What Is TMJD?
TMJ is the temporomandibular joint. This sliding hinge connects your jaw to your skull, allowing you to clench or grind your teeth, among other things such as chewing, swallowing, and talking. You can feel this muscle by placing your fingers below and in front of your ear and clenching your teeth.
While the exact cause of TMJ Disorder can be difficult to determine, pain and/or achiness are common reasons to seek treatment. A combination of genetics, arthritis or jaw injury, poor posture, chronic tooth clenching or grinding often result in TMJ Disorders. Sometimes TMJ Disorders are abbreviated TMD or TMJD. We will use those terms interchangeably.
Signs and Symptoms of TMJD
Muscle soreness where jaw connects to skull (temporomandibular joint)
Radiating facial pain, jaw pain, or neck pain
Discomfort chewing
Limited movement or locking of the jaw
Painful clicking, popping or grating when opening or closing mouth
A change in the way the upper and lower teeth fit together
Chronic untreated TMJD can even lead to discomfort eating, talking and swallowing
Causes of TMJD
Many TMJD symptoms arise from muscle tension triggered by stress. When you are under stress, you may begin grinding or clenching your teeth, often without knowing you're doing it.
Tooth grinding and jaw clenching can tire the jaw muscles, leading to a cycle of muscle spasm, tissue damage, pain, sore muscles, and more spasm. Sometimes this will happen while you are sleeping.
Some other causes of TMJD can be an injury to the temporomandibular joint, arthritis, damage to the articular disk that cushions the joint, or problems with the joint shape itself.
Sometimes the exact cause of TMJD remains unclear.
How to Treat TMJD
Life in NYC is stressful and TMJD is something that we see often in East Village Acupuncture and Massage There are many approaches to reducing the stress that can lead to temporomandibular joint disorders (TMJD).
At EVAM, we believe we need to train ourselves to release tension. It takes practice and mindfulness, especially as we don't always realize we are allowing stress to build up in our jaw muscles. Spending a few minutes performing the following exercises and making them part of your daily routines will help with TMJD as well as reducing stress levels in general.
Follow these simple practices
Set a gentle timer to remind you to do a little self check-in to see if you notice tension anywhere in your body, especially your jaw.
Close your eyes and do a quick scan of your body starting at your feet and ending with your head and face. Pay attention to any areas where you feel tense and consciously try to release these areas.
Roll your shoulders back and down while paying attention to your posture in general.
While you are working or reading get in the habit of gently placing the tip of your tongue on the roof of your mouth- this makes it harder to hold tension in your jaw.
Keep a diary- write down all of the thoughts you had during the day that you felt unable to voice out loud.
Begin, or continue, a simple meditation, yoga or Qi Gong practice. (see below) These relaxation techniques will help lower stress levels generally. Even a very brief meditation is quite helpful.
Check out our blog post "Acupressure for Stress and Anxiety"
Lastly, consider buying a moldable mouth guard (sometimes called a night guard) to wear while sleeping. These are available at any pharmacy. After wearing it for a week inspect it to see if it shows signs of teeth grinding. If so you may want a more sophisticated one made by your dentist.
Below are some videos that were made by EVAM staff that are helpful for treating TMJ pain and stress.
Continuing Management of TMJD at EVAM
During our intake conversation with patients we determine what is out of balance and develop a plan to restore an equilibrium. This balancing of Qi forms the basis of a Traditional Chinese Medicine approach to treating TMJD.
Treating TMJD in the EVAM Clinic
Goals:
We treat stress by encouraging the free movement of Qi throughout the body.
Your acupuncturist will release or "reset" the chronically tight facial muscles.
Provide suggestions for home treatment (see above suggestions)
Your practitioner will develop a treatment plan that provides ongoing, long-term relief.
Acupuncture treatment:
We frequently combine Traditional Acupuncture Points with Trigger Points. The TCM focuses on points on acupuncture channels, while the trigger points focus on muscle dysfunction.
The Traditional Acupuncture Points we often needle are local points on the face or jaw: ST 5, ST 6, ST 7 GB 2, SJ 17. These are on the Stomach, Gall Bladder and San Jiao channels.
We also needle specific facial muscles in order to trigger the tight muscles fibers to release. This allows the muscle groups to relax and feel looser.
Often we release the following muscles using trigger points: Trapezius, Temporalis, Pterygoids and Masseter.
Understanding Parasympathetic vs. Sympathetic Nervous Systems
The Parasympathetic Nervous System (PNS) and the Sympathetic Nervous System (SNS) make up our Autonomous Nervous System.
Most of us are familiar with the "fight or flight" response to stress. This is your Sympathetic Nervous System (SNS) at work. At EVAM we believe that living in NYC with all the background noise, pace of life and day-to-day challenges keep our SNS constantly active in a low grade response to a chronic level of minor stress.
The Parasympathetic Nervous System (PNS) functions during calm "rest and digest" situations. It regulates bodily functions like digestion and urination. By using Traditional Chinese Medicine, combined with a calm clinic environment, we are able to stimulate the PNS. The PNS is activated by acupuncture needles inserted on the Stomach, Gall Bladder and San Jiao channels.
While resting quietly with the needles in, your PNS will have a chance to balance the stresses of an overactive SNS.
This time (approximately 45 minutes) spent resting provides the foundation for resolving TMJD as well as reducing stress levels in general.
Root and Branch Approach
The Root is the reason or basis for a condition.
The Branches are the symptoms.
We focus on the Root cause for a patient's TMJD. We use the acupuncture points discussed above to treat this root cause. Often the root is stress or anger that keeps the SNS overactive.
We also use trigger point acupuncture to treat the Branches ie: the tight facial muscles that lead to discomfort. Focusing on relaxing these muscles helps restore a general sense of relief.
Ongoing Self-Care
Try to avoid chewing gum and eating sticky hard to chew food. This reduces stresses on the jaw muscles that are frequently sore in people who suffer from TMJD.
You can use massage and acupressure on these points to treat discomfort at home in between clinic treatments.
Check out our Blog about Acupressure for Anxiety!
How do You Use Acupressure
Set aside several minutes.
Sit or lie down in a comfortable position.
Relax, close your eyes, and breathe deeply.
Place a thumb or finger on the acu point and gently massage in a circular motion
Begin with gentle pressure and increase to firm, deep pressure for 1-10 minutes in a small rotating or up-and-down movement.
At EVAM we regularly suggest that our patients treat themselves with acupressure between visits to our clinic. Many patients find the few minutes it takes to stimulate several pressure points is relaxing and helps maintain the benefits of their regular acupuncture treatments.
TMJD is a manageable condition when treated in a thoughtful manner by combining Traditional Chinese Medicine, trigger point Acupuncture and self-care. These treatments, when used with relaxation techniques, result in a very positive outcome.
Our community clinic is dedicated to helping patients maintain their heath through proactive treatment and ongoing maintenance protocols as well as treatments focused on more acute problems. Self-administered acupressure is a proven complement to acupuncture. Please feel free to contact us at EVAM to schedule an appointment with one of our wonderful practitioners.