by Dr. Jonathan Chung
One of the most common and troublesome problems that I’m noticing in my practice is a condition known as Temporomandibular joint dysfuction, or TMD for short. In fact, many of you may have heard someone talk about their TMJ or having TMD, but didn’t quite know what it was.
TMD involves the joint that connects your jaw to your head. Proper movement of this joint is critical to proper function. Some of the symptoms caused by TMD include:
- Sharp/stabbing jaw pain
- Inability to open the jaw properly
- Neck pain
- Painful clicking
- Teeth grinding
and much more
It has rapidly become one of the more common reasons for visits to a neurologist and pain clinics, because of the dramatic impact on your quality of life. Many times, this condition is treated with medications like neurontin or anti-depressants. In some cases, muscle relaxers or injections to the joint.
What does this have to do
with the neck?
A search of PubMed will show numerous references for increased incidence of TMD in conjunction with a whiplash injury, or head/neck trauma. A review showed that people with whiplash/head injury actually have more severe pain and more pronounced dysfunction of the joint.
Another review showed that just treating the jaw in these whiplash related cases showed poorer outcomes suggesting that the cause of the problem may be outside the joint itself. The whiplash associated cases showed just a 48% improvement compared to the non-whiplash cases which improved 75% of the time. That leaves a huge amount of people who are still in pain and suffering because the primary insult to the body was not addressed properly.
TMD usually comes in 2 varieties.
1. Muscular dysfunction – the muscles of the jaw (pterygoids, masseter, temporalis) become hypertonic and dysfunctional creating pain ful musculature and sloppy movement.
2. Articular dysfunction – the joint itself can have problems. Dislodging of the disc, arthritic degeneration, and inflammation can irritate the very sensitive nerve endings that cover the joint.
Not much can be done about arthritic breakdown of a joint. However, this is a less common cause of TMD. The most common causes of TMD stem from muscular imbalance and dislodging of the articular disc. In a way, these two problems are intimately related. When you have bad jaw muscles moving the jaw abnormally, then it leaves more room for the articular disc to shift out of place.
So what can make these jaw muscles dysfunctional? To know that, we have to know what controls the muscle. Every muscle in your body is controlled by a nerve. Whether it be a big bulky bicep, an achy sore back muscle, or the strong pumping of a heart muscle, nerves signal how they fire.
For the jaw muscles, a special nerve called the Trigeminal Nerve emanates from the skull and provides nerve supply for the face, jaw muscles, teeth, brain, and other important structures.
The trigeminal nerve is one of twelve specialized nerves called Cranial Nerves. The unique thing about Cranial Nerves is that they do not exit out of the spine. They actually begin come out of the brain and the brainstem, and exit out of the skull. Therefore, a problem with one of the cranial nerves is usually indicative of a problem at the brain stem.
Atlas Displacement, Whiplash,
and the Brain Stem
One of the reasons that my office gets referrals from dentists and neurologists for TMJ patients is because of how Atlas Displacement Complex impacts the health and function of the brain stem. While the top of the neck doesn’t apply direct pressure to the brain stem, the movement and function of the neck has large implications for this important piece of anatomy.
When someone has an episode of whiplash, there can be substantial damage and injury to the neck, but the more concerning portion is what happens to the nervous system. A phenomenon known as Central Sensitization occurs. This problem happens when the brain stem fires inappropriately. When this happens, even the slightest touch or movement can trigger a pain sensation in the brain.
This is why many doctors can find no physical damage to the body, but people will suffer with chronic pain issues like fibromyalgia. People recognize this quickly when the pain is stemming from the neck, shoulders or back, but the reality is that this same thing is happening in the jaw muscles.
To get to the root of someone’s problems, we have to evaluate this critical, but under studied part of the nervous system. How does an Upper Cervical Chiropractor address this?
1. Restore healthy positioning to the neck – create a state of Normal Structure in the neck so that the proper signals get to the brain.
2. Increase circulation through the brain – proper alignment ensures that blood flow to and from the brain stem properly. Proper blood flow means better nerve firing.
3. Restore healthy biomechanics to the jaw – Once the neck alignment is restored, most of the time the jaw will reset on it’s own. However, sometimes gentle jaw adjustments may be necessary. This can be done with the help of a skilled specialist called a Neuromuscular Dentist.
But don’t take our word for it. Here are what some of our patients have said on Google Business.
Thank you Dr Chung for your help in getting me through those initial weeks after experiencing horrible pain, fear and anxiety that comes with TMJ. Your immediate and ongoing compassion and support has been a life-saver for me! I had fear not only of the jaw problem but of chiropractors in general after having a bad experience with “cracking and popping” treatments! After your treatments, I am really amazed at how much better I feel and know I am in good hands every time I walk through your door! If anyone is in need of chiropractic care, be kind to your body, don’t hesitate to call on Dr. Chung, he will take care of you.
– Marian Neihoff
I recently had some extensive dental work done and experienced severe jaw pain for over a week, and couldn’t eat without severe discomfort. Diagnosed with TMJ, I went to see Dr. Chung, and he was able to make me pain free, in just 3 visits !! I can’t thank him enough , other than to say he’s got my business life!
– Richard Bomar
420 STATE ROAD 7
POYAL PALM BEACH, FL 33411