Temporomandibular joint and muscle disorders

Temporomandibular joint and muscle disorders (TMJ disorders) are problems or symptoms of the chewing muscles and joints that connect your lower jaw to your skull.

Causes

There are two matching temporomandibular joints -- one on each side of your head, located just in front of your ears. The abbreviation "TMJ" literally refers to the joint but is often used to mean any disorders or symptoms of this region.

Many TMJ-related symptoms are caused by the effects of physical stress on the structures around the joint. These structures include:

  • Cartilage disk at the joint
  • Muscles of the jaw, face, and neck
  • Nearby ligaments, blood vessels, and nerves
  • Teeth

For many people with temporomandibular joint disorders, the cause is unknown. Some causes given for this condition are not well proven. These included:

  • A bad bite or orthodontic braces
  • Stress and tooth grinding. Many people with TMJ problems do not grind their teeth, and many who have been grinding their teeth for a long time do not have problems with their TMJ joint. For some people, the stress associated with this disorder may be caused by the pain as opposed to being the cause of the problem.

Poor posture can also be an important factor in TMJ symptoms. For example, holding the head forward while looking at a computer screen all day are strains the muscles of the face and neck.

Other factors that might make TMJ symptoms worse are stress, poor diet, and lack of sleep.

Many people end up having "trigger points" -- contracted muscles in your jaw, head, and neck. Trigger points can refer pain to other areas, causing a headache, earache, or toothache.

Other possible causes of TMJ-related symptoms include arthritis, fractures, dislocations, and structural problems present since birth.

Symptoms

Symptoms associated with TMJ disorders may be:

  • Biting or chewing difficulty or discomfort
  • Clicking, popping, or grating sound when opening or closing the mouth
  • Dull, aching pain in the face
  • Earache
  • Headache
  • Jaw pain or tenderness of the jaw
  • Reduced ability to open or close the mouth

Outlook (Prognosis)

For many people, symptoms occur only sometimes and do not last long. They will go away in time with little or no treatment. Most cases can be successfully treated. Some cases of pain go away on their own accord without treatment. TMJ-related pain may return again in the future. If the cause is nighttime clenching, treatment can be very tricky because it is a sleeping behavior that is hard to control.

Mouth splints are a common treatment approach for teeth grinding. While some splints may silence the grinding by providing a flat, even surface, they may not be as effective at reducing pain or stopping clenching. Splints may be effective in the short-term but could become less effective over time. Some splints can also cause changes in your bite. This may cause a new problem.

Prevention

Many of the home-care steps to treat TMJ problems can prevent such problems in the first place:

  • Avoid eating hard foods and chewing gum.
  • Learn relaxation techniques to reduce overall stress and muscle tension.
  • Maintain good posture, especially if you work all day at a computer. Pause often to change position, rest your hands and arms, and relieve stressed muscles.
  • Use safety measures to reduce the risk of fractures and dislocations.