Snap… Crackle… Pop…
Here Comes the Holiday Season!

By: Zoe Fackelman, PT Lake Country Physical Therapy and Sportscare, PC’s Founder

An increase or onset of jaw, neck or facial pain is common before and during the holiday season due to the increase in demands placed on our already busy schedule.

All of what the holiday season means to you can be stressful creating tension in our neck and or headaches and upper back pain. Extra shopping, decorating, wrapping, cooking and often with deadlines encourage repetitive trauma and strain on our muscles and joints. We tend to clench our teeth while trying to be patient with longer lines and inexperienced cashiers. Grinding of the teeth subconsciously occurs during our sleep while our brain sorts though our lengthy to do list. The end result can be a snap, crackle or pop in the jaw, headaches, facial, neck and /or upper back pain.

Taking a deep, cleansing, belly breath every waking hour will help ease the side effects of what some call the “crazy season”. The proper way to take a deep, cleansing, belly breath is to draw air slowly and deeply in through your nose allowing your belly to rise. Pause for 2 seconds, and then slowly let all of the air flow out of your nose while your belly deflates. The goal of this breath is for your exhalation to be twice as long as your inhalation. Try taking this breath now. Do you notice the release of tension in your face, jaw, neck and shoulders?

A common question we hear as seasoned physical therapists is, “I did not know PT could help my jaw pain. I thought all I could do is wear my night splint and deal with the pain.” Physical therapy is a first choice treatment option. Not all physical therapist are trained to treat the jaw, so it is important to ask about experience treating the jaw. Some physicians and dentists are aware of the benefits of TMJ Physical Therapy.

A clicking jaw from a physical therapist’s point of view can mean several things. A pain free clicking can be a result of a malformation of your jaw resulting in a joint problem or simply a muscle imbalance. Eventually, you will likely experience jaw pain or neck pain or both. When you have pain, we often hear, I have TMJ.

TMJ is short for temporomandibular joint… your jaw. You have two TMJs, one on the right and one on the left side of your face. Your mouth opens and closes because of muscles allowing jaw movements that occur at both temporomandibular joints.

When jaw movement is not working quite right, there is pain or fatigue in the jaw with chewing or talking. You may find you have clicking, popping or clunking sounds when you move the jaw, difficulty opening your mouth, locking of the jaw, headaches, neck and or upper back pain or tightness, dizziness or ringing in your ears, then you have TMD (temporomandibular joint disorder/dysfunction). Dysfunction means difficult function/use.

Did you know more than 10 million people suffer from TMD? What causes TMD?

• A visit to your dentist can cause jaw pain from holding the mouth open too long. If you are having a dental procedure and your jaw begins to ache, ask if frequent breaks from the dental work can be taken so you can close your mouth. Also be sure your neck is supported during the procedure.
• TMD is so common because we are a sitting society, often at a desk with our head held forward for prolonged periods of time. Think Sit Tall! Take a break every 20-30 minutes. On a long drive, get out of the car at least every hour and walk around for 5-10 minutes. Think Stand Tall! When you are working over a counter or on the line the shoulders round forward and the head follows. Think Lift the Chest! Cradling your telephone on your shoulder or carrying a child on your hip throws your spine off center and places the head in an awkward positioning causing strain on the jaw. Think of keeping your neck and back long! The head forward position puts a strain on the muscles, disks and ligaments of the TMJ, neck and upper back. As a result, the jaw is forced to rest in the opened position, and the chewing muscles become overused.
• Clenching at night is called Bruxism. There may also be grinding of the teeth. Clenching and grinding while sleeping is usually because of stress. There is constant strain on the TMJs and surrounding muscles and the end result is pain and tooth enamel wearing down.
• Problems with the alignment of your teeth as you close your mouth is called malocclusion. If the teeth come together in an atypical fashion then there is greater stress placed on your TMJs.
• Broken bones are called fractures. A traumatic accident involving the face or head can cause a fracture to the maxilla the bone that houses the upper teeth or the mandible, the bone that houses the lower teeth. Bones heal, but can leave behind a stiff, painful TMJ.
• Facial or jaw surgery can cause a loss of mobility and functions of the jaw.
• Jaw muscle spasms known as trismus prevent the mouth/jaw to fully open. This lockjaw can be a cause and a symptom of TMD. Trismus can also be caused by trauma to the jaw, tetanus and radiation to the face and neck.

Jaw pain is one of the symptoms of TMD. It is important for you to know that jaw pain can be a symptom of a heart attack. Seek medical care immediately if your jaw pain is accompanied by:

• Chest Pain
• Shortness of Breath
• Dizziness
• Left Arm Pain
• Numbness in Your Left Arm
• Nausea

We specialize in treating TMD and all its associated conditions. We will work closely with your primary care physician or dentist. We review your medical history, previous surgeries and other injuries to the head, face, neck, upper back, shoulders and jaw. We conduct a physical examination and develop a personalized treatment plan for the physical therapy office setting and for at home. Your treatment plan will include pain reflex release techniques (PRRT) and other intraoral (inside the mouth) manual therapies to reduce your pain by 50 percent the first session. Modalities such as biofeedback, ice, heat, iontophoresis, ultrasound, electrical stimulation may be used to help manage pain while jaw movement is restored.