Jaw pain is quite common for several reasons.
First, it is one of the most commonly used joints in the body. Our jaw joints move every time we eat and when we talk. Add to that the use from those who chew gum, and there is a lot of motion in these joints every day.
Second, the muscles of the jaw are among the first to respond to emotional stress. The tension can build up in these muscles, altering the normal function and alignment of the joint, leading to clicking, locking, inflammation and pain. This built-up stress can cause clenching of the jaw at night, called bruxism. If left unchecked, there will eventually be damage to the teeth and the joints themselves.
The jaw also is unique in that there are two joints joined together — you cannot move one without moving the other. Because of this arrangement, a small restriction on one side can cause a significant compensation on the other. For this reason, it is common to see joint and muscle stiffness on the side opposite the pain and inflammation, at least in the early stages. As time goes on, the problem tends to equal out from side to side.
The brain gets a lot of nerve feedback from the jaw, so when there is a problem it tends to affect other structures in the area. In my experience, helping an inflamed and painful jaw often helps relieve headache, both migraine and tension types. Some patients notice their sinus congestion improves, sometimes immediately after the treatment. A few even report changes in their vision and hearing. Occasionally even cases of dizziness and tinnitus, or ringing in the ears, respond when the jaw is corrected. Some of these patients were not even aware there was tension in the jaw until the area was tested.
Treating the jaw is not unlike treating other joint and muscle problems. First, address any lifestyle factors adding to the problem, such as gum-chewing. Patients also are advised not to sleep on their stomachs because stress is placed on the jaw and neck in that position. Controlling stress is important for many patients. A forward head posture also stresses the jaw. Any problems in the joints and muscles of the neck need to be corrected for the jaw to function normally.
Once lifestyle issues are addressed, treatment of the mechanical problems can begin. I use the three-finger test in my office. It is very useful because it doubles as a stretch for tight jaw muscles. You should be able to fit the first three fingers into your mouth without pain or even much of stretching sensation. If you can’t, there is a restriction in the jaw, either in the joint or in the muscles. If it is only a muscular problem, the test can then be used as a stretch. I teach patients to start at about 10 seconds and slowly increase up to a minute. If the joint is affected, it is usually best to correct it before beginning any stretching. Stretching a joint that is out of alignment usually only serves to aggravate it. The jaw joint can be manipulated, but it requires a very gentle touch. I usually do not do it manually but use an adjusting tool that gives me more control over the treatment.
The muscle tension can be treated with deep-tissue release. Treating the muscles inside the mouth requires use of a glove. As with any chronic muscle tension, there often is a “knot” that easily is felt by the trained hand and the area can be quite tender. A steady pressure is used to release the knot. It usually takes several sessions, but once they get the feel of it most patients can do it themselves. This simple treatment can make a huge difference, including reducing night grinding. As with any pain syndrome, acupuncture can be very effective at easing pain and inflammation related to mechanical problems in the jaw.
When treating jaw pain, I recommend starting with conservative care instead of rushing to use a lot of medication and high-tech testing and imaging, such as CT scans. If these treatments are not effective, the patient can always go to the more aggressive therapies later.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at noonanchiropractic@gmail.com.