Using chiropractic instruments to relieve TMJ

Snap, crackle, pop.

You might expect to hear these sounds from a breakfast cereal, but if the source of the noise is your jaw, you might be a bit concerned. Not to worry though, the problem might be temporomandibular joint (TMJ) and muscle disorder (TMD), an uncomfortable, but treatable, condition that involves the jaw.

According to the National Institute of Dental and Craniofacial Research (NIDCR) , an agency of the National Institutes of Health (NIH)  approximately 10 million Americans suffer from TMJ; with the cost of managing the disease runs approximately $4 billion.

What  is TMJ?

The TMJ Association, defines TMJ as “a collection of medical conditions affecting one or both jaw joints or their associated muscles and other tissues.”  The disorder negatively affects jaw movements involved with eating, chewing, speaking, swallowing and making facial expressions.

At a recent TMJ Association meeting researchers presented scientific findings that indicate female TMJ patients may also experience other conditions, such as chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, and other systemic illnesses.

According to the Mayo Clinic, the temporomandibular joint operates like a hinge on each side of the face that connects the jawbone to the skull. The root cause of the disorder is not clearly understood, but individuals who grind or clench their teeth, or have a genetic predisposition, arthritis or some sort of trauma to the jaw are more apt to develop symptoms.

To date, no one intervention has emerged as the gold standard for care but the NIDCR reports that symptoms typically resolve on their own. For temporary relief, the NIDCR recommends over-the-counter or prescription pain relievers or anti-inflammatory medications. Adopting some stress reduction techniques might also help ameliorate symptoms. While aggressive interventions, such as surgery, are not recommended, researchers continue to examine a number of non-invasive options to help address symptoms.

Finding relief

James W. DeVocht, DC, PhD, associate professor at the Palmer Center for Chiropractic Research in Davenport, Iowa, and colleagues explored the use of chiropractic protocols using chiropractic instruments for patients with temporomandibular joint disorder (TMD). In 2003, he conducted a small, prospective study with nine volunteers who had articular TMD.

According to the study, patients received full spine and TMJ adjustments using chiropractic instruments. Subjects had adjustments three times a week for two weeks and then, depending on personal progress, for six additional weeks. Findings at the end of the study indicate that the use of the chiropractic instruments improved TMD symptoms.

Fast forward ten years, and DeVocht teamed up again with other chiropractic and dental researchers to explore intervention options to manage chronic TMD.  This study involved 80 subjects who were randomly assigned to one of four groups: reversible interocclusal splint therapy (RIST), a dental device designed specifically for each patient; chiropractic instrument adjustments; sham chiropractic instrument adjusting; and self-care only. The authors note that all subjects were taught a comprehensive self-care program.

Patients reported modest improvements across all groups, and the findings set the stage for a larger study that will help determine viable treatment options for patients with myofascial TMD, according to the authors.

Additionally, the authors point out that minimally invasive therapies that emphasize “patient self-awareness and self-management” make the most sense and help to forge “a significant therapeutic alliance between the clinician and the patient.”

For temporary relief in between chiropractic visits, the NIDCR recommends self-care practices, including using ice packs, consuming soft foods and avoiding wide yawns, chewing gum, and other extreme movements involving the jaw.