The temporomandibular joint (TMJ) is responsible for opening or closing the jaw: chewing, yawning, clenching, biting, all rely on the TMJ to work smoothly and painlessly to function properly. The movement of the jaw joint is just another function we can easily take for granted, because it is only when we have pain and dysfunction that we might ever have reason to think about it at all. And when pain comes, it is one of the most disrupting of all musculoskeletal conditions. I see it often in my Beverly Hills, Los Angeles, and West Hollywood chiropractic practice, and by far the most common cause for painful popping and clicking of the jaw in TMJ syndrome is the release of pent up stress.
I have observed that the clients who come to see me for severe jaw pain, clicking and popping of the jaw, and sometimes neck pain and headaches tend to be stoic people, the kind that may endure great deals of stress without letting it show to the outside world. These people either have to hold in their emotions for personal or professional reasons, or they just do not feel comfortable unleashing their stress for all to see, and so they are masters at containing themselves under tense times. As a result, these folks internalize the energy meant to be released. But this energy has to get dissipated somehow, and it often does so through grinding of the teeth (bruxism). Bruxism can and does happen at all hours of the day, but the grinding is typically ferocious at night. Some people grind out a squeaky tune as they clench in their sleep, while others, stoic as ever, grind in silence. Bruxism engages the muscles of mastication (or the muscles of chewing), and the major ones surround the jaw joint.
The major muscles in question are the pterygoid muscles. These muscles attach to the jaw, the lateral one, pulling the condyle of the jaw forward and down to allow jaw opening, while the medial one is involved in closing, among other things. Either prolonged opening (dental work) or prolonged closing (clenching) can cause fatigued or spasmed muscles. A clencher, then, would create this environment over time by excessive contracting of the jaw muscles. Add to this dysfunction gum chewing (or chewing ice), and you will almost surely have a jaw pain episode upon you.
When the pain happens it might start out as soreness around the temples, cheeks or ears even, but as time goes on, the pain can become rather excruciating. It is not uncommon for jaw pain sufferers to be unable to lay their face on the side, so stomach or side sleeping becomes impossible and thus sleeping on one’s back becomes a necessity. This simple change can disrupt the normal sleep, as I have had a number of TMJ syndrome patients complain of fatigue and exhaustion due to jaw pain derived insomnia. Sometimes ear pain or ringing is present, and it is not uncommon for TMJ syndrome sufferers to have neck pain radiating into the shoulders, and even headaches coming from the excessively tense jaw muscles. The most classic sign of TMJ syndrome, however, is a persistent clicking and popping of the jaw upon opening the mouth. Even if pain is minimal, this symptom can be maddening to the person who hears, “click, click, click,” on every bite and chew.
The treatment for this condition can be complex, as there are a number of factors contributing to the syndrome. Each element must be properly assessed and addressed, so the jaw pain must be treated independently from the neck pain and consequent headaches. Most chiropractors can treat TMJ syndrome effectively without any adjusting (or cracking in laymen’s terms), and co-management with a dentist might be in order. At the very least, TMJ sufferers need to wear a night guard for the teeth, mostly as a protective against cracking them, which is exactly what happens if TMJ issues are left untreated. Unfortunately, a night guard will not remove the pain that is currently there – that will need to be done by a chiropractor or other qualified practitioner – but it will prevent the pain from returning once it has been cleared.
Jaw pain and clicking might be one of the most painful musculoskeletal conditions I treat in my Beverly Hills, Los Angeles, and West Hollywood chiropractic office. If you get to it sooner better than later, the chances it will respond favorably to conservative care (non-surgical). However, long-standing untreated or poorly treated jaw pain disorders may end up needing surgery. If you are having any of the symptoms I have described, call me and let us evaluate your jaw. You may be a few simple treatments away from a return to normal, pain-free function. Catch the jaw click before it becomes pain.
