Chiropractors can help determine the cause of TMJ pain by evaluating the jaw and joint through x-rays, an orthopedic evaluation and a neurologic exam. Chiropractors can then treat TMJ with adjustments and soft tissue therapy to improve joint function.
What does TMJ stand for and how do you describe this condition and what causes it?
Dr. Luke Stringer: TMJ essentially is a definition for the temporomandibular joint. That essentially means the joint in your jaw. Temporo is part of the skull. Mandibular is the jaw and then obviously joint is a joint. The condition essentially, is classically characterized by pain in the jaw, and getting pain when you’re talking, when you’re eating, essentially pain when you’re using your jaw and that’s classically the condition in terms of what it causes and what’s it called.
What are the symptoms people experience with TMJ? When should they call a doctor or a chiropractor for help?
Dr. Luke Stringer: Classic symptoms are essentially pain in the jaw, and it can vary. It can be pain first thing in the morning, upon waking. It can be pain after eating, pain after talking through a presentation, but you’re just going to get this pain in the jaw. If you feel your face and you find the corner of your jaw and you slide up, you’ll see what we call the zygomatic arch, that bony point just underneath your eyeball there. That’s where the jaw is. You’ve got a lot of jaw, big muscles in there in that jaw, that essentially control how that jaw moves. We use them obviously to talk, to eat, et cetera.
Mis-alignments in the jaw, from the neck and the actual jaw joint itself and adhesions that form within the tissues create pain. Pain can vary. It can be a dull, stiff, achy pain. It can be a sharp, stabbing pain. Pain can refer to the back of your skull or into your face. It’s pretty miserable.
Just like any other condition, you should get the condition treated sooner rather than later, because the sooner you get on top of it, the less time, energy and effort you’re going to have to put into correcting it. Also, the less the damage that condition is going to create into that joint, specifically. Chiropractors certainly can help. Chiropractors do really good work with temporomandibular joint pain.
That was my next question. Why would someone see a chiropractor for help with TMJ?
Dr. Luke Stringer: Great question and chiropractors focus their clinical training on the treatment of the spine and the nervous system specifically, and remember, you have essentially two types of the skeletal system. You’ve got your axial spine, which is all your vertebrae, neck, upper, mid-back, lower back, sacrum, pelvis. Then you have your appendicular spine, which are all the joints that anchor into that spine, shoulders, hips, knees, and jaw is part of that. Chiropractors get extensive training on evaluation of how that joint should essentially function and all the new research coming out of the American Dental Association. We work with a lot of the dentists in the city here and the new research from the ADA states unequivocally, that temporomandibular joint pain is a side-effect from lack of cervical curve.
Your cervical curve, if you’re eyeballing your posture in the mirror, your ears should sit on top of your shoulders, top bone on top of the bottom bone. It should have a negative 42-degree curve. Through traumas, car accidents, for example, or repetitive stresses, corporate environment, lots of sitting, over time, that curve can shift out of alignment. When it shifts, it shunts that jaw forward. When the jaw’s not in alignment and you’re using that jaw, and over time it creates wear and tear, and that’s classically causing the jaw pain. Chiropractors, specifically chiropractors who practice chiropractic biophysics to clinically address the curvature of your neck and objectively change it to get really, really good results TMJ patients.
Could you describe some of the specific chiropractic treatments you would use to help treat somebody with TMJ?
Dr. Luke Stringer: Absolutely. It’s going to be a three-pronged attack, essentially, Liz. First thing we need to do is evaluate joint function. Every joint in the body, particularly the spine, well any joint, should be able to move freely and stably. The top two bones in your neck, c1, c2 Cervical 1, Cervical 2, your skull sits on top of those bones. When those bones are in alignment and moving well, all those nerves that come out of that joint go back into your head and they innervate eyes, ears, nose, throat.
We need to evaluate how those joints are moving because classically, more often than not, if you have a subluxation, which means that joint is shifted or it’s not moving well, you’re creating stress and tension on the joint and the tissue and the nerves, right up at the cervical level. A lot of our TMJ patients are really subluxated. They’ve shifted in that upper cervical level.
How would you adjust that? You’d adjust that through adjustments. You need to get that joint moving. However, like you just asked me, what are the, well, how can chiropractors help? Well, in this office our diagnosis is going to be objective. We’re going to shoot some x-rays. When you evaluate your x-rays, you’re looking for alignment. Specifically, for example, when you’re looking at the spine from the front, you should be in alignment, but if you have any lateral shifts left to right or any rotational shifts, that can create tension on the muscles, the joint, the nerves, which can also create shifts in the jaw and refer pain into that jaw. From the side, as we just discussed, top bone on top of the bottom bone, a negative 42-degree curve. As you start to lose that curve, your head is then going to start to shift forward. When it shifts forward, it creates tension to the muscle and joints shift out of alignment.
How we practice, and as many other chiropractors practice, in a similar manner to us, it’s called chiropractic biophysics. It’s all science and data. You can objectively address those shifts through something called spinal traction. When you get your spine back into alignment, fix the joint function, and lastly, address the soft tissue changes in tissues consistently under a state of stress and tension, new postural shifts or poor alignment. The muscles are working too hard. They break down and adhesions like glue in a muscle, it doesn’t do well. If your jaw’s out of alignment and the muscles are working too hard to try and keep you in alignment when you’re eating or talking, for example, that tissue is actually going to break down. Those adhesive changes need to be addressed too.
In our office, we can do some specific soft tissue therapy, so the muscles that sit in your jaw or your masseter, but specifically a muscle called your pterygoid. It’s really a big culprit with temporomandibular joint pain. When you address those three factors and then supplement in some postural rehab through just the upper-cross syndrome, all those big muscles that pull you forward and shift your head forward, you can get really good results with TMJ and we get awesome results with our TMJ patients.
For a new patient coming to see you for help with TMJ, what would their first visit involve?
Dr. Luke Stringer: Great question, Liz. All of our new patents will obviously fill out their intake form and they’ll provide us with a health history. Then, one of our doctors will sit down and we’ll do a really detailed consultation, based around that history, figure out when the pain started, how often it is, how it’s affecting their life, et cetera.
Then, we’ll perform an orthopedic evaluation. The evaluation’s going to be involving two exams. An orthopedic exam, we’re going to take your spine through its range of motion then we’re going to evaluate how well joints are moving. Like we just discussed, we’re going to look for joints that aren’t moving well. They’re creating stress and tension onto the joint and the tissue, and the nerve.
We’ll perform a neurological exam, and we’ll figure out if there’s any nervous system activity, various tests we do for that. Then lastly, we’re going to shoot some x-rays, an objective finding. When we shoot x-rays, chiropractors are going to look at them a little different than medical doctors. Yes, we’re looking for pathology, breaks, fractures, infections, any quirky stuff like that. But we’re also, when we evaluate our x-rays, evaluating from a biomechanical standpoint. How is your spine different from normal? And how is that shift creating stress and tension on the joint, on the tissue, or on the nerve that’s causing your pain? We’ll send you home on the first day. We don’t like to treat on the first visit, simply because we don’t guess at what we do.
We’ll evaluate the case. We’ll have the patient come in for the second visit and that’s when we’ll go through all our clinical findings, go through diagnostic findings, explain to the patient what’s causing their pain, and then we’ll figure out best form of treatment for that case. We’ll go through that with the patient and then we’ll get them going.
Our treatment’s essentially going to be involving three to four aspects, joint function through adjustments, getting the joint in alignment and moving, spinal traction, to address any structural shifts that we have in the spine, which needs to be addressed objectively, to get long-term correction. All the new research is stating that. We’ll take you through some soft tissue protocols to break down any chronic adhesive tissue, tissue that is just not healthy, doesn’t move well, it’s weak, inflexible.
Then obviously, we’ll take you through a functional exam, like you would’ve done on the first day and we’ll figure out what muscles are doing too much work and which muscles aren’t doing enough work. Then, we’ll adjust those imbalances through physical therapy. When you address all those four factors, you can get really good results. That’s why we’ve got over 200 five-star Google reviews and we’re the highest-reviewed clinic in Chicago.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.