TMJ stands for the temporomandibular joint (temporal like the temple bone of your skull and mandible meaning your jaw bone). The TMJ is one of the most complicated joints of your body. Movement of this joint is finely coordinated allowing us to open our mouths wide and move our jaws from side to side so we can talk, chew, yawn, swallow and sneeze. See below for a picture.

When the TMJ becomes tight and painful, the condition is called TMJD or temporomandibular joint dysfunction syndrome. There are many causes of TMJD including direct trauma to the jaw like might happen in a car accident or fall, tooth aches or misaligned teeth, traumatic or poorly done dental work, jaw clenching, grinding teeth, neurological problems, poor posture, and even strong emotions which could lead to stiffening of the muscles of the jaw or head for extended periods, which could also produce strain on the joints and muscles in this area.

When the TMJ undergoes one of above mentioned traumas, the muscles around the joint reflexively tighten up to protect the joint. At the same time, that protective vice, limits the jaw’s ability to move and causing pain associated with the chronic contraction of facial muscles as we try to fight them whenever we try to speak or eat. This fight between us and our body’s response to trauma is one of the major causes of the discomfort associated with TMD.
 

Conservative Treatments Include:
Habit Modification: Avoid the activity that is causing the stress including nail biting, gum chewing, and ice biting.

Postural improvement: One of the causes of TMD is bad posture, especially if you head sticks forward of your body which causes great stress on the neck. Try improving your posture especially while sitting.

Exercises: These are the physical therapist’s area of specialization. An experience physical therapist can tech you exercises that help you lengthen and relax the muscles surrounding the joint reducing tension and pain. They can also help you with posture improvement, increasing mobility of the joint, and increasing coordination of movement.

Diet Modification: Avoid foods that are difficult to chew. Increase the amount of soft foods in your diet like soup and yogurt or cut your food into small pieces.

Medication: Some anti-inflammatory drugs can help with the pain and discomfort but rarely address the cause of the TMD. You should consult with your physician before using any drugs.

Compresses: Apply hot packs or cloths soaked in warm water over the area of pain. This may help reduce the muscle spasms. Alternatively, cold compresses or ice packs can reduce swelling. Try both at different times and see which helps you more.

Dental appliances: There are some devises such as splits or nightguards that can be prescribed by physicians, physical therapist, and dentists after you have received the diagnosis of TMD.

Invasive or Irreversible Treatments:
These should be avoided as much as possible. Treatments that have not been shown to be effective and might even worsen the TMD include.

Orthodontics to change the bite
Crown and Bridge work to balance the bite
Grinding down the teeth to bring the bite into balance (called occlusal adjustment)
Repositioning splints also called orthotic which permanently alter the bite

Surgery including TMJ replacement or implants have not been studied adequately with long term clinical trials to establish safety or effectiveness. Be sure that you are working with an experienced provider and that you get independent opinions if you are considering this option.