Temporomandibular Joint Dysfunctions

TMJ, also known as Temporomandibular Joint Dysfunction. This means that there is pain and difficulties in moving the jaw. This can happen from a muscular imbalance, stress, injury to the jaw, or from having prolonged dental work. This condition can heal on its own if it’s just pain that you’re feeling. However, if there is something wrong with the joint, in the jaw itself, it may only be able to be fixed with physical and manual treatment.

If the joint has structural damage, such as fractures and dislocations, the only way to fix it is with medical intervention. This includes surgery and wiring until the bone can heal. Even if surgery is needed, quite often there is a need for physical or manual therapy to help relearn how to move the jaw correctly without using one side more than the other, after you have healed from the surgery itself.

Temporomandibular Joint Dysfunction Treatments using Massage

Massage can work on the different muscular structures both along the outside of the jaw and even up into the temples, as well as on the inside of the mouth. And let’s not forget the muscles in the front and the back of the neck, which can also affect how the jaw works. It is also one of the main reasons why, when someone has whiplash from a car accident, they often get TMJ or some of the symptoms of TMJ.

Most of the time TMJ treatments starts on the upper back and into the back of the neck. This helps relieve some of the tension that you have, and can sometimes resolve minor TMJ conditions with just this type of release. Afterwards you will have to be face up for the rest of the treatment. At this point, the muscles at the front of the neck, especially the ones that help lower the jaw, as well as the ones that help you with swallowing will be worked on.

Any one of these muscles can have what is known as trigger points, or active knots, which can cause a lot of pain in the area, or refer pain to another part of the jaw. Then there are the muscles that are used to close the jaw, the one over the jaw itself, the masseter, which is the strongest muscle in the entire human body relative to its size. The other muscle that helps close the jaw is the one that goes into the temple and attaches to the other side of the joint in the jaw, on the mandible. Both of these muscles can be very tight and tender when touched. Many times, due to chewing more on one side then the other, these muscles will be more tender, and even tighter on one side of the face compared to the opposite side. This is the cause for the jaw to slightly deviate to the same side of the tightness if there is a jaw deviation present.

Now for the more uncomfortable part of the treatment, that is most effective. It is also the part that, at the beginning of your treatment sessions will be the shortest part, and gradually gets longer after each treatment. This is where work is done on the inside of the mouth. Three muscles are worked on in this position, for one of these muscles, this is the only way that it can be worked on. As for the other two, they can be treated on the outside of the mouth, however not as effective as treating it on the inside of the mouth.

The muscles that can be only treated on the inside of the mouth are located at the back of the mouth. They are just behind the back molars, where the jaw turns into a “C” shape. The next is on the inside of the jaw, between the tongue and the jaw, this is one of the ones that can be worked on outside of the mouth. It is near the corner of the back of the jaw, under the jaw itself, closer to the throat. Lastly, it is back to the masseter muscle that was mentioned earlier, this one you are working on both the inside and the outside at the same time. This is where the therapist uses their finger like a pincer, allowing it to be easier to work on trigger points that are in the muscle. Before any of these muscles are worked on the patient and the massage therapist will have to discuss and agree on hand signals for you to use so you can let the therapist know if you are still handling the treatment well, or if you want them to stop.

Massage Treatment Plan for TMJ

Each of these sessions should only last for about 30-45 minutes for everything put together, starting with doing only about 5 minutes inside the mouth, as long as the patient can tolerate it. At the end of each session, you should be able to notice a difference in your jaw already. This can be from having less pain to having an easier time with being able to open and close the jaw. However, you may also notice that you could have a bit of swelling in the areas that were worked on in the mouth. This is very common, and making sure that you have freezies, or ice cubes later on at night to be able to suck on is beneficial. The main objective at the end of all of your treatments is to have little to no pain, as well as being able to put three of your knuckles, of your non-dominant hand (for example, if you are right, handed you want your left three knuckles), to be able to fit between your bottom and top teeth comfortably.

Depending on the severity, the number of sessions can vary, but you will want to do at least three sessions about one a week or one every two weeks. Then the therapist will be able to reassess your condition and know how you are progressing. This will be a pretty good indication as to how you are reacting to your treatment and will have an easier time being able to tell how many more sessions that you need to have. Also as a reminder, make sure that you communicate with your therapist during this entire treatment, as it can be uncomfortable, and you don’t want to be in more pain than you were coming into the treatment.