Temporo-Mandibular Joint Syndrome

What is TMJ?


TMJ (temporo-mandibular joint) syndrome or TMD (TM disorder) is a problem with the busiest joint in your body – the jaw joint, which moves about 2,000 times a day. The misalignment can affect some of the many nerves and tissues that travel through the area. Some estimates suggest that over 10 million Americans are affected by TMJ and the condition appears to be more common in women than men.


The temporo-mandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head – the temporal bone. If you place your fingers just in front of your ears and open your mouth, you can feel the joints. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control its position and movement.


For most people, pain in the area of the jaw joint or muscles is not a serious problem as the condition can be occasional and temporary with pain eventually going away with little or no treatment. However, sometimes significant, long-term symptoms can occur.

Causes of TMJ:


A common cause of TMJ is trauma – not only to the head, neck and jaw but to other parts of the body structure including the hips and tailbone. A fall on the sacrum (lower spine) in time can cause pelvic imbalance that will affect the jaw, head and neck.[i]


Other causes of TMJ may include poorly fitting braces or other orthodontia, impacted wisdom teeth, spinal and postural unbalance symptoms, spinal nerve and emotional stress. TMD and spinal problems are often related. By relieving spinal stress chiropractic can relieve stress on TMJ.[ii]


Surgery should not be done until chiropractic and proper dental support is provided – with the exception of a tumor, fracture or serious joint pathology.[iii]

What are TMJ Disorders?


The temporo-mandibular joint is among the most complicated in the body due to the combination of hinge and sliding motions. Because of its complex movement and unique makeup, the jaw joint and it controlling muscles can pose a challenge to both patients and chiropractors when problems arise.


Researchers generally agree that the conditions fall into three main categories:


  1. Myofascial pain involving discomfort or pain in the muscles that control jaw function.
  2. Internal derangement of the joint involving a displaced disc, dislocated jaw, or injury to the rounded area at the end of the bone (condyle) where muscles and tendons attach.
  3. Arthritis – referring to a group of degenerative or inflammatory joint disorders that can affect the TMJ joint.

What Are The Signs and Symptoms?


A variety of symptoms may be linked to TMJ disorders. Pain, particularly in the chewing muscles and/or jaw joint, is the most common symptom. Other symptoms include:


  • radiating pain in the face, jaw, teeth or neck
  • jaw muscle sti­ffness, locking or limited movement
  • painful clicking, popping, grinding in the jaw joint when opening or closing the mouth
  • a change in the way the upper and lower teeth ‑t together
  • headaches, loss of hearing or ringing in the ears (tinnitus)

Diagnosing and Treatments:


Because the exact causes and symptoms are varied, identifying disorders can be difficult. Your chiropractor will note the description of symptoms, take a detailed medical and dental history and examine problem areas, including the head, neck, face and jaw. Imaging studies may also be recommended.


Facial pain can be a symptom of many conditions, such as a tumor, sinus or ear infections, various types of headaches and facial neuralgias (nerve-related facial pain). Ruling out these problems first helps in identifying TMJ disorders.


Your chiropractor will schedule a program of adjustments for your treatment of TMJ. As well there are a few self-care practices that may help to alleviate pain while you are undergoing your adjustments, such as:


  • eating soft foods
  • avoiding extreme jaw movement (such as wide yawning or chewing gum)
  • learning techniques for relaxing and reducing stress


Also, your chiropractor may recommend gentle stretching and relaxing exercises for your particular condition.


Irreversible Treatments:


Irreversible treatments that have NOT been proven to be effective – and may make the problem worse – include orthodontics to change the bite; crown and bridge work to balance the bite; grinding down teeth to bring the bite into balance or dental orthotics, which permanently alter the bite.


Other types of treatments, such as surgical procedures, including implants, invade the tissues. Surgical treatments are controversial, often irreversible, may cause severe pain and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders.


Chiropractic adjustments are non-invasive and will treat not only the existing problem, but in most cases also treat the area of the body which could be the main root of the TMJ problem and without the trauma of surgery or drastic dental alterations.

[i] Clark GT, Green EM et al Craniocervical Dysfunction Levels in a Patient Sample From a Temporomandibular Joint Clinic Journal of the American Dental Association, 1987;115:251-56. July 12, 2015

[ii] UC Berkeley Wellness Letter, March 1994

[iii] Smith G. Personal communication. Jan. 1991.


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