What Tmj treatments are available in the UK?
TMJ or Temporomandibular joint is the joint that connects the lower mandible to the skull (temporal bone), i.e., your lower mandible to your upper mandible. These joints slide and rotate in front of each other and we have one on each side.
When the joints are properly aligned the system works smoothly. When these structures are not aligned properly different problems might pop up.
TMJ Disorders are disorders of the jaw muscles and fascia, the temporomandibular joints, and the nerves causing pain in the joint and the muscles around it, pain and other symptoms around the ear and temple.
TMJD symptoms:
- Jaw and face pain and stiffness
- Locking of the joint and difficulty opening and closing the mouth
- Ear pain and ear ringing
- Feeling of clogged ear
- Ache or tenderness on the joint
- Heachache/migraine
- Teeth clenching or grinding is usually associated with TMJ Disorder
TMJ Disoders causes are hard to determine and are different for each person. Tmj Disorder can develop as a result of a combination of factors. Although there might be factors like degenerative joint disease or direct injury to the jaw and arthritis, these are not the most common causes of TMJ Disorder.
As per the National Institute of Dental and Craniofacial Research the most common cause of TMJ Disorders is Myofascial pain (restrictions on the fascia). Unfortunately this doesn’t seem to be very well known by both the general public and health professionals. This lack of knowledge limits and complicates the treatment process for people experiencing this presentation, and they are usually left confused and in limbo without a real and effective treatment option.
When looking at available treatment options in the UK, the list is unfortunately short and not very effective:
- The first thing usually advised is a Mouth guard. In most cases these don’t fulfil their purpose, with no effect on pain levels or symptoms and with a lot of people chewing right through them in a few weeks. Although they might seem like an economic option, they can be expensive.
- Painkillers. This doesn’t fix the problem.
And that’s it. These are the two non-invasive options most available within the system at the moment.
- Surgery: This is the last option, to be avoided as far as possible.
None of these three options address the main cause for TMJ Disorder that we mentioned above
What’s the fascia?
The fascia is the most unknown and most recently discovered organ in our body. The fascial system is the soft tissue that interpenetrates and surrounds organs, muscles, bones and nerve fibres, endowing the body with a functional structure.
Far from being purely a structural element in our body, the fascia is also one of the richest sensory organs in our body, embedded in nerve endings and mechanoreceptors and responding to different and complex signals. The fascia is alive, like any other organ in our body.
What’s the best TMJ treatment or TMJ Disorder treatment?
In TMJ disorders, the fascia that surrounds the jaw joint is irritated for different reasons in different people. Therefore the best and only effective approach to releasing the pain and symptoms associated with it is releasing the fascia.
As we speak about TMJ disorders and the fascia as the most common cause for these presentations, we must mention stress as one of the most important triggers for fascia irritation.
Since fascia is a complex organ that responds to both pressure triggers and something as complex as stress, releasing it requires a specialised professional to do the job. Someone that has extensive knowledge in anatomy and is able to correct related structural imbalances caused by fascia restrictions but also has the ability to tune into and calm the client’s nervous system, reducing the stress response. These group of professionals are not part of the established medical system and are not always easy to find. Search for Myofascial Release specialist if you want to find someone local to you. You might need to try different therapists until you find one that produces effective results for you.
Fascia irritation and fascial restrictions often host active Trigger Points or knots. Trigger Points are hyper-irritable spots within a taut band of muscle fibres. These points can often be felt like knots on the muscle. Active Trigger Points cause pain and symptoms either local to the area where they’re located or radiating pain and symptoms onto a different part of the body to that where they’re located. Thanks to the amazing job of Dr. Janet Travell we now know the pain patterns of different muscles and like a map we can use them to track the origin trigger point or muscle causing the pain and symptoms.
Trigger Points respond to sustained pressure and can be released by applying steady pressure over a period of time, usually of at least between 8-12 seconds.
In case of TMJ Disorder the fascia of the jaw, neck, shoulders and upper back area is usually irritated and hosts active trigger points that are causing the pain and other symptoms. A good effective treatment approach will include the release of these structures.
For example, Trigger Points in the SCM muscle, located at the front of the neck, are known to refer pain upwards into the ear, causing ear pain and ear ringing. Like the SCM, many other muscles located around the neck and shoulder area are known to refer pain and symptoms linked to TMJ Disorder.
Myofascial pain and irritation can also be a result of a wider cause, usually involving a hyper-sensitised system. It is therefore critical to take into consideration and include the central nervous system within the treatment method.
At INSIDE we provide specialised treatment for TMJ disorder with very good results usually within 1-6 weeks. We treat this presentation using a combined approach of advanced techniques like myofascial release techniques, trigger point work, advanced stretching techniques and sports massage techniques amongst others. We use a whole-body, multidimensional approach where different biopsychosocial factors of the person are considered and not just the tissue or muscle itself. It’s this combined approach what we believe sets this treatment method apart.