Dr. James DiGregorio Talks About TMJ Pain, Physical Therapy, and the Pandemic
With our most recent pandemic and being forced to wear masks out in public, I began to hear an increase in complaints of TMJ or pain, myself included. With this growing issue, I figured that I would highlight what TMJ is, how it is affected with the pandemic, and solutions for the pain.
First off, what is TMJ and how does it cause pain?
- The temporal-mandibular joint is a saddle-hinge joint at the top of your jaw
- The joint consists of two bones with a disc located between them and small muscles surrounding the joint
- Pain is often caused by overuse of muscles around the area or impingement of the disc between the joints
Common reasons for TMJ pain?
- Clenching of the jaw
- Stomach sleeping
- Post dental work/surgery requiring extended period of time with the mouth open
- An increase in stress
- Car accidents/whiplash
- Shoulder pain or neck pain/headaches
- Postural abnormalities and overactivity of sternocleidomastoid muscles
- An increase in sitting
- Wearing a mask?
How can wearing a mask aggravate this pain?
- Reducing your jaw ROM during talking leads to over activity of muscles around the joint
- People are dissuaded from talking with a mask covering their mouth which leads to an increase in stiffness
- People needing to project their voice due to a barrier being over their mouth
- Adjusting the position of the mask with facial muscles
Symptoms of TMJ:
- Face, ear, jaw, or mouth pain
- Difficulty and painful chewing (only being able to take small bites)
- Jaw locking
Self care techniques for TMJ pain:
- Icing of muscles around jaw
- RACABADO exercises for TMJ pain (set of 6 exercises to retrain muscles around the joint)
- Practicing relaxation of muscles around the joint
- Stretching of neck muscles
Physical Therapy for TMJ pain:
- Manual release of muscles around TMJ and upper neck areas
- Manually improving joint mobility and disc placement between the joint
- Modalities such as electrical stimulation to reduce pain
- Re-educating muscles around TMJ to reduce pressure and stress on the joint
- Postural re-education to reduce activation of sternocleidomastoid muscles
TMJ pain is an issue that will rarely go away without either self-treatment or professional treatments. Common treatments from your dentist or oral surgeon will be night guards or oral surgery which may solve the main problem. A combination of passive and active care techniques are necessary for full alleviation of jaw pain.
By Dr. James DiGregorio, PT, DTP of SHC Montvale