Overview and Treatments for Temporomandibular Joint Disorder: By Dr. Viorel Iliescu & Dr. Damiana Corca
By the estimate of the National Institute of Dental and Craniofacial Research, as much as 5-12% of the US population suffers from Temporomandibular Joint Disorder (TMJD). Common therapies such as ice, chewing on softer foods and temporary pain drugs may bring some relief, but if you are one of the 15% of the above number that develops chronic TMJD, you surely know that these therapies are like giving massage to a wooden leg.
Between the click noises, the zigzagging of the jaw, the inability to eat right, and the discomfort or pain, I bet you feel as if the joint has got a life of its own! Oftentimes other symptoms, apparently unrelated, such as neck pain, visual, auditory, and equilibrium disturbances and even emotional or personality changes are present. Let’s discover together what can be done to restore the proper function of this joint.
Causes of TMJD
Dr. John E. Upledger, DO, has done extensive research on TMJ and he stresses how important it is to have a proper diagnosis to find what the causes of the dysfunction are. Such causes can be categorized as primary and secondary: primary when the problem roots in the joint itself and secondary when it is triggered by other conditions, in the latter case being rather a consequence than a cause. The approach can obviously be very different depending on the diagnosis.
1. Craniosacral System Dysfunction
This involves the dysfunction of the Craniosacral system, which may include the whole system from sacrum to occiput. Moreover, in Dr. John E. Upledger’s expertise, this imbalance can sometimes lead to the most common cause of TMJD – temporal bones not being synchronized. The slightest pathological rotation, externally or internally, may lead to TMJD.
2. Dental Problems
These causes are common as well, and might make more sense to patients, as they can usually tell if the problems started after a dental work. Improper tooth stature can rapidly lead to pain. Sometimes root canals and surgeries can leave problems behind. Teeth and gum diseases left untreated could also potentially lead to TMJD. This is just an overview, as there are other dental issues that could affect the TMJ. We should also not forget physical trauma.
3. Post traumatic Problems
Unsolved emotional problems and trauma can lodge in the tissue, many times forming energy cysts that can lead to TMJD, which surely will not respond to conventional means of treatment.
TMJD can arise due to common stressors such as emotional upset, poor posture, and environmental pollution.
6. Structural and Somatic Problems
This includes muscles, bones, ligaments – anything that is related to the structure and the soma of the body. For example, some skeletal injuries and muscle dysfunctions can trigger TMJD.
7. Degenerative Diseases
Wear and tear of the joint, arthritis – fortunately it is not very common in this joint, and allergies and autoimmune diseases are some other causes of this disorder.
Treatment Modalities for TMJD
There is quite a bit of research that proves the efficacy of Acupuncture in TMJD. Acupuncture can be combined with microcurrent acupuncture, moxibustion, and magnet therapy. Acupuncture and associated therapies promote healthy masticatory muscles and temporomandibular joint function, which lead to remission of the painful or bothersome symptoms.
2. Craniosacral Therapy & SomatoEmotional Release
Craniosacral therapy involves a combination of techniques, from synchronization and balancing possible rotation of the temporal bones, releasing the occiput bone and the masticatory muscles. Craniosacral therapy involves many other techniques, too many to list in this article. It also facilitates other internal healing changes triggering the homeostatic equilibrium. Moreover, this whole process comes hand in hand with SomatoEmotional Release, releasing so much of the destructive emotional trauma.
3. Neuromuscular Therapy
Within Neuromuscular, trigger point therapy can be highly effective in treating TMJD as it releases the stressed areas of the muscles and brings more oxygenated blood and nutrition. Possible nerve compression and postural distortion can also be involved in TMJD.
4. Myofascial Release
Dr. Janet Travel and Dr. David Simons cover in their book Myofascial Pain and Dysfunction the tremendous importance in treating TMJD from the soft tissue perspective. As I have mentioned before, myofascial release does not stand by itself, acupuncture, craniosacral, and neuromuscular therapy work on this level as well.
5. Dental Work
When the cause of the problem is poor tooth stature, periodontal diseases, infections or other similar disorders, than it is obvious that the root of the problem needs to be solved. Your dentist will evaluate and correct the offending issue leading to a quick relief most of the times.
6. Nutritional Support
Omega 3 fatty acids, Coenzyme Q10, Vitamin C, and an anti-inflammatory diet is effective for prevention and healing of this joint.
Bottom line is that when it comes to TMJD we should not view it in a simplistic way; if the jaw hurts let’s fix it. It is rather a complex joint with profound ramifications and when it is distorted it can come from a variety of reasons. Likewise, a local TMJD could fast lead to a variety of systemic imbalances.
The real secret of treating this disorder really lies in its correct analysis and accurate diagnosis by a skilled practitioner. Nonetheless, a proper combination of the above therapies rather than only using one of them is of crucial importance as well.
Be healthy and happy! And let laughter therapy work wonders for your Temporomandibular joint!
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By Dr. Viorel Iliescu, MPhys, DOM, AP, Dipl. Ac., LMT & Dr. Damiana Corca, DOM, AP, Dipl. O.M. & C.H.
St. John. (1995). Neuromuscular Therapy Pain Relief Seminars 4, TMJ Dysfunction, Hands, Feet & Eyes. Manual Written by Paul S. John.
Travel, J., Simons D. (1983). Myofascial Pain and Dysfunction, The Trigger Point Manual, The Upper Extremeties, Volume 1. Baltimore, MD: Williams & Wilkins
Upledger, J. Vredevoogd, J. (1996). Craniosacral Therapy. Seattle, WA: Eastland Press.
Upledger, J. (1995). Craniosacral Therapy II, Beyond the Dura. Seattle, WA: Eastland Press.
Upledger, J. (1996). SomatoEmotional Release and Beyond. Palm Beach Gardens, FL: UI Publishing.
Upledger, J. (1995). TMJ Evaluation and Treatment Plan, Upledger Institute Chart
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