TMJ Physiotherapy

The Temporomanibular Joint is the most used joint in the human body.

Each of us has two TMJs, which should work together as a team.

Jaw disorders are the most common chronic musculoskeletal disorder, second only to chronic lower back pain!

TMJs are located in front of each ear: when functioning properly, the left and right TMJ are the only joints that work coordinated as a single unit, you don’t have one jaw opening without the other. Because the TMJ uses both synchronised and 3D movements, it’s distinguished as the most complex joint in the human body.

Your TMJ is essential in every day life, from chewing, talking, kissing, and even breathing.

TMJ explained

When your TMJ isn’t properly cared for, you may be at higher risk of developing all sorts of dysfunctions, often abbreviated as TMD (Temporomandibular disorder). Recent studies show that TMD is a complex multi-systemic condition involving far more than merely the jaws and teeth. It involves the circulatory, digestive, endocrine, exocrine, immune, nervous, reproductive, respiratory, and the musculoskeletal system.

Developing TMD can happen at any age. There are several theories as to why, but the statistics are clear that this issue is much more prevalent amongst women in their 20’s-40’s.

  • On average 57% of the general population will show signs of TMD (e.g. a clicking jaw, deviation upon opening or closing, or pain upon touching the area).
  • 33% of the general population will experience TMJ pain at one point in their life.
  • 15% of the general population will develop chronic TMD / TMJ pain.

What are the symptoms of TMD?

  • Pain & Stiffness in any (or all) of the following: jaw, ears, neck and shoulders, which can lead to headaches
  • Movement disorders, incl but not exclusive to: jaw locking, popping or clicking, limited mouth opening/closing, a bite that feels ‘off’
  • Other symptoms associated with TMD can include discomfort, dizziness, stress, vision problems and tinnitus.

How can Physiotherapy treat TMD?

It’s very common for TMD patients to be treated by multiple medical professionals, such as Dentists, Physiotherapists, and Psychologists.

Your first-line of defence when it comes to treating TMJ should be Physiotherapy. It has practically no risks, and has been shown to reduce pain and improve functional outcomes for individuals with TMD e.g. increased mouth opening, chewing tougher foods, ability to talk without getting tired as quickly, etc. These results have been proven to benefit the patient both in the short-term and in the long-term, and involve no irreversible procedures. The literature is on our side with regards to the minimal risks VS high potential rewards.

There are multiple treatment modalities that can be implemented within Physiotherapy:

  • Exercise Therapy is considered a first-line treatment modality in the management of TMJ disorders. Several types of exercises that may be effective include specific jaw strengthening exercises, jaw stretching exercises, postural exercises, and general fitness exercises.
  • Manual Therapy focuses on restoring and improving your musculoskeletal system with hands-on treatment. The treatment methods within manual therapy include joint mobilisations, oscillations, gentle manipulations, harmonising techniques, neural glides, and soft tissue techniques.
  • Dry Needling for TMD is the skill of penetrating a solid needle (similar needle used in acupuncture) through the skin and underlying tissue to affect changes in physiology. Using this modality we can treat musculoskeletal disorders, pain and movement dysfunctions involving the TMJ. The Dry Needling techniques serve in your best interest as they appear to have better and safer outcomes than using surgery and splints for treating TMD.

What results can you expect from Physiotherapy?

These are three-pronged, from biological and psychological through to social.

  • The main benefit is the avoidance of surgery. Biological benefits include a gain in mobility and range of motion, the reduction (or elimination) of pain and stiffness and improved neuromuscular coordination.
  • Psychologically reduced anxiety and less disturbed sleep can lead to improved cognitive function.
  • Which tallies with the social benefits of more confidence and greater self esteem.

This service is available at Finchley Rd, Mansion House, Monument and Parsons Green to book a Consultation with one of our TMJ specialists please email, call 020 7036 0286 or book an appointment online below.

See below for more information on TMJ, including questions you should ask before starting treatment.

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Educating yourself on the anatomy of the TMJ and on various TMD conditions.

There are various questions you should be asking yourself before you begin treatment:

  • What is the purpose of particular treatment types, and why could it be helpful / necessary in my case?
  • Is the treatment reversible, or is it irreversible?
  • What other treatments are available?
  • What are the advantages of the proposed treatments rather than other forms of therapy with respect to benefits and risks?
  • How much will the treatment plan cost?
  • Has the treatment been studied in clinical trials for safety and effectiveness?

Alternative treatment options for TMJ

Your Dentist may have offered you a splint. There are three broad categories which explain why your dentist would recommend that:

  • The splint is intended to provide pain relief and improve jaw function so it can move more smoothly.
  • To protect your teeth from grinding during the day or at night.
  • The splint can be intended as a first step in a multi-step procedure.

According the 2020 National Academy of Medicine report, “Data regarding the effectiveness of intra-oral appliance therapy in the treatment of TMJ yields mixed results… ”  So here are a few questions to ask your Dentist before going down the splint route:

  • Why are you recommending the splint?
  • What are my other treatment options?
  • Will I be able to stop using this device once my symptoms improve?
  • What happens if my pain gets worse while wearing the splint?
  • What happens if I develop changes in my bite after wearing the splint?
  • When am I supposed to wear the splint?
  • How long do I have to wear the splint to feel some form of improvement?
  • If the splint doesn’t help, what are the next steps?

The surgical route most definitely has a place in the hierarchical strategy for treating severe TMJ problems.

With the benefits in mind, it’s important to understand the full picture. Surgery is controversial, often irreversible, and should be avoided when there are other options available.

If surgery is recommended, make sure you ask the following questions:

  • What’s the reason for the surgery?
  • What are the risks involved?
  • Are there alternative types of treatment that may be beneficial before going down this path?

Failure to respond well to conservative treatments does not necessarily mean that surgery is necessary, but it is an option.

If you decide to go through with surgery after all, you should be made aware of both short-term and long-term implications on your life. These include shopping tips (purchasing: e.g. straws, a blender and ice packs), non-chew meals and planning tips (e.g. pre-/post-surgery and personal assistance if necessary).

What is temporomandibular joint dysfunction?

When your jaw isn’t properly cared for, you may be at risk for developing all sorts of dysfunctions abbreviated as TMD (Temporomandibular disorder). Recent studies show that TMD is a complex condition involving all body systems e.g. musculoskeletal, endocrine, digestive, etc.

TMD is the most chronic musculoskeletal disorder only 2nd to chronic lower back pain.

What causes TMJ dysfunction?

The original cause to TMJ dysfunction can be traced back to 3 reasons:

  1. Predisposing factors e.g. systemic diseases, hypermobility, anatomical variants, etc.
  2. Initiating factors e.g. teeth grinding, nail biting, gum chewing, whiplash, dental procedure, etc.
  3. Perpetuating factors e.g. anxiety, depression, cognitive or behavioural disorders, stress, etc.

What is TMJ disorder treatment?

TMJ treatment involves a holistic approach with hands-on and hands-off techniques.

Hands-on therapy / Manual techniques include soft tissue techniques (similar to massages), trigger point therapy, stretches, nerve glides, articular mobilisations, and specific dry needling techniques that alleviate pain and improve function.

Hands-off therapy includes exercise therapy, cognitive behavioural therapy, relaxation drills, and stress management.

How much does TMJ treatment cost

The cost of an initial appointment with a Physiotherapy TMJ specialist is £155. Follow up appointments are £107.

What is the difference between TMJ dysfunction, Temporomandibular joint dysfunction, TMJ disorder, and TMJ syndrome?

TMJ stands for Temporomandibular Joint, which is your jaw joint. Just like your knees and elbows are joints, so is your jaw. The only difference is that your left and right knee don’t work together automatically, but your jaw does.

When the integrity or balance in the joint, muscles around the joint, or other structures in the area is disrupted, the jaw can cause some serious discomfort which is referred to as TMD which stands for Temporomandibular Disorder. This is in essence a dysfunction of the joint, because a “normal” jaw shouldn’t cause such discomfort.

Can physiotherapy help with TMJ dysfunction?

Short answer, yes. How quickly it can help and to what extent physiotherapy will help your specific problem completely depends on your unique situation.

What does a TMJ physio do?

Physiotherapy is the first-line of defence when it comes to treating jaw dysfunctions as it has minimal risks, has been shown to improve pain and functional outcomes in the short-term and in the long-term, and involves no irreversible procedures.

A TMJ Physiotherapist Specialist will assess your situation by looking at your jaw and the other associated structures to diagnose the issue at hand. A good physiotherapist will clarify the ongoing problems you’re having and explain the best course of treatment which will most often include a combination of exercises, relaxation drills and manual techniques such as massage, Dry Needling and mobilisations.

What is TMD?

TMD stands for Temporomandibular Disorder. This is a collective term for any problem that may be attributed to a jaw dysfunction.

What's the difference between TMJ dysfunction and TMD?

TMD stands for Temporomandibular Disorder, which is a dysfunction of the Temporomandibular Joint (TMJ).

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