Could The Chiropractor Help Your TMJ?

I've talked several times in this blog about TMJ (temporomandibular joint) disorder. Today, thanks to a patient or two over the last few months, I want to talk about TMJ disorder and chiropractors.

A few months ago, a patient mentioned to me that he was going to a chiropractor for his TMJ disorder. I found that a little odd, but hey, I'm always open to new ideas and such, so I asked about it some more. Turns out, my patient went three or four times and wasn't totally sure if the chiropractic treatment was working or not.

A month or two goes by and another patient tells me she went to a chiropractor for her TMJ disorder. She was on the "everyday" plan for two weeks, and again, the results were somewhat unclear; pretty much along the lines of "I think I might be feeling better" -- which is not definitive. So I decided to do a little research and blog about it.

Let's start by briefly going over what TMJ disorder is: TMJ disorder (TMJ Syndrome) is a blanket term for acute or chronic inflammation of the temporomandibular joint (which is what connects your mandible to your skull). The most common causes range from bruxism (teeth grinding), trauma, excessive nail biting, degenerative joint diseases and many more. Essentially, TMJ disorder is quite common.

The biggest symptoms are discomfort and pain in your jaw, difficulty in chewing, earache, headache (including migraines), dizziness, neck and shoulder pain and a host of others. (If you are interested in more causes and symptoms, some good information on TMJ Disorder can be found at tmj.org) (1).

Many times, TMJ Disorder symptoms can be treated with home remedies and lifestyle changes -- sometimes on your own, and sometimes with some help from your doctor or dentist. For example, if the cause of your TMJ disorder is bruxism, I, as an NYC Cosmetic Dentist can help you there (not that you need to see me -- any dentist can likely help you). Sometimes, treatment can go a surgical route as well. But I had never heard of chiropractic treatment for TMJ until my two patients mentioned it. I was a little skeptical at first, and after doing some research, I am even more skeptical.

Let me start by saying that I have been a fan of chiropractic treatment for one's back and the like. But I was less sure about TMJ.

I looked long and hard online for any credible information regarding chiropractic as a treatment option for TMJ Disorder. The only positive information I found was from chiropractors and chiropractic organizations themselves (2). To me, that's a little bit telling. The website "chirobase," which is a somewhat "chiropractor-skeptical" website run by a doctor and contributing chiropractors who want honest information on the subject "out there" has this very question answered (in the negative) by a chiropractor (3).

A little more telling is that Mayo clinic does not mention Chiropractic as a treatment option at all (4). And finally, we have this tidbit from TMJ.org that directly addresses the question:

There is insufficient scientific evidence of safety and/or efficacy of the various chiropractic treatment methods recommended for treating TMJ problems. However, we are aware of some cases in which the patient's condition was improved. On the other hand, we also heard from patients for whom such treatment did not provide relief, patients whose TMJ problem was actually caused or worsened by chiropractic treatment or physical manipulation of the jaw.(5)

The leading website and information source for TMJ Disorder basically says there is little more than anecdotal proof. This sounds somewhat like what my own patients reported.

One more time, I want to state that I am not against chiropractic treatment for the "classic" problems, pain and symptoms that it seems to effectively address. But just because a chiropractor might help neck and shoulder pain (and hey, neck and shoulder pain can be a symptom of TMJ disorder) does not mean a chiropractor can treat TMJ.

Ok, how do you feel about this? Is there anyone out there who has had a chiropractor successfully treat your TMJ Disorder? Or not? Either way, I'd really like to hear from you. Because again, all I could really find on the positive side is information and articles written by chiropractors themselves. Both of my patients had "unclear" results. I should ask them again when they come back to get the rest of the story.

Until next time, keep smiling!

1 - www.tmj.org

2 - http://www.chiro.org/research/ABSTRACTS/TMJ.shtml

3 - http://www.chirobase.org/17QA/tmj.html

4 - http://www.mayoclinic.com/health/tmj-disorders/DS00355

5 - http://tmj.org/site/content/tmjd-we-get-questionsand-comments#4

 

Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly

Comments

[spunkymunky]

01:33 PM on 09/04/2011

The theory of chiropractic is that it cures anything and everything. Cracking a joint expels air from the joint after which the air slowly seeps back in. Its disturbing to me how this can be ascribed to treating ailments?

[shellyamber]

01:00 AM on 10/03/2011

No, you are very wrong. The nervous system runs the body, which is made up of hundreds of nerves carrying messages to and from the brain to every cell in the body. The 'super highway' of information from the brain to the body is the spinal cord, which is protected by vertebra. Imagine those vertebra as moving parts, because they are. Put the top of a straw in one fist then cover the bottom of the straw with your other fist. Imagine your fist as the vertebra. Now distort your fists by twisting one one way and the other another, causing the straw to bend or even twist. Imagine fluid going thru that straw as "information". Information can mean involuntary information like "lungs.... breathe, heart...beat." If there is interference, the information can be distorted or can't travel as accurate as it would if the vertebra were aligned. If your t6 vertebra is subluxated this can cause information to your galbladder to get distorted. The brain is sending messages to the galbladder and the cells that are to work properly aren't getting the information as intended, or vice versa.
A subluxation can be a serious problem. It can cause pain, and over time, disease. When you understand that the nervous system runs everything, your cells, your adrenal glands, and organs, you understand that keeping that nervous system protected from damage is a health issue. A properly aligned spine CAN AND DOES make a person healthier.

[aleltu67]

04:08 PM on 09/03/2011

magnesium may also help, but only if the TMJ stems from a muscular disorder. Many times TMJ is actually a neuro-mechanical disorder.

[aleltu67]

04:06 PM on 09/03/2011

chiropractic DOES deal with the underlying problem IF the problem stems from the TMJ joint, or cervical spine (which can affect the nerves that innervate the TMJ joint). As Lindsay already stated, if this is indeed the patients problem, then one visit to the chiropractor will not solve the problem immediately. The chiropractor has to "mold" the joint back into place, which can take several adjustments (still much cheaper than drugs/surgery in the long run!). It is also important to know that not every chiropractor is adequately equipped to deal with TMJ problems. Some have more extensive training dealing with TMJ than others. It would be a good idea for a patient with TMJ to do some research first, before making a decision as to which chiropractor to see.

[NEllison]

09:04 AM on 09/03/2011

Chiropractic can provide temporary relief from TMJ, but it does not deal with the underlying problem.

Anyone suffering from TMJ and chronic upper back and neck muscle spasms and pain should consider a Magnesium Deficiency as the cause. Magnesium deficiency is one of the most common and underdiagnosed problems resulting in a host of illnesses including Muscle cramps, constipation, high blood pressure, heart attack, depression, obesity, diabetes, etc. Since it is a co-factor in over 300 chemical processes in the body, it's deficiency wreaks havoc on all body systems, but neck, back and jaw muscles seem to be particularly susceptible.

Recommended Reading: The Magnesium Miracle by Carolyn Dean
mgwater.com
http://www.livestrong.com/article/466599-does-magnesium-help-tmj/

[Katiepdx]

03:07 PM on 09/02/2011

I struggled with TMJ and a host of severe symptoms related to it for decades. I wore a splint, fitted by a dentist. I had chiropractic adjustments to my spine. I had countless massage treatments. I not only practiced yoga, but ended up teaching it for many years (back when yoga was still considered a little weird . . . how times have changed!). While I did get some relief from stretching and yoga, the symptoms always returned if I let up from doing yoga for more than a day or two. What finally resolved the problem completely and brought really lasting relief (I haven't done yoga for over 8 years now) was learning how to inhabit my body with the same alignment we all discover as toddlers. This turns out to not only be the answer for TMJ sufferers, but for many aches, pains and other health conditions. This video, while not about TMJ directly, demonstrate the principles of natural alignment that resolved my TMJ, and other chronic pain issues, once and for all. While not a quick fix (there is no such thing!) this really works!
http://www.youtube.com/watch?v=NsY7y_BoVkk

[oneplustwoboys]

11:11 AM on 09/02/2011

Here is a government-funded study going on right now. Excerpt taken from http://www.palmer.edu/FundedResearchProjects. You may want to follow this study...

Conservative Treatment of Patients with Temporomandibular Disorders (TMD) – A Pilot Study
Principal Investigators: James DeVocht, D.C., Ph.D., and Clark Stanford, D.D.S., Ph.D.

The TMD study is a collaboration between the Palmer Center for Chiropractic Research and the Dow Institute of Dental Research at the University of Iowa in Iowa City, Iowa to compare four interventions for the treatment of patients with chronic TMD. The Activator Methods protocol of chiropractic treatment will be compared to three reference groups: dental treatment (reversible interocclusal splint therapy), self-care only, and placebo care. Eighty participants will receive treatment for 2 months with outcome measures assessed at 2, 3, and 6 months. This study is a project under the Developmental Center for Clinical and Translational Research in Chiropractic (DCRC I) Grant funded by the National Institutes of Health.

[Lindsay Rom]

10:29 AM on 09/02/2011

When I started seeing a chiropractor in '01, one of the things he found right away was TMJ. I had always had tension in my jaw from years of grinding my teeth in my sleep, not to mention I was training as a singer then, and had permanent jaw discomfort despite all the training and exercises I'd been given to loosen those muscles. I hadn't thought to mention the TMJ, though, since I was under the (misinformed) impression that he could only work on my back and knee problems. Then he started doing an Activator Protocol, using a tool that delivers light force to the joint before the surrounding muscles have a chance to seize up. Within a couple months, my jaw went from clicking and cracking every day, many times a day, to barely tensing at all.

Where people get tripped up with chiropractic is their thought process that one visit will be enough. You can't eat right one day and lose 20 pounds, you can't work out 30 minutes one day and have marvelous muscle tone. Chiropractic needs to be consistent before you notice significant progress, but I've found that it's ultimately worth it.

[Michael McIrvin]

10:28 AM on 09/02/2011

You also seem to be making the case that the only way to handle TMJ disorders is by seeing a dentist. I know plenty of people who have not had positive results with TMJD cared for by dentists. Its difficult to see how you can draw these conclusions based on the experience of two patients. I suggest you do a bit more research before writing.

[drvittoriarepetto]

06:39 PM on 09/02/2011

And you might try looking at the major source of published medical studies at Pub Med http://www.ncbi.nlm.nih.gov/pubmed which comprises more than 21 million citations for biomedical literature from MEDLINE, life science journals, and online books instead of Chirobase.org which is an anti-chiropractic site.
Here's a few articles : http://www.ncbi.nlm.nih.gov/pubmed/12975628
http://www.ncbi.nlm.nih.gov/pubmed/16320863
and here's a page w a number of articles http://www.ncbi.nlm.nih.gov/pubmed?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=18616071

And yes I'm a doctor of chiropractic who is certified in applied kinesiologist which means that I look at the tone of the muscles of the TMJ, the Neck, the Cranials as well as adjusting therse areas when I'm dealing w/ a patient w/ TMJ and it takes a lot more than 2 visits to take care of a TMJ problem.