TMJ Pain & Disorders
"Studies in animals and humans have shown a biomechanical and anatomical relationship between the jaw and neck regions... and that [jaw] and neck muscles are jointly activated [during jaw motion]". Haggman-Henrickson B., J Dent Res, 2006.
TMJ & Neck
The scientific literature reveals that neck dysfunction is associated with TMJ pain and dysfunction (TMD) up to 70% percent of the time more often than TMD existing alone without neck involvement, around only 20% of the time. Treatment of TMD should involve caring for the jaw initally. However, for TMD that does not easily resolve with jaw treatment alone, there needs to be an evaluation of the neck. If a neck disorder is discovered, treatment of the neck is also needed.
In fact, researcher E.F. Wright wrote in theFebruary 2000 issue of the Journal of the American Dental Association that postural training of the head and neck combined with self management was signficantly more effective than self managment alone. Other studies have found that treating Forward Head Posture with neck rehabiliation improved results in TMD patients that had facial pain and limited mouth opening.
The connection between the neck and jaw is much like a piece of clothing, say a shirt. Pulling on the bottom of ones shirt will eventually drag enough slack out the entire cloth to stretch the top of the shirt tight over ones shoulders.
One of the nerves that goes to the face is Cranial Nerve 5. The "center" or nucleus, of this nerve lies inside the spinal cord, under the base of the skull. From the nucleus of CN 5 exit the branches, going to the forehead, under the eyes and to the jaw. These nerves relay signals back and forth. Problems in the neck that send pain signals into the spinal cord can affect this nucleus. The result is neck pain can then radiate into the face, mimicing TMD. The reverse is also true. Pain signals in the TMJ can go into the spinal cord, to this nucleus, and then exit out, referring pain into the neck.
One other note regarding pain overlap. This nerve, CN 5, and it's nucleus are involved in many type of headaches, such as migraine, cervicogenic and tension type headaches.
Putting It Together
So for patients who suffer, what does all of this mean? First it means that the location of pain may OR may not be source of pain. Secondly, patients should be aware that both the jaw and then neck may need treatment.
If you suffering with TMJ pain, call 651-925-5530 and make an appointment for an evaluation. If you need to be co-treated by a dentist, an appropriate referral will be made.
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