For those who have experienced the pain of temporomandibular joint disorders, along with the head and neck aches that often accompany it, relief can sometimes seem temporary and fleeting.

But physical therapists don’t want you to give up hope, as physical therapy, or PT, has emerged as a reliable and non-invasive treatment option for those who have been suffering with the disorder affecting the jaw muscles and joints.

“We have gotten much better at dealing with this, and our patients are getting better, and getting better faster,” said Cody Suder, a physical therapist at UCHealth SportsMed Clinic in Steamboat Springs. “The goal with physical therapy is to use our knowledge of anatomy, arthrokinematics, or joint movement, and physiological healing to minimize or completely eliminate your pain.”

What is TMJ and what causes it?

TMJ, as the disorder is commonly referred to, is named after the temporomandibular joint, which is a compound-hinge joint connecting the jawbone (mandible) to the skull. The jaw opens and closes at that hinge point.

But when that area becomes dysfunctional for various reasons, the joint doesn’t open and close correctly, leading to pain in the jaw, face, neck, ear and head. The jaw often makes a “pop” sound when it opens and closes. In some instances, it will not pop back into place and stays in a ‘locked-joint’ position.

The affliction can be caused by a traumatic injury to that area, overuse, poor posture or certain congenital conditions that predispose individuals. Often, TMJ cases are caused by bruxism, which is an involuntary grinding of teeth or clenching of the jaw while sleeping.

If you have TMJ, the symptoms are usually obvious. While most people will experience an occasional popping of the jaw, the big difference with TMJ is that the annoyance will turn into a constant and painful problem.

“If the clicking or popping in your jaw is painful, chances are pretty high that TMJ is present,” said Suder. “This is apparent in everyday tasks such as chewing and talking. The muscles that allow us to chew and open and close the mouth are going to be painful, and it’s going to hurt.”

Physical therapy emerges as a TMJ treatment option

Mouth guards or teeth spacers worn at night to prevent people from grinding their teeth and clenching their jaw are typically prescribed for patients with TMJ. But during the past decade, many people suffering from TMJ have found relief through PT.

PT can not only help with TMJ pain management, but in some cases, it can stop TMJ it altogether.

Management is not just in the jaw; in fact, it often originates in the neck or surrounding structures. The upper cervical vertebrae are often considered the first three vertebrae supporting the head. These vertebrae are situated very close to the trigeminal nerve, a nerve originating in the brainstem responsible for facial sensation and supporting muscles that allow chewing. This nerve and branches lie near the temporomandibular joint, the hinge joint connecting the jaw to the skull.

When the C1, C2 and C3 vertebrae become inflamed and “angry” for various reasons, they interfere with the trigeminal nerve, which because of its proximity to the jaw, can irritate the temporomandibular joint and cause TMJ pain.

“As physical therapists, we’re working on mobility of the cervical spine and decreasing tension in that area,” said Suder. “We do soft tissue massage and small joint manipulation to move the temporomandibular joint in the direction where it’s become hypomobile or stuck.”

What happens during a typical PT session to treat TMJ?

As the patient lies on their back, stomach or side, Suder would locate the restricted vertebral or temporal mandibular joints, mobilize them and perform soft tissue mobilization through massage or myofascial release.

He would use a technique called dry needling on the involved muscles. A thin, sterile needle inserted into the cheek trigger point will cause the muscle to twitch when pricked, which releases a chemical substance that cause tension and pain in the jaw joint.

He would then massage the soft tissue of the cheek and inside the jaw, followed by corrective exercises specific to each patient.

Suder uses these techniques on patients over several weeks in clinic and then provides patients with corrective exercises that they can do at home. Dry needling can be very effective, as it gives people a window of being pain free so they can do their exercises properly.

“It’s just like anything else – these PT exercises can be very beneficial, but you must be diligent about keeping up with them,” he said. “My goal is always to be the last person you see for this, to give you the skills and knowledge so you can treat this on your own, and to support you with the necessary exercises and steps to prevent this from happening again.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.