involves the process of applying gentle pressure on the muscle tissue and fascia. Identifying the places of muscle resistance and applying pressure on these “pressure points” can help alleviate pain.

Relaxation Techniques for Temporomandibular Joint Dysfunction

For facial muscles, tongue proprioception and Tongue control

Using the tongue and the roof of the mouth can help reduce the pain in the jaws.

Drawing circles on the roof of the mouth with your tongue can create circular motions and can help reduce the pain.

Another technique is to fill the cheek with air and let it out as a puff. Making a clicking sound with the tongue can also help increase mobility in the jaw region and help soothe the pain.

Breathing exercises such as inhaling through the nose and exhaling through the mouth over a period of time can also help relax the jaw.

Temporomandibular Joint Dysfunction: Modalities Usage

Various modalities can help address the issue as well.

Cryotherapy, where cold temperatures are applied, is used on the region of pain for 15 to 20 minutes and can help reduce inflammation. It can also provide soothing relief and help increase mobility.

Thermotherapy where a higher rate of temperature is used on the body and tissue region, allows the muscle to relax and provides relief from inflammation and pain. This also helps increase blood flow and circulation in the region.

TENS therapy can also be used, where low-intensity electric pulses are applied to the area of tissue damage or pain. This allows the muscles to relax and improve conditions.

Exercises for Temporomandibular Joint Dysfunction

Goldfish exercises half mouth:

Keep to the tongue on the hard palate of the mouth. Place one finger on each joint. Place the other index finger on your chin and then let the mandible (lower jaw) partially drop down and back with the help of the index finger.

Chin tucks

Making a double chin by quickly tucking your chin into your neck is a simple and fun exercise to perform that can help increase mobility in the jaws.

Bottom Line

TMJ occurs when there is discomfort in moving the jaw and reducing movement in the jaw region

It can be a result of injury, bone wear, and tear, muscle spasm, or joint locking

It can be treated with exercises, physiotherapy and if needed surgery

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