March/April 2003 Alternative Health
TMJ Pain

by Pam Pennington LMT, CNMT

  • Do you have problems opening your mouth wide?
  • When eating or talking, is there grinding or popping in your jaw; does it hurt to chew?
  • Do you have problems moving your jaw straight up and down?
  • Do you get headaches, stiff neck, unexplained eye pain?
  • Can you turn your head to look straight out over your shoulder?
  • Do you grit your teeth; h as your dentist ever suggested a night tooth guard?
  • Do you have pain in your upper or lower front teeth, not related to cavities?
  • Do you have unexplained ear pain?

If you said yes to any of these questions, you may have Temporo-Mandibular Joint pain (TMJ). It involves tight muscles in and around the jaw (the Temporo-Mandibular Joint), the mouth, neck, the temples and some areas on the back of the head. So why does it hurt in the ears, teeth, and around the eyes? Sometimes the problem area is not where the pain is. That pain is called referred pain--it is referring from the muscles that control the actions of the jaw.

Trigger points (areas of increased neurological activity) often have pain referral areas. In other words, areas where the nerve is more active in a muscle can make other areas, also served by that nerve, feel pain, even though they are not directly being activated. A NeuroMuscular Therapist will gently work areas of the scalp, forehead, neck, ears, and even the shoulders to deactivate the trigger points and release tight muscles in and around the jaw.

Whiplash
If you’ve had an accident or injury, particularly with a whiplash when the neck is forced back and forth, you may also experience severe headaches, earaches and jaw pain. Most muscles affecting the back have attachments to points on the vertebrae called spinous processes or transverse processes. These muscles cascade into or overlay other muscles along the vertebrae which reach all of the way up to the base of the skull and extend out to the mastoid process of the temporal bone (located just behind the ear). Also attached to that same area are other muscles that rotate and flex the neck to the side and front, and the mandible (a.k.a. the jaw bone). All of these may be affected by a whiplash. After the initial healing from the accident, gentle massage techniques can be very helpful in relaxing and healing those muscles.

Stress activates the Autonomic Nervous System to be ready for fight or flight. Muscles tighten, and may remain tight, leading to ischemia, trigger points, nerve entrapment, and postural distortions due to painful muscles. (Guarding or holding a limb in a different position may occur because the muscles hurt when held in the normal position.)

Stress is a major contributor to TMJ pain. The jaw is a place that we concentrate a lot of energy and store that energy in the muscles. When stressed, it is very common to grit or grind the teeth. This tightens the muscles of the temporomandibular joint, creating a cycle of pain. The jaw hurts, we grit our teeth against the pain, which can extend into a full blown tension headache, which increases the tension in the muscles because of the pain, which may increase the tendency to grit or grind the teeth. Often, the stress (and/or pain) does not disappear at night. Eventually the teeth may become ground down and the dentist will recommend a night guard. The night guard can prevent further damage to the teeth but may not stop what caused the original problem.

A NeuroMuscular Therapist can help to release the muscle tension. If there is clicking or popping in the jaw, there are techniques that can also help with that. Relieving the pain and problems of the temporomandibular joint will take some commitment on your part. Your therapist may give you exercises and other recommendations that will optimize your healing process.

Extensive dental work is another common cause of TMJ pain. If this happens, and surgery was not involved, it would be advisable to see your NeuroMuscular Therapist to help with tight muscles and pain before it becomes worse and causes damage to the teeth from tooth grinding. If surgery was involved, your mouth will need to heal before your therapist can work on you. (About six weeks, or ask your dentist to be sure.) In working on TMJ, a NeuroMuscular Therapist may need to work inside the mouth with gloved hands, gently coaxing the muscles to let go of the tension.

NMT -- NeuroMuscular Therapy--is a comprehensive program of soft tissue manipulation techniques. It balances the central nervous system with the structure and form of the musculoskeletal system. NMT uses low pressure massage techniques to release the muscles: working on the cause of the pain, not just the symptoms.

For further information on NeuroMuscular Therapy and how it can help other areas of the body, call:
Pam Pennington, CNMT, LMT, OR. Lic.# 8027.
503 244-4427.
Her office is at
10175 SW Barbur
Suite 306 Portland OR 97219.