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TMJ - Exercise and Diet Treatments

Explores associated disorders including plugged ears, fibromyalgia, neck pain and more.

 

Contents:



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Overview

TMJ is the commonly used acronym for temporomandibular joint disorder. The pain associated with TMJ is thought to be caused by displacement of the cartilage where the lower jaw connects to the skull causing pressure and stretching of the associated sensory nerves. I developed a very bad case of TMJ several years ago, along with an overall case of fibromyalgia. My jaw was so painful that I had to eat baby food at times.

In looking for a cure, I bought a lot of books and spent hours on online research. I went to see many different types of practitioners, including TMJ specialists, dentists, doctors, orthopedists, an acupuncturist, chiropractors, physical therapists, massage therapists, and more, in order to try to find a cure for my TMJ pain and overall fibromyalgia. Eventually it worked and now my pain is gone. The TMJ treatment options that helped me are listed below.

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The Cause of My TMJ

In my case, my jaw was where I really hurt, but it actually wasn't the source of my pain. The source of my pain was tight muscles from other parts of my body pulling on my jaw, causing pain and pulling it out of alignment. The practitioner who helped my TMJ the most was a physical therapist who specialized in ergonomics, posture training and body alignment. He looked at my body as a whole, and his treatment to improve my posture and body alignment helped me a lot. Below is a picture of how my body used to look when my TMJ pain was at it's worst. The dark circles are tension points with knotted muscles and the shaded lines are where my skin, nerves and muscles were being pulled taught between the tension points.

I had TMJ near point B, but as my physical therapist explained to me, that isn't where my pain was originating from. At points A and C I had tight knotted muscles. At points B and D my muscles were weak and stretched out. Other problems that I had that were all interrelated with my TMJ were scoliosis, a frozen shoulder (between points B and C), kneecaps that pulled inward, a twisted thorax, a pronated right foot, plugged ears, ear pain and knee pain. As I slowly figured out how to get my body better aligned and my muscles balanced, these problems all started clearing up in unison, including my TMJ.
diagram of tension points causing jaw pain

 

Food for Thought

The most important point to remember, and the number one reason I see in my email for people never really recovering from TMJ, seems to be that most people fail to consider the possibility that the place in your body where you are feeling pain may not be the place in your body that is causing the pain. Your jaw may be hurting because of muscle tension pulling on your jaw from some other part of your body.

We have a two story house, and we recently had foundation work done. The house was sagging on the first and second stories, but the engineers spent most of their time examining the crawl space under the house and had the construction crew fix the support posts in the crawl space. The source of the problem was not in the same place as the symptoms of the problem. Think of your TMJ as being in your "second story", and consider the possibility that your real problem might start with alignment problems somewhere else in your body, like in your knees or maybe even you feet. As shown above, a muscle knot in my right leg over time was pulling down on my shoulder and jaw.

If you have TMJ, look in the mirror and see if your shoulders are evenly balanced from side to side and front to back. Beside shoulder issues, many people with TMJ also suffer from a forward head posture that pulls the jaw out of proper alignment.



 

Contributing Factors

I realize now that there were a multitude of factors that contributed to my TMJ. My body alignment problems were one, but there were also other factors. These were:

I had a hereditary connective tissue disorder called Ehlers-Danlos syndrome. TMJ is common in people with Ehlers-Danlos syndrome, Marfan syndrome or other connective tissue disorders. Besides TMJ, other common features of connective tissue disorders are mitral valve prolapse, hypermobile joints (also called being double jointed), myopia (nearsightedness), irritable bowel syndrome, fibromyalgia, pectus excavatum (sunken chests), scoliosis, hearing problems, anxiety disorders, heart palpitations, poor wound healing and bleeding problems. Some people, especially women, with connective tissue disorders have what is called a Marfan habitus or mitral valve prolapse syndrome. They are tall and thin with long arms and legs, scoliosis and/or a chest deformity such as pectus excavatum or pectus carinatum.

A study from Sweden found, "an association between joint hypermobility, abnormal skin connective tissue composition, mitral valve malfunction, and musculoskeletal disorders in young women with TMJ dysfunction, especially internal derangement." Basically, TMJ, hypermobility, defective connective tissue and MVP seems to occur together, either in people with defined connective tissue disorders such as Ehlers-Danlos syndrome or people in the general population with mild connective tissue abnormalities.

See my home page for more information on connective tissue disorders. I had most of the problems listed above and a lot more. I never knew they were all interrelated, or that there was a name for my health problems, until I was diagnosed by a rheumatologist with Ehlers-Danlos syndrome. After my diagnosis, I started looking up things on the Internet and everything started to click. I put up this web site describing my health problems, what seemed to help me, and how I thought my symptoms were all logically interrelated and related to nutrition. Now I literally get hundreds of thousands of visitors a year from people with variations of many the same symptoms as I have had, including TMJ.

I also suspect that I had a problem with defective hyaluronic acid. Hyaluronic acid is also called Hyaluronan, or HA. Hyaluronic acid is a component of connective tissue that functions to cushion and lubricate various body parts.  HA occurs throughout the body in abundant amounts in many of the places people with TMJ also have problems, such as other joints, eyes and heart valves. A study on PubMed showed that people with TMJ had abnormalities of hyaluronic acid compared to people without TMJ. Interestingly, one of the latest treatments for TMJ is injections of hyaluronic acid or oral supplements focused on improving hyaluronic acid.

Overuse of my hand on the side where I had TMJ was another contributing factor. I had TMJ on my right side where I used a computer mouse for hours at a time. I think the tightness caused from gripping the mouse all day tightened my muscles on that entire side of my body and contributed to my TMJ pain and fibromyalgia. My TMJ pain also developed after I had kids and spent a lot of time pushing baby strollers, so I think that was another contributing factor. I have two sons close in age, so when they were little I had two babies to take care of at one time. I would push both of them around in a very heavy, double stroller. I think the gripping and pushing action from pushing the stroller around tightened my hand and shoulder muscles and also contributed to my TMJ. To make things even worse, I used to purpose push their stroller uphill for exercise. In hindsight this tightened the muscles too much in the front of my shoulder on my right side. I know now I should have embarked on a more balanced program of stretching and strengthening.

I also suspect that I had a magnesium deficiency. As you can see from the chart below, many of the conditions that are linked to TMJ such as mitral valve prolapse and fibromyalgia are also linked to low levels of magnesium. Mg deficiencies can cause both tight muscles and defective connective tissue. One of the things that helped my MVP, fibromyalgia and TMJ was adding more foods rich in this important mineral to my diet.

Conditions Linked to TMJ

Conditions Linked to Magnesium Deficiency

   
   
   
fibromyalgia
   
   
   
   

According to the TMJ Association web site, the majority of TMJ patients are women in their childbearing years. Interestingly, most of the people who develop mitral valve prolapse and fibromyalgia are also women in their child bearing years. TMJ, fibromyalgia and mitral valve prolapse all commonly occur together, all occur primarily in women of child bearing age, and at least two of the three conditions (MVP and fibromyalgia) have been linked to magnesium deficiencies. Interestingly, excessive menstruation has been linked to magnesium deficiency, which may explain why women of childbearing age (menstruating women) then have more conditions linked to magnesium deficiency than the population in general.

Interestingly, magnesium is needed to make hyaluronic acid, so it is not surprising that conditions linked to magnesium deficiencies and conditions linked to hyaluronic acid abnormalities tend to go hand in hand. Besides TMJ, conditions where magnesium deficiency may play a role include fibromyalgia, keratoconus, nystagmus, insomnia, asthma, allergies, attention deficit disorder and migraine headaches. Headaches and TMJ commonly occur together. Many people believe the TMJ causes headaches, which seems highly plausible. However, since headaches are linked to magnesium deficiency, another possibility to consider is that TMJ and headaches are both manifestations of a common root cause--a magnesium deficiency.

 

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Diet Treatments That Helped My TMJ

There's a whole list of diet changes that I made to help my pain problems, including my TMJ, in my section on foods that helped my fibromyalgia. I've included a few of the diet changes here that I believe helped my TMJ the most below:

  • Cutting back on salicylates. I believe this masy be at least in part because salycilates block vitamin K. (See my section on health conditions linked to vitamin K deficiencies for more on salicylates.)
  • Cutting back on wheat and dairy, especially whole grains.
  • Avoiding foods and supplements with a lot of vitamin C or iron. While
  • Avoiding foods with sugar, yeast and preservatives.
  • Eating more fat, especially moderate amounts of saturated fat.*
  • Eating more red meat for zinc, iron and vitamin B12.
  • Eating organ meat occassionaly for micronutrients.
  • Eating vegetable soup with a lot of vegetables and beans for magnesium, meat and sometimes broth made from animal parts (bones, tendons, etc. for hyaluronic acid.)

My kids have never had TMJ, but one has had neck pain and both children are prone to fibromyalgia. So this means I have three people to experiment on in our family to see what helps our pain problems. While exercises, posture training and yoga help a lot, the number one factor that influences whether we have joint and muscle problems or not on a given day seems to be our diet, especially the amount of magnesium rich foods we eat.

I also used to suffer from menorrhagia (heavy menstrual bleeding) which I suspect was one of the reasons I was magnesium deficient. I was able to control my menorrhagia through changing my diet, which is written up in my section on Menorrhagia.

* I've gotten a number of emails from people questioning my intake of dietary fat and high cholesterol concerns. For more information on saturated fat and the health risks associated with low cholesterol levels, see my web page Low Cholesterol: The Overlooked Health Risks.

My Experience with Jaw Splints

One of the initial treatments I had for my jaw was a splint from a dentist. Wearing the splint changed my pain level from really bad to unbearably excruciating. Not only that, the splint changed my bite so that my molars no longer met and I couldn't chew food. Fortunately, within a few days after I stopped wearing the splint, my bite returned to normal.

I've had one email since my site has been up from someone claiming success from a splint, but far more people have written that they have had success with therapies such as acupuncture, rolfing or yoga to help their TMJ jaw pain. It is interesting to note that these are all therapies that address tension in the muscles surrounding the jaw.



Exercise for TMJ

Besides the diet changes, the following environmental changes also helped to reduce my TMJ pain:

I bought extra sharp knives for chopping vegetables. We try to eat extra healthy so I make a lot of meals using fresh produce. Cutting fruits and vegetables frequently had been adding to my muscle tension on my hands and arms. With the extra sharp knives I didn't have to put as much pressure on my hands to cut things.

The best book I've found for jaw pain is Taking Control of TMJ. It is one of the few TMJ books that focuses on total body alignment, yoga and diet for temporomandibular joint disorder. The simplistic approach that many other TMJ books have seems to be that since a person's jaw is hurting, we'll have them do a lot of jaw and neck exercises. However, obvious solutions are often wrong. In my case, and I suspect many others, my jaw was where I had the most pain, but it wasn't the cause of my pain. Doing exercises only on my jaw just increased my pain because they pulled on already irritated muscles and didn't address the source of my pain.

This book has extensive information on body alignment, and it is the one of the few books I found that described what was really wrong with my body: tight muscles in other parts of my body that were pulling on my jaw and shoulder. As you can see from the picture above, I had one shoulder that was higher and one shoulder that slumped lower than the other. The side with the lower shoulder was where my jaw, ear and neck hurt. This was the source of my pain. The Taking Control of TMJ book addresses how to correct these types of problems with information on sleeping positions, diet changes to release tight muscles, posture tips to prevent imbalanced muscles and therapeutic yoga postures to reduce overall body and jaw tension.

"When we professionals fail to look at the total patient, head to toe, and consider all of the factors contributing to the jaw problems, our treatments fail, and the patient does not get well."

Robert O. Uppguaard, writing in Taking Control of TMJ

 

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Treatment Summary

The treatments that ended up helping my TMJ the most involved improving my overall posture and body alignment and loosening up my tight muscles. My TMJ pain came from tight muscles in my hands, shoulders and other parts of my body pulling on my jaw. I suspect that may be a cause of TMJ pain for other people, too.

TMJ impacts women of childbearing age more frequently than it effects other segments of the population. TMJ commonly occurs along with fibromyalgia, tinnitus, migraines, mitral valve prolapse and other conditions linked to magnesium deficiencies. A major factor in all of these associations may be that because magnesium gets depleted through the menstruation process, women of child bearing age are more likely to be at risk for conditions linked to a deficiency of this mineral.

Here's a recap of what helped me:

  • Changing my diet, especially to get more magnesium.
  • Improving my computer workstation set up and switching to an optical scanner mouse.
  • Using a fanny pack instead of a purse.
  • Using extra sharp knives in the kitchen.
  • Seeing a physical therapist who specialized in ergonomics and posture.
  • Doing yoga postures and ergonomic stretches every day.
  • Using a styrofoam back roller.
  • Using trigger point therapy and moist heat to relax my muscles.
  • Reading and studying the books listed above on yoga, repetitive stress injuries and body alignment

I don't know if these treatments will help other people with TMJ, but they helped clear up my TMJ problem completely. Most of these treatment ideas such as getting enough magnesium in your diet, setting up your computer work station correctly, improving your body alignment and doing gentle yoga poses are generally considered low cost, low risk healthy things to do anyway, so they may be worth considering if you suffer from TMJ pain.

 

  

 

 

 

 

Related sections of interest:

Natural Treatments for Fibromyalgia

My Personal Causes of Neck Pain

Thoracic Outlet Syndrome Defined

What Causes TMJ?

Finding a Good Physical Therapist

 

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