• Dr. Donald Littlewood

Jaw pain got you down?


Why does my jaw hurt?


This is one of the most frequent questions I get in my office, and it seems to be increasing as time goes on. But what exactly is this jaw pain & how can chiropractic care help? I promise I'll get into that, but before I do, let's do a wee anatomy lesson.


Anatomy of the TMJ



The temporomandibular joint, otherwise known as the TMJ or the jaw, is a complicated joint in the skull that incorporates the mandible, the cheekbone, a cartilaginous disc, muscles & innervation from the head & neck.


The TMJ is a unique joint that both translates & rotates in order to open and close the jaw. It also contains a disc that acts as a shock absorber during TMJ activity. It has no direct blood or nerve supply, but the attachment of the disc by the ear has a lot of both & can therefore cause pain.


The main movements that happens in the jaw are opening & closing. Opening the jaw comes mainly from the lateral pterygoid muscle, while the closing the jaw is done by the masseter, medial pterygoid & temporalis muscles.


There are also three ligaments involved in the jaw joint. Two of them attach to the inside and outside of the mandibular condyle and its groove in order to limit extreme motion. There is also the capsular ligament that surrounds the joint space & the disc to keep all the lubrication fluid in the joint.


Temporomandibular joint disorder

Now that we've got some of the basic anatomy covered, let's talk about some of the disorders that can come from the TMJ as well as their signs/symptoms.


Jaw pain is a pretty common occurrence these days, with ~25% of people experiencing it at any given time. I actually think this number is a bit low.



There are some pretty common signs & symptoms that frequent jaw pain sufferers, including pain, limited range of motion, headaches, noises & locking in the jaw, and ear pain.


There are three different types of TMJ disorders: disc displacement, arthritis & muscular.


Articular disc displacement

Otherwise known as internal derangement, articular disc disorders are the most common articular disorder of the jaw. This type of jaw pain is marked by disrupted movement, joint noises as well as clicking & locking.


In internal disc derangement, the disc moves forward which causes its attachment at the bone to stretch. Once the jaw closes, the disc comes back into place which is what causes the popping/clicking noise.


Why does this cause pain? Well if you remember earlier in the blog post I said that the disc itself has no blood or nerve supply, but its attachment at the bone does. A lot of blood vessels & nerves, in fact. It is the stretching of the disc that causes the pain.


Arthritis

There are a few different types of arthritis that can be found in the TMJ, but by far the most common one is degenerative joint disease, more commonly known as OA.

Like most conditions in the body, we don't fully know why this happens, but we do know that it isn't coming from one source. There are chemical, mechanical, inflammatory & immunologic components that come together to cause OA, including repetitive & excessive mechanical stress.


Patients suffering from OA of the jaw often experience pain with chewing, tender joints with decreased range of motion, a grinding noise in the joint & referred pain into the head and neck.


Muscular

By far the most common type of TMJ disorder is muscular. 50%+ of all TMJ cases are muscular in origin, and the majority of those that aren't have some sort of muscular component to their presentation.


The muscles that are most commonly affected are the ones that you use to chew your food, so the masseter, the pterygoids & the temporalis muscles. When these muscles get overworked, they become tight which causes soreness in the jaw, neck & head.

Now at this point, I'm sure you are all wondering why we get this muscular TMJ pain. Well, TMJ pain is frequently induced by stress. This is because when we are stressed, one of our first reactions is to clench the jaw. This clenching, as well as grinding the teeth at night, is known in the biz as bruxism.


Tips for easing TMJ pain

The real reason you're here, amirite?!


Easing jaw pain can be quite challenging, but I am here to offer a few really good tips you can use to decrease the pain and increase your range of motion.


Stress reduction

If you've been following along here or on my socials, you'll know that I am big into stress reduction. Stress plays such a massive role in all facets of our health, and as I said before, jaw pain is no different. In fact, if you have jaw pain getting your stress under control is crucial.


Stress reduction looks different for different people, but there some strategies that are pretty overarching.

  • Diaphragmatic breathing: breathing through your belly instead of your chest is a way to activate your parasympathetic nervous system [PNS] which triggers your body's 'rest & digest' phase

  • Exercise: another great way to activate your PNS is through exercise. Exercise also releases endorphins which act as your body's opioids to decrease any pain you are feeling. This exercise doesn't have to be intense; a 30 minute brisk walk is all you need.

  • Creativity: doing something creative keeps your mind focused, releases dopamine [your happy chemical] & can also help you process trauma. Doing something like knitting, painting, or gardening is akin to meditation when it comes to stress reduction.

If you are looking for more info/tips on stress reduction, head to this blog post I wrote on the topic!


Self-massage techniques

Since the jaw muscles are so influential in jaw pain, I wanted to give you a self-massage technique that you can use whenever you are feeling a little sore.

This self-massage technique is for the masseter muscle, which is one of the main players in TMJ pain.

  1. Find the masseter muscle by starting to poke around in front of your earlobe until you find a sore spot in the meaty part of your cheek. This is the masseter.

  2. Push in firmly and slowly open your mouth. You will likely feel some pain or discomfort as you do this. This is okay as long as its not more than a 5-6/10.

  3. Relax and repeat 5-6 times on both sides

NB: this might cause some increased soreness in the area for a few hours. This will go away, and your jaw will likely feel even better after!


Jaw exercise

I wanted to end this blog post with a quick exercise that you can to to help realign & synchronize your jaw mechanics. It's called controlled opening.

  • Start by placing the tip of your tongue on the roof of the mouth, just behind your front teeth

  • Slowly open your mouth, only going as wide as you can with your tongue still on the roof of your mouth.

  • Repeat 6-8 times 3x/day

Final thoughts

Jaw pain is pretty common & quite painful. The good news is, it can be solved. Reducing your stress, self-massage and exercise can help & so can seeing me. If you or someone you know is experiencing jaw pain, please do not hesitate to get in contact with me & book your free phone consultation.

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