FACIAL AND JAW PAIN (TMJ)

What is TMJ?

TMJ stands for Temporomandibular Joint, which is the joint connecting the lower jawbone (mandible) to the temporal bone of the skull. This bilateral joint is essential for jaw movements, allowing us to perform everyday functions like chewing, speaking, and swallowing.

Temporomandibular Disorders (TMD) encompass a group of conditions that affect the TMJ and the surrounding structures. These disorders can arise from various factors, such as jaw misalignment, muscle tension, trauma and stress.

An estimated 75% of the U.S. population has experienced signs or symptoms associated with disorders involving the TMJ.

Symptoms of TMJ

Jaw pain or tenderness
Pain or discomfort in the face, jaw, neck, or shoulders
Difficulty or discomfort while chewing
Clicking, popping, or grating sounds when opening or closing the mouth
Limited range of motion in the jaw
Locking of the jaw joint
Ear aches or pain around the ears
Headaches, especially in the temples or around the temples
Tired or tense facial muscles
Toothaches or sensitivity without dental issues
Changes in how the upper and lower teeth fit together
Dizziness or vertigo in some cases

Treatment

A range of treatments are available for TMJ disorders at Hobson Institute, including the specialized Rocabado Method.

The Rocabado Method is a specialized approach designed to address TMJ disorders and related craniofacial and cervical conditions. Named after its developer, Dr. Mariano Rocabado (Dr. Jenny’s mentor), this method focuses on a holistic and multidisciplinary approach to treating patients. The Rocabado approach consists of evaluation of the head, neck and TMJ joints to determine the cause of jaw clicking, jaw pain, headaches, migraines, and ear and neck pain. A physical therapist will complete a thorough examination of the spine, starting at the pelvis to evaluate alignment up to the cranium and TMJ.

The Rocabado approach restores the proper position of the head on the neck, called the cranio-vertebral angle. Slouching can promote loss of alignment and development of a “straight neck” or “inverted cervical lordosis”. Cervical lordosis promotes healthy neck joints and use of the neck with the least amount of load or compression.
Loss of cervical lordosis can promote lower cervical degenerative changes such as osteophytes, bone spurs, degenerative disc disease, herniated discs and more. Restoring proper posture promotes improved neck range of motion, normal lordotic curvature of the neck, restoration of cranio-vertebral angle, decreased facial and shoulder tension, and more.

- Specialized Manual Therapy: To restore full range of motion, joint mobility and decrease pain of the jaw, neck and upper back
- Soft Tissue Mobilization: To decrease your facial swelling and pain
- Dry Needling: May be recommended to address active trigger points of the head and neck muscles
- Education: To decrease chronic headache and jaw pain through exercises and postural correction. We may not realize the daily habits that are actually hurting us and overloading our joints and soft tissues
- Postural Screening and Re-education: To decrease pressure in the jaw, face, neck and shoulders
- Facial Exercises: To decrease tension in the face, head, neck and upper body
- Breathing Exercises: To restore nasal diaphragmatic breathing patterns to reduce neck tension and chest or mouth breathing
- Gait Training: To improve and optimize our alignment during gait to reduce head and neck tension
- Myofunctional Therapy: Training the tongue to rest up gently on the palate, strengthening the tongue when it is weak, and positioning it for optimal swallowing function will restore proper support to the throat airway and reduce stress to the head and neck

Frequently Asked Questions

How Long Are Treatment Sessions?

The initial evaluation may be longer, but most visits are typically 45-60 minutes.

What is the Frequency of Treatment?

A typical treatment plan might consist of twice per week, for one month and then as symptoms improve, tapering to once per week.

Should Children be Screened for TMJ, Head and Neck Problems?

Children with poor posture are on their way to becoming adults with poor posture and can experience chronic tension and pain in the body. Children frequently are undertreated and should be evaluated.

An evaluation is also recommended for any child prior to initiating orthodontia or braces to determine if an underlying mouth/TMJ condition or posture may worsen with monthly orthodontic treatments that require wide opening.

Additional Resources

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