Chiropractor in Te Puke Talks about Chiropractic Care and TMJ

The actual causes of TMJ Syndrome are divided into four categories, from most commonly seen to least commonly seen:

1. Muscle Dysfunction - Most often, the muscles that move the jaw become dysfunctional and spastic. In particular, the medial pterygoid, lateral pterygoid, masseter, and the temporalis muscles become targets for our approach in the clinic here. [note: I would argue that TMJ Syndrome, distilled down, is largely a myofascial pain syndrome.]
2. Disc Problems - There is a cartilaginous disc that cushions the temporomandibular joint. It is connected and it influences several other structures integral to proper TMJ function. Any derangement or displacement of this disc will have significant impact on the TMJ’s overall function. The jaw popping noise often heard in TMJ Syndrome is in fact the condyle snapping over and back across the displaced disc in those patients. The gentle adjustments I perform are targeted at reducing this displacement and resetting the TMJ properly. [note: notice the relationship of the ear canal to the TMJ? This will help you understand why some patients exhibit significant ear complaints. See my case study below.]
3. Arthritis - Specifically, osteoarthritis or degenerative joint disease of the TMJ itself. This is the common wear-and-tear form of arthritis wherein the joint surfaces begin to degrade and remodel. Less frequently, other arthritic diseases can affect the TMJ, such as rheumatoid arthritis.
4. Temporal Arteritis - A rare condition, but one that any competent clinician must rule out when presented with a patient exhibiting TMJ Syndrome complaints.

Historically, this condition has been managed by oral surgeons, orthodontists and dentists as well as various medical specialties including pain management and rheumatology. Since the three most common causes of TMJ Syndrome involve the muscles and joints, it was only natural that chiropractors would begin to take a more active role in helping these patients. This makes even more sense when you consider the overlapping neck pain and headache that are seen in TMJ Syndrome patients; both of these conditions respond very well to chiropractic care.

If a TMJ Syndrome patient’s dentist is comfortable treating TMJ, we can work together to develop a comprehensive and unique treatment strategy that addresses all of the patient’s TMJ Syndrome complaints. I humbly tell you that my methods for treating temporomandibular disorder (TMD) are quite successful. In fact, I am unaware of any of my patients that have completed our treatment program that required TMJ surgery.

Adjustments may be used in your treatment of TMJ depending on the cause of your jaw disorder. During an adjustment, the chiropractor may press on your jaw, skull or upper spine to relieve irritated nerves and increase your jaw’s range of motion. Soft tissue based therapies including Active Release Technique may be incorporated into your treatment. This is a patented tissue based therapy that breaks up adhesions and scar tissue on the surrounding muscle and ligaments. This is proven to be a very effective method when combined with regular chiropractic treatments or as a standalone treatment.

• DO - eat soft foods like soups and stewed vegetables. Meal replacement shakes can also be helpful during an acute flare-up to ensure that you are getting adequate nutrition while not working your TMJ.
• DO NOT - eat hard foods or foods that require a great deal of hard chewing.
• DO - use ice over your jaw. Heat may feel good, but it is likely only temporary.
• DO NOT - open your mouth to its limits (e.g., yawning).
• DO - use over-the-counter or prescription pain medicines as they may provide relief.
• DO NOT - use over-the-counter or prescription pain medicines longer than a few days. Pain is like a fire alarm and the medications simply turn off the alarm while doing nothing about the fire.
• DO - call us if you require pain medication for longer than 72 hours, you need to get those flames put out and we have the fire extinguisher!
• DO NOT - chew gum or taffy and avoid all other repetitive jaw movements.
• DO - perform TMJ exercises, but…
• DO NOT - perform TMJ exercises if your TMJ Syndrome gets worse from doing them. Unless and until you have tried working with a TMJ chiropractor and failed to reap benefits, you should avoid therapies that permanently change your bite or jaw structure. This includes crown and bridge work, bite altering orthodontia, permanently altering your bite by grinding down teeth, or bite-repositioning splints. These should only be done as a last resort.
• DO NOT - have TMJ surgery unless you have truly exhausted every other clinical resource. Unfortunately, no research has been performed to prove the safety and long term effectiveness of these risky and invasive procedures.