PHYSIOTHERAPY IN TMJ DYSFUNCTION
Temporomandibular joint (TMJ) dysfunction is a very common patology that might affect around 30% of the population, with a higher prevalence in women comparing with men. Jaw pain is one of its most characteristic symptoms, often caused by bruxism .
The TMJ is a bicondylar joint between the jaw and the temporal bone, and acts as a sliding hinge, allowing opening, occlusion and lateral deviation movements.
Periarticular muscles are in charge of controlling their position and movements, which are inserted around the joint and allow us to make gestures, speaking, chewing or yawning.
TMJ disorders cause pain and dysfunction. This problem seems to be more common in women than men and it is frequently the object of treatment with physical therapy, effective in 90% of cases.
WHAT ARE THE MAIN SYMPTOMS?
- Pain in the jaw, ear or face.
- Headache, neck or back pain.
- Blocked jaw and occlusion problems.
- Stiffness in the jaw muscles.
- Difficulty or discomfort in chewing or opening the mouth.
- Change in the type of bite, tooth wear.
- Clicking or cracking of the jaw.
WHAT CAUSES THE ATM ALTERATIONS?
- Stress or anxiety. Tendency to clench or grind teeth ( bruxism ).
- A bad occlusion.
- Orthodontic treatment.
- Injury to the jaw or the temporomandibular joint.
- Wear of the disc or cartilage of the joint.
BRUXISM AND MANDIBULAR PAIN
One of the main causes of temporomandibular dysfunction is bruxism or clenching teeth. It is estimated that up to 40% of the population unconsciously clench or grind their teeth at night, generally due to stress or other genetic factors.
The tension generated by the occlusive musculature, mainly ruled by the masseters, can generate a constant tension in the joint, producing headaches, jaw , neck, among others.
Bad postural habits also are conditioned by the tension of these muscles, as well as the articular discs and the ligaments of the joint.
Physiotherapy treatment is essential in the approach to bruxism. Mainly objectives will be to reduce tension of the muscles surrounding the TMJ, as well as those of the neck, and to treatment the pain using specific manual therapy techniques.
Night discharge splint will also help to control symptoms and protect our teeth, so it´s also advisable to consult with your dentist.
PHYSIOTHERAPY TREATMENT OF TMJ
It usually requires the collaboration of several specialists, among which the figure of the physical therapist and the dentist stands out. Physiotherapy treatment can help re - establish control of jaw tension, the joint itself, rehabilitation of occlusion and the control of symptoms . Its main objectives are the following:
- Manual therapy (mobilizations), very effective in the short term for increasing vertical opening.
- Mandibular exercises , assisted and resisted assets.
- Postural education to reestablish posture and improve the resting position of the jaw, head, neck, sternum and shoulder blades.
- Treatment of pain with mobilizations and heat or cold in painful areas.
- Deactivation of trigger points (PGMs), myofascial techniques and massage therapy in areas adjacent to the TMJ (neck and back).
- Self-relaxation techniques.