Physical Therapy May Be the Answer to Jaw Pain

Physical Therapy May Be the Answer to Jaw Pain

May 2019

When Bonnie Julien experienced jaw pain last year, her immediate thought was that a tooth was the likely culprit. She visited her dentist, who diagnosed her with temporomandibular joint and muscle (TMJ) disorder and recommended alternating hot and cold packs and avoiding hard foods, along with doing special exercises.

Julien followed the regiment for about a month. At first, it seemed to work.

“The pain got better,” the Bremerton resident says. “But then, it became worse.”

This time, her dentist recommended physical therapy. With a planned cruise just a few weeks away, Julien began therapy sessions with Dave Damon, physical therapist with Kitsap Physical Therapy.

This time, her dentist recommended physical therapy. With a planned cruise just a few weeks away, Julien began therapy sessions with Dave Damon, physical therapist with Kitsap Physical Therapy.

“I didn’t have any trouble eating while on the cruise,” she says. “I’m still feeling great.”

Julien’s dentist couldn’t determine why she had TMJ disorder (also called TMD) because there was no obvious source of the problem. Damon says that is not uncommon. While face trauma, teeth grinding (bruxism) and teeth clenching are some of the common causes, issues like stress can also cause TMD.

“It can also simply develop without a mechanism,” he says. “You may just develop a breakdown in the joint.”

For some individuals, TMD is related to arthritis. That was the case for Port Orchard resident Donna Gizzi, whose pain was so severe that for about four months, she could only consume liquid food.

“I was losing weight like crazy because I couldn’t have any solid foods,” she says.

Her pain continued to worse, despite consultations with two dentists. Fortunately, Gizzi was undergoing physical therapy for an unrelated condition at Kitsap Physical Therapy — and her therapist recommended Damon. That’s when she learned that her pain and inability to open her mouth was due to arthritis that had spread to the jaw.

“I’ve had arthritis for many years but never in my jaw before,” she says. “I went to see him religiously and he finally got my jaw to open and close.”

Gizzi’s pain is now gone, and she’s returned to a regular diet. She was surprised that a physical therapist could help.

“I call him miracle Dave — he was amazing,” she says.

The National Institutes of Health estimates that more than 10 million Americans may suffer from TMD. The condition is more common in women than men, and in most cases, it doesn’t indicate a serious problem. The pain may go away without treatment, but some people experience a reoccurrence.

Common symptoms include:

  • Local pain in the jaw
  • Jaw snapping or clicking
  • Facial pain
  • Headache, especially in the temple area

“There’s often a referred pain because you develop trigger points for muscles when you chew, and that can cause pain to reflect into the eye or ear, as well as a feeling of stuffiness in the ear,” Damon says.

He says that for individuals with habits like teeth clenching or grinding, techniques like relaxation therapy, manual manipulation and stabilization exercises help retrain the motor system.

“For someone with those kinds of longtime habits, it takes some tricks to undo them and break up those patterns,” he says. “You have to use special techniques to interrupt those habits, get the muscles to relax, and improve motion.”

Patients suffering with TMD may seek invasive measures such as oral appliances or surgical procedures. Those treatments often have high costs — possibly adding to thousands of dollars.

“Physical therapy provides interventions that are fairly simple yet effective,” Damon says. “It’s worth trying conservative care and home self-management because that can help most people, at least to some degree.”

He notes that even patients who’ve experienced long-time, chronic jaw pain can benefit from physical therapy, and may see their pain completely alleviated.

“We teach them self-care, and together with hands-on techniques and treatments, we can help reduce pain and dysfunction they may have been dealing with for many years,” he says.

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