When To See A Professional For TMJ Issues
TMJ issues usually present with pain in and about the jaw line, trouble opening and closing, limited opening and closing, clicking and popping in the jaw, headaches and possibly dizziness. There are a few other types of issues caused by TMJ problems, but they are rare.
There are really two main reasons to seek professional help with TMJ Issues:
Your Problem Is Actually A Medical Emergency Unfolding
You Are No Better With The Home Exercises Alone, Or You Are Better, But Not Best
Your Problem Is a Medical Emergency
Trauma: Usually most people don't wonder if they have broken jaw, they just know. Mostly because it hurts so much! Jaw trauma can happen from slips and falls and bar fights. Some sports are more likely than others to produce these, basketball comes to mind. If you are experiencing jaw pain from a trauma, YOU NEED TO PRESENT TO A MEDICAL DOCTOR RIGHT AWAY! Delay with something like this can really impact the outcome, and could represent a life threatening situation if your airway became obstructed.
Referred Pain From The Heart: Most people understand that pain from a heart attack or super high blood pressure can refer pain somewhere, typically down the arm. You should also be aware that heart issues can refer pain to the neck and jaw as well. This is more common in women than men, but it can happen in both sexes. Referred pain from the heart often comes on suddenly and without warning. It isn't likely to be accompanied by any problem opening or closing your mouth, and won't have any clicking or popping associated. Heart referral pain usually has a "crushing" or "vice grip" sensation associated with it, and it is made worse by exertion, like going up stairs or walking fast. LIKE TRAUMA, IF YOU SUSPECT A HEART ISSUE MIGHT BE CAUSING YOUR PAIN, DON'T WAIT GET TO AN EMERGENCY ROOM, EVEN IF YOU ARE UNSURE!
Temporal Arteritis: Temporal Arteritis is an inflammation of the blood vessels in and about the scalp. It is usually described as a very severe headache, the worst you have ever had. Unlike the others, this one can be aggravated with eating and talking (movement of the jaw). It can come and go. If left untreated it can cause a lot of problems and while not as likely as a heart event to be life threatening it can have some serious complications.
Not Better, Or Not Best....
For many people with TMJ issues, time and the simple home exercises we went over in the last article (How To Help Yourself With TMJ) are all they need for their condition to resolve. However, some people just don't get better, or they are better but are still having some pain and problems. There are several reasons this can be the case:
- Your pain is coming from some other muscle or joint besides your TMJ in part or in whole. There are several muscles that can refer pain to the Jaw area so that it actually feels like Jaw pain, but isn't. The two most common are the sternocleidomastoid muscle and the trapezius muscle. If this is the case, you likely won't have any problem opening or closing your mouth (no popping, clicking or limited movement) but you will have pain in the area.
- Your pain is coming from an issue with your teeth. This would be things like a cavity, erupting wisdom teeth, an abscess etc. Usually this type of pain while it may have some pain around the jaw joint, is more predominant around the injured area inside the mouth along the gum line. These areas may also be very sensitive to heat, cold and pressure. You may also show some signs of infection like swollen glands and lymph tissue with an abscess.
- Your pain is coming from a severely degenerative joint (arthritis). This usually only happens in long standing jaw issues where time and bad mechanics have had enough time to wear down the area.
- Your pain is coming from an altered "bite" .Common altered bites would be things like an over or underbite. Other changes in bite can be caused by missing or malpositioned teeth and dental work.
- Finally, and most commonly, you may have muscle and joint issues that are just to "embedded" to resolve with home exercises and muscle work. Scar tissue, large trigger points, joint adhesions are all things that may just need extra work to resolve. Home exercises and muscle work play a role, but not until the underlying restrictions are resolved.
Who Should You Be Seeing ?
A large majority of TMJ pain cases resolve on their own. The ones that don't resolve on their own often respond well to the home exercises over four to six weeks. If you are still dealing with problems four weeks after diligently adhering to a home program it may be time to seek help.
For cases of trauma, possible referred pain from the heart and jaw pain with intense headache (Temporal Arteritis) you should have already presented to your medical doctor.
If you know you are suspicious that you might have a cavity, abscess, loose tooth / dental work or think you are having a problem with erupting wisdom teeth then it makes sense to present to your dentist.
If it seems like your teeth really haven't changed there is a good chance your pain may be coming from the muscles that surround the jaw. In fact, it is estimated that at least %50 of TMJ issues come from this. Addressing them directly can be very helpful. Medical doctors and dentists often treat this with non-steroidal anti-inflammatories and muscle relaxers. Chiropractors and physical therapists typically work with trigger point therapy, heat packs, massage and therapeutic exercises. Some practitioners have begun to integrate cold laser (non-surgical) and specific nutrition for inflammation and muscle spasm, usually Chiropractors and some dentists.
If you find you also suffer from a lot of anxiety and depression, counseling and or biofeedback may be useful, especially if you do a lot of "night grinding".
I have dealt with TMJ issues off and on over my whole career. The last several years we have seen that increase quite a bit, likely due to the phones and computers we are all on as alluded to at the start of this series on Technology Syndrome. In addition to addressing the muscles and joint issues of TMJ with pressure point therapy and adjusting, we have begun to add in cold laser therapy for both inflammation and pain control. That combined with sensible nutrition for spasm and inflammation can be an effective tool for managing most TMJ issues.
If you are unsure as to which way you should go, please feel free to contact me. We can talk on the phone for free, and I am happy to answer any questions you have and help you determine what direction you should go with a TMJ issue.
Yours in Health,
Doug Williams, D.C.
TMJ Relief Center At Care Chiropractic
134 Executive Drive #3
Lafayette, Indiana
47905
(765) 448-6489
