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Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition? What Not To Do Temporomandibular Joint Disorder Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check. Chewing Gum - Gum chewing is not recommended for individuals with TMJ.
- The jaw is one of the most used joints in the body.
- Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
- Resting sore muscles and joints is the first step in injury recovery.
Eating Chewy and Hard Foods - Chewy and hard foods make the jaw have to work overtime.
- Avoid eating hard foods like chewy candies, hard and chewy breads, vegetables like corn on the cob, and fruits like apples.
- These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.
Chewing Only On One Side - Many individuals chew their food on only one side of the mouth.
- This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
- Stay aware of chewing habits and make sure to utilize both sides of the mouth.
- Individuals with dental issues or tooth pain are recommended to see a dentist.
Non-Functional Jaw Activities - Going through each day, individuals tend to do things unconsciously or out of habit.
- For example, individuals:
- Reading or writing might chew on a pen or pencil.
- Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
- These activities can place stress on the joint, worsen the condition, and extend the healing process.
Resting on The Chin - Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
- This position can be comfortable, but it can affect the jaw.
- This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
- Breaking the chin resting habit can allow the joint to relax and heal correctly.
Teeth Clenching - Bruxism is the medical term for clenching the teeth.
- This can occur during the day or during sleep.
- Teeth clenching is often brought on by stress and can place incredible pressure on the jaw's muscles and worsen TMJ.
- A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)
Slouching - The function of the jaw is closely related to body posture.
- The jaw operates optimally when the head is above the cervical spine and the posture is upright.
- Slouching can change how the jaw muscles work and the way the jaw opens and closes.
- Part of physical therapy for TMJ is working on posture adjustments and training.
- This can involve strengthening the back and shoulder muscles and setting up posture reminders.
- Sitting and standing correctly can keep the jaw operating properly.
Postponing Treatment - Many with musculoskeletal issues and symptoms wait for the pain to go away.
- Individuals having problems with their jaw should not wait to get treatment.
- TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
- A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
- Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)
Treatment Treatment can involve: - Initial treatment focuses on pain relief and jaw function opens and closes improvement.
- Exercises to get the jaw moving normally.
- Joint mobilizations.
- Treatments to maintain proper muscle function. (Amira Mokhtar Abouelhuda, et al., 2018)
- A guard can help with night teeth grinding/bruxism.
- Anti-inflammatory treatments.
- In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
- Follow recommendations on what not to do and avoid certain activities.
General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. https://doi.org/10.11607/jop.1151 Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. https://doi.org/10.1371/journal.pone.0059980 Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. https://doi.org/10.2147/JMDH.S178507 Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon's perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. https://doi.org/10.1111/adj.12593 Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477 Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. https://doi.org/10.5125/jkaoms.2018.44.2.43 Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. https://doi.org/10.11607/jomi.te20
Prescription Medications: Sciatica is a term used to describe neuropathic/nerve pain. It is a prevalent condition known as a lumbosacral radicular syndrome. It’s discomforting, numbness, and tingling, combined with sharp shooting pain that can present anywhere from the low back where the nerve begins and down the leg into the foot. The most common cause is a bulging or herniated disc. The first medical recommendations are: - Ice and Heat packs
- Physical therapy
- Chiropractic
- Over-the-counter pain relievers:
- Acetaminophen - Tylenol
- Non-steroidal anti-inflammatory drugs - NSAIDs:
- Naproxen - Aleve
- Ibuprofen - Advil, Motrin
However, when that is not enough, the next step usually involves prescription medications to treat the nerve pain. Prescription Medications The following are a few prescription medications for sciatica: When it comes to prescription medications for non-specific lower back pain, medical guidelines are in agreement. Here’s a look at what the research shows about their effectiveness. Diclofenac Inflammation is a normal response of the immune system. However, the inflammation can irritate the nerves of the spinal column to the rest of the body, causing swelling and sciatica symptoms. NSAIDs are available as over-the-counter and prescription meds and can reduce inflammation, bringing relief from nerve pain, including sciatica. Dosage Diclofenac is taken by mouth with its total daily dose or TDD and can range from 75 to 200 mg. Side Effects Possible short-term side effects of NSAIDs can include: - Upset stomach
- Heartburn
- Nausea
- Headache
- Dizziness
Gabapentin Gabapentin is commonly used to treat diabetic neuropathy and chronic sciatica nerve pain. However, it can take some time, possibly more than two weeks, to activate, and its effectiveness relieves sciatic nerve pain for up to 3 months. It works by calming down nerve cells to relieve neuropathic/nerve pain. It calms down the nerves by lowering the amounts of chemicals in the nervous system. An overabundance of chemicals can excite the nerve cells to the point of inflammation. Substance P is a neurotransmitter and a neuromodulator that plays a role in how the body perceives pain. Gabapentin helps to lower substance P levels. Dosage It is taken by mouth with its TDD typically between 900 to 3,600 mg, divided into multiple daily doses. Side Effects Common side effects include: - Drowsiness/sleepiness
- Dizziness
- Arms and/or Leg swelling
- Diarrhea
- Weakness
Topiramate Like the other anti-seizure medications, topiramate is thought to relieve nerve pain by calming down the nerve cells by attaching to the glutamate receptor and preventing it from activating pain signals. Topiramate is commonly used to alleviate sciatica symptoms but may not be as effective after three months and does not lower disability from the low back and sciatic pain. Dosage The TDD for topiramate ranges between 50 to 400 mg. Side Effects Side effects can include: - Drowsiness/sleepiness
- Sleep problems
- Mood/behavioral changes
- Trouble with memory
- Nervousness
- Appetite loss
- Weight loss
- Dizziness
- Numbness or tingling sensations
General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Baron, R., et al. (2010). The efficacy and safety of pregabalin in the treatment of neuropathic pain associated with chronic lumbosacral radiculopathy. Pain. Dydyk AM, Conermann T. Chronic Pain. [Updated 2021 Nov 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553030/ Oliver Enke, Heather A. New, Charles H. New, Stephanie Mathieson, Andrew J. McLachlan, Jane Latimer, Christopher G. Maher, C.-W. Christine Lin. Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ Jul 2018, 190 (26) E786-E793; DOI: 10.1503/cmaj.171333 Rasmussen-Barr, Eva, et al. “Non-steroidal anti-inflammatory drugs for sciatica.” The Cochrane database of systematic reviews vol. 10,10 CD012382. 15 Oct. 2016, doi:10.1002/14651858.CD012382
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Protein deficiency, or hypoproteinemia, is when the body has lower-than-normal protein levels. Protein is an essential nutrient in bones, muscles, skin, hair, and nails, and maintains bone and muscle strength. The body does not store protein, so it is needed daily. It helps make hemoglobin, which carries oxygen throughout the body, and chemical enzymes, which cause reactions that maintain organ function. A lack of enough protein can cause problems like muscle loss, fatigue, a weakened immune system, and chronic pain. Injury Medical Chiropractic and Functional Medicine Clinic can provide nutritional guidance and develop a personalized nutrition plan to restore musculoskeletal health and function. Protein Deficiency When digested, protein breaks down into amino acids that help the body's tissues function and grow. Individuals can become deficient if their bodies can't effectively digest and absorb the proteins within the foods they eat. Symptoms When the body doesn't meet the required protein amounts or can't absorb protein efficiently, it can lead to symptoms, including: - Chronic fatigue.
- Increased infections and illnesses.
- Reduced muscle mass.
- Loss of muscle mass.
- Slower injury healing times.
- Sarcopenia in older individuals.
- Swelling in the legs, face, and other areas from fluid buildup.
- Dry, brittle hair that falls out.
- Cracked, pitted nails.
- High blood pressure during the second trimester of pregnancy/preeclampsia.
Causes Protein deficiency can have various causes, depending on the individual case. Certain medical conditions include: - Malnutrition or undereating - an individual does not eat enough calories or avoids certain food groups.
- Anorexia nervosa.
- Inflammatory bowel disease.
- Gastrointestinal disorders.
- Kidney problems.
- Liver disorders.
- Celiac disease.
- Chronic obstructive pulmonary disease.
- Cancer.
- Acquired immune deficiency syndrome.
Increase Protein Intake Adequate protein intake is essential to maintain healthy amino acid levels to support cell structure and function. The requirement differs for everybody based on age, sex, and physical activity levels. Protein is available in a wide variety of animal and plant foods. Recommended nutritious protein sources for optimal health and fitness include foods such as: - Beans and legumes
- Oats
- Eggs
- Cheese
- Lean beef, chicken, turkey, and pork
- Seafood
- Seeds
- Nuts
- Various kinds of nut butter
- Greek yogurt
- Quinoa
- Tofu
Protein is essential for all cells and body tissue and can impair body function in short supply. Although diet-related protein deficiency is rare in the United States, certain medical conditions can increase the risk. Adding protein to a diet is simple and can be achieved by incorporating various foods from either plant or animal sources. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Bauer, Juergen M, and Rebecca Diekmann. "Protein and Older Persons." Clinics in geriatric medicine vol. 31,3 (2015): 327-38. doi:10.1016/j.cger.2015.04.002 Brock, J F. "Protein deficiency in adults." Progress in food & nutrition science vol. 1,6 (1975): 359-70. Deutz, Nicolaas E P, et al. "Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group." Clinical nutrition (Edinburgh, Scotland) vol. 33,6 (2014): 929-36. doi:10.1016/j.clnu.2014.04.007 Hypoproteinemia MedGen UID: 581229 Concept ID: C0392692 Finding https://www.ncbi.nlm.nih.gov/medgen/581229#:~:text=Definition,of%20protein%20in%20the%20blood.%20%5B Paddon-Jones, Douglas, and Blake B Rasmussen. "Dietary protein recommendations and the prevention of sarcopenia." Current Opinion in clinical nutrition and metabolic care vol. 12,1 (2009): 86-90. doi:10.1097/MCO.0b013e32831cef8b Pappova, E et al. "Acute hypoproteinemic fluid overload: its determinants, distribution, and treatment with concentrated albumin and diuretics." Vox sanguinis vol. 33,5 (1977): 307-17. doi:10.1111/j.1423-0410.1977.tb04481.x
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Temporomandibular joint disorder: How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition? For answers to any questions you may have, please call Dr. Jimenez at 915-850-0900 or 915-412-6677