Temporomandibular Joint Disorder|Joint Pain Relief

Part 1: A BASIC UNDERSTANDING of TMJ SYNDROME

The Origins of TMD/TMJ Syndrome

TMD/TMJ Syndrome is a collection of seemingly unrelated symptoms caused by reflexive actions of the muscles of biting and chewing. It comes from brain-muscle conditioning acquired by trauma or stress. As with all conditioning problems, it can be changed with proper training, usually with no need for other interventions -- but such training is outside the scope of dentistry (though within the scope of clinical somatic education).

The jaw muscles, like all the the muscles of the body, are subject to control by conditioned postural reflexes, which affect chewing and biting movements. The reason people don't go around slack-jawed and drooling, for example, is that a conditioned postural reflex causes the muscles of biting and chewing always to remain slightly tensed, keeping their jaws closed.

People's jaw muscles are always more or less tense, even when they are asleep -- but the norm is very mildly tense -- just enough to keep the mouth closed and lips together.

The degree of tension people hold is a matter of conditioning.

Conditioning Influences

For brevity, I'll discuss only conditions that lead to dental stress and not the normal development of muscle tone in the muscles of biting and chewing.

These influences fall into two categories:

• Emotional Stress


• Physical Trauma

I can't say from empirical studies which of these two influences is the more prevalent, but from my clinical experience, I would say that physical trauma is by far the more common cause of TMJ Syndrome.

Emotional Stress

Ever heard the expressions, "Bite your tongue"? "Grit Your Teeth"? "Bite the Bullet"? "Hold your tongue"? "Bite the Big One"? They all have something in common, don't they? What is that?

To someone who regularly represses emotion or the urge to say something, these expressions have literal meaning.

Such repression, over time, manifests as tension held in the muscles of speech -- in the jaws, mouth, neck, face, and back -- the same as the muscles of biting and chewing.

Physical Trauma

Although people experience trauma to the jaws through falls, broken teeth, intense toothache, blows, and motor vehicle accidents, the most common form of physical trauma is dentistry. Dental surgery is traumatic. The relevant term is "iatrogenic" -- which means "caused as a side-effect of treatment". Dental surgery is a major cause of TMJ Syndrome. No doubt, this assertion will cause much distress among dentists, and I regret that, but how can we escape that conclusion?

Consider the experience of dentistry, both during and after dental surgery (fillings, root canal work, implants, cosmetic dentistry, crown installation, injections of anaesthetic, even routine cleanings and examinations). Consider the response we have to that pain or even the expectation of pain: we cringe.

We may think such cringing to be momentary, but consider the intensity of the memory of dental surgery; it leaves its impressions on the nervous system as patterns of tension. (Who's relaxed going to the dentist? -- or coming out of the dentist's office?) The physical after-effects show up as tension in the jaws and neck, and often in the spinal musculature, as well -- and as a host of other symptoms.

Let's go back to our fond memories of dentistry.

If you've observed your physical reactions in the dentist's chair, you may have noticed that during probing of a tooth for decay (with that sharp, hooked probe they use), you tighten not just your jaw and neck muscles, but also the muscles of breathing, your hands, and even your legs. It's an effort to stay in the chair while feeling the urge to escape.

With procedures such as fillings, root canal surgery, implants and crown installations, the muscular responses are more specific and more intense. For teeth near the back of the jaws, we tense the muscles nearer the back of our neck; for teeth near the front of the jaws, we tense the muscles closer the front of the throat.

This reflexive response has a name: Trauma Reflex.

Trauma Reflex is the universal, involuntary response to pain and to expectation of pain.

It gets triggered in relation to the location of the pain and to our position at the time of pain. Muscular tensions form as an action of withdrawing, avoiding, or escaping the source of pain.

In dentistry, with the head commonly turned to one side, in addition to the simple trauma reflex associated with pain, we have the involvement of our sense of position, and not just the muscles of the jaws are involved, but also those of the neck, shoulders, spine.

All of these conditions combine into an experience that goes into memory with such intensity that it modifies or entirely displaces our sense of normal movement and position. We forget free movement and instead become habituated or adapted to the memory of the trauma (whether of dental work or of some other trauma involving teeth or jaws). Our neuro-muscular system acts as if the trauma is still happening, even though, to our conscious minds, it is long past.

Since accidents and surgeries address teeth at one side of the jaws or the other, the tensions occur on one side of the jaws or the other. Thus, the symptoms of such tension -- jaw pain, bite deviations, and earaches -- tend to be one-sided or to exist on one side more than on the other.

The proof of the role of trauma reflex? -- the permanent changes of bite and tension of the muscles of biting that have behind them a history of dental trauma -- and the changes people experience as they undergo somatic education, which dispels trauma reflex (evident in its results).

Every dental procedure (and every surgical procedure) should be followed by a process for dispelling the reflexive guarding triggered by the procedure.

Part 2: SELF-RELIEF/SELF-CURE of TMJ SYNDROME

In this section, I'll provide instructions for a somatic exercise to retrain your control of the muscles of biting and chewing.

You do this somatic exercise lying on a firm surface (carpet or blanket on the floor) on your belly.

1. Nestle your chin in your hands with your thumb behind and fingers in front. Your elbows are spread wide.


2. Gently open your mouth and grasp your chin with both hands.


3. Gently bite, preventing your teeth from meeting with resistance from your fingers against the force of your biting action.


4. Slowly relax the biting action, keeping firm hold of your chin with your fingers, and very slowly tilt your head back by a few degrees. You are separating your teeth by tilting your head back, rather than by dropping your lower jaw. (Special tip: as your mouth opens, feel your nasal cavity open.)


5. Keeping your head in position, gently bite, again, resisting with your finger grip.


6. Slowly tip your head back further as you relax the biting action.


7. Alternate biting-against-resistance and relaxing, opening wider until your mouth is as open as you can let it go.


8. Let go with your fingers and, with mouth open, lift your head and legs.


9. Slowly relax to complete rest.

Repeat a number of times in each practice session. You'll find that your jaws get looser and that you can open your mouth wider, each time.