TMJ (Temporomandibular Joint)

Head, Neck and Facial Pain is a broad term used by professionals to cover a wide range of symptomatology.  Symptoms of the upper quarter include headaches, facial pain, intraoral pain, cervical pain, upper extremity pain and chest pain.  There can be pain in or around the ears, vertigo, ringing in the ears, pain in or around the eyes with visual disturbances, tightness of the throat, difficulty swallowing or hoarseness.  It is important to differentially diagnosis and evaluate whether there is a dysfunction in the neck which is referring pain and muscle tension into the head and face, whether there is a cranial lesion or whether there is a joint problem of the TMJ.  Symptoms of the TMJ are TMJ pain during mandibular movement, mastication (chewing) and speech, joint sounds, such as clicking, popping or grating, and locking open or closed of the mouth or restrictions in mouth opening.  In trauma cases, where there is a direct blow to the face, films and possibly an MRI are warranted to rule out condylar fracture or disc derangement.  Without specific joint or serious medical findings, diagnoses frequently fall into the TMD or Temporomandibular Disorder category.  TMD is related to chronic postural aberrations and falls into Myofascial Pain Disorders.  It is up to the therapist to comprehensively evaluate and treat a client’s head, neck and TMJ as well as his/her posture to completely resolve his/her complaints.  Occlusal issues contribute to and may cause compression of the TMJ and create abnormal muscle activity in the mouth.  Slouched posture and clenching of the teeth contribute to compression of the neck and the jaw.  Specific treatment to the neck and jaw along with postural re-education are essential with a goal of balancing the head, neck and spine.  Dental referrals are made to balance the occlusion and for appliance consideration.  Ms Wheaton’s Master’s Thesis was titled “Mandibular Position and Its’ Relationship to Occlusion, Posture and Muscle Activity”.