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TMJ and Chiropractic
You may have heard or experienced a condition called TMJ which is a condition of clicking or pain in the Temperomandibular Joint (TMJ) or jaw. It is more correctly termed TMD which stands for Temperomandibualr Disorder (TMD). These occur as a result of problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw.
Causes include:
- Injury to the jaw, Temperomandibular joint, or muscles of the head and neck (such as from a heavy blow or whiplash)
- Grinding or clenching the teeth, putting great pressure through the TMJ
- Stress, which can lead to clenching teeth, and/or tight facial and jaw muscles
- Arthritis in the TMJ
- Disrelationship of the complex jaw joint
Common symptoms of TMD include:
- Decreased ability to open the mouth wide
- A locked or stuck jaw either in an opened or closed position
- Clicking, popping or grating sounds in the jaw joint on jaw movement
- Pain or tenderness in the face, jaw joint, neck, shoulders and/or ear, including headaches and earaches
- A tired feeling in the face
- A change in the bite, as the teeth are not aligned
Intra-oral Cranials is a technique that your Chiropractor may use that is extremely effective in improving the movement of the jaw joint and hence reducing the symptoms relating to TMD. This Cranial technique addresses the bones of the skull and jaw to normalise the relationship of the skull with the jaw and the neck, and allow the jaw to move smoothly and freely and with its normal range.
Acupuncture for Neck and Shoulder pain
Neck and shoulder tension is one of the banes of modern life – when severe, the pain often extends down the arms and also can lead to headaches and jaw stiffness. It can really limit your life. But you don’t have to be stuck with it!
Acupuncture is great for melting those knots. Within 4-6 treatments we usually see substantial relief, with the hard areas becoming much looser. The time taken for this to happen depends on how long the tension has been there for, and how severe it is.
The treatments are very gentle – Acupuncture use extremely fine needles that you barely notice, plus moxibustion, a form of herbal heat treatment. The combination works really well in relaxing muscles, especially in the shoulders and neck
During a treatment, our Acupunctuirists uses a combination of Acupuncture points specifically targeted at any imbalance underlying the muscle stiffness, as well as local points to bring fast relief. We also look at lifestyle measures to help prevent the problem recurring.
Tara is a Registered Acupuncturist with many years’ experience in treating neck and shoulder issues. Health-fund rebates are available for Acupuncture treatments.
Neck and shoulder pain.
Many of us live with permanently stiff shoulders or a neck that seizes up from time to time. Our modern lifestyle is a major culprit, with computer work (especially on laptops) putting a lot of strain on the neck and shoulders. Out-of-control stress levels don’t help either. One of the worst environments for neck and shoulder pain is a high-pressure work environment with badly set-up computers and cold air flowing down on you from air conditioning. With this sort of combination of stress, poor ergonomics and the tendency to tense up the shoulder muscles in response to cold, it’s not surprising that so many people suffer from stiff neck and shoulders.
Other things that can trigger neck and shoulder pain are prolonged driving, freehand writing or drawing, occupations involving a lot of repetitive use of the arms (hairdressing comes to mind), and playing some musical instruments.
So what can be done? Obviously it’s important to address anything in your lifestyle that might be contributing, which could involve a rethink of your work or leisure patterns. I’ve included a list of other tips at the end.
But what if your shoulders and neck are still sore after doing everything you can to relax them? This is where acupuncture comes in.
Japanese acupuncture uses several needling techniques to melt tension in the neck and shoulders. Another technique that is great for neck and shoulder pain is moxibustion – the use of a warming herb on the tight, painful areas. Cupping is also very useful. But much of the treatment is done away from the local painful region– as it is just as important to treat the constitutional pattern that Oriental medicine sees as causing disruption to the flow of energy, as we see this as underlying the neck and shoulder pain. This ensures that treatments will have a lasting effect.
We usually see an improvement within 4-6 weekly treatments, and when this happens we scale back the frequency of sessions as your body “relearns” this state of reduced tension. Eventually most people will just need the occasional top-up session every few months or so during periods of particularly intense activity or stress.
Tips for relieving neck and shoulder stiffness:
- Make sure your desk is properly set up. Many offices these days have ergonomic guidelines and it’s also possible to have an expert review your set-up.
- Give your neck and shoulders a break by taking lots of breaks from computer work, or other intense activities like writing freehand, drawing, music practice or driving. Aim to have a break where you get up, walk around and stretch after every 20 min of typing etc.
- If at all possible, avoid sitting in air-conditioning, or wear a scarf (or a top with a collar that covers your neck).
- Warmth helps most people with this sort of pain, so try hot showers or heat packs.
- Try to build some type of relaxation into your day, like meditation, yoga or Tai-Chi. Another really useful strategy is to focus on becoming aware of shoulder tension as it builds up and repeatedly and deliberately relax and drop your shoulders. Tricky to do at first, but it gets easier with time.
- It is also often possible to strengthen other muscles in the upper body so that your traps don’t take all the strain. If you go to a gym, ask one of the trainers to show you how to strengthen these muscles.
Stress and your body, part 2.
Now, after reading Part 1 in last months newsletter, you may have a better understanding of how readily our body reacts and changes in response to stress. These changes will often occur without us having any awareness of them, but there are many other changes that occur that that we can feel. Many patients present to me with various aches and pains, that very often have an underlying cause of stress. When we are dealing with stress our body reacts in certain predictable ways. There are 3 muscles that will always tighten in response to stress. They are your diaphragm, your upper Trapezius and your Suboccipital muscles.
Your diaphragm is a sheet of muscle that sits like a dome and divides your internal body in half. It sits below your lungs and heart and above the rest of your organs, and is important in breathing as it moves down to help your lungs draw breath in and up to help push air out of your lungs. When it is tight it is not able to move down and this results in feeling short of breath. As it is attached to structures on the inside around the level of the lower ribs, any tightening of the diaphragm can pull on these structures and often create a twist in that area. This can result in pain in the back, along the spine, around the ribs, and sometimes even pain on breathing.
The upper Trapezius muscle sits across the top of your shoulders and up into the lower neck, as it tightens it will pull the shoulders up and pulls the neck down into the shoulders. This affects your posture and will create discomfort in your shoulders, between your shoulder blades and also your neck. It can also cause a pinching of the nerves in your neck resulting in numbness or a tingling or pins and needles sensation in your hands or fingers.
The Suboccipital muscles are short muscles that join the back of your skull to the upper neck. Any tightness in these muscles will cause your head to tilt back. They can give you pain in the upper neck and in the back of the skull. Tightness in these muscles together with the Trapezius muscles creates poor posture and stiffness running from the skull to your shoulder blades, resulting in neck and shoulder pain as well as headaches. Sustained tightness and resulting poor posture in this area can often result in achiness in your upper arm.
Another common reaction to stress is clenching or grinding your teeth. Apart from this being damaging to your teeth, it causes very tight jaw muscles. This in itself can give you pain around the jaw which can feel like a headache. These tight muscles will also affect the upper neck and temples due to where they attach, and cause neck pain and stiffness and headaches.
Stress is a part of every persons life, and it can be positive, such as it being a motivator, but it can also cause problems. Just like everything in life there needs to be balance for there to be health and wellness. Stress can be balanced by exercise and relaxation, so it is important to find forms of exercise and relaxation that work for you, and incorporate that into your daily life.
Neck and shoulder pain exercises.
Neck and shoulder pain is a very common ailment in today’s times, and it is almost always due to our posture, especially when our days are spent at a desk usually in front of a computer. Firstly the position we are in is not always the most ergonomic. We are all different heights and sizes and desks and chairs don’t always accommodate for these differences. We may be using 2 monitors and moving left to right to work on both, or twisting to get folders from shelves that are next to us or behind us.
Secondly we may be sitting at your computer for hours at a time without getting up and having a break, and then to compound that we can be so focused on what we are doing we often forget to sit up correctly and often end up with a rounded lower back, a forward head position and rounded shoulders. This will almost always lead to tight muscles and pain in the shoulders, between the shoulder blades, and up into the neck. It can often contribute to headaches also. Then as a consequence of these tight muscles it becomes more difficult to maintain a good posture, so it then becomes a cycle of poor posture leading to muscle spasm, causing poor posture.
Some simple things you can do to stop this cycle from occurring!
- Firstly be mindful of your office/desk setup. Have your computer square in front of you with the monitor at a height so that the centre of the screen is at a 15degree down angle from your eyes. Have the monitor as far away from you as possible while still comfortable for you to read. It should be a minimum of 50cm. Also have your computer at right angles to a lit or window to minimize any glare on the screen. The keyboard should be situated such that your elbow is at 90 degrees, or even slightly lower. This helps your wrist to be straight and reduces the potential for a repetitive strain injury. Have your chair at a height so that your feet are flat on the ground and thighs are perpendicular to the floor.
- Secondly, be conscious of your body. No matter how ergonomic your desk setup is, it wont help if you dont think abouthow you’re sitting. Most importantly, don’t slouch. try and sit with your back straight and your shoulders back and down. Have your head up and try to elongate your neck. Get up every 20min to have a walk around, and a stretch.
- Thirdly, stretch…
- At work
- Neck – by bending it gently to the left hold it for 10 sec, bring your head back to neutral, then repeat 4 more times. Do the same with the neck bent to the right. Then also forward by tucking your chin in and bending it towards your chest. Then bend your neck backwards by looking up to the ceiling. While doing these stretches keep your shoulders down.
- Shoulders – loosen up your shoulders by firstly shrugging the shoulders, hold them up for 5 sec then let them drop. Repeat this 4 times.
- Roll your shoulders slowly backwards bringing them as far up, back, down and forward as possible. Do this 5 times. Then roll them slowly forwards 5 times, again bringing them as far up, forward, down and backwards as possible.
- At home
- At the end of the day when you get home get a small rolled towel, about 10-15cm in diameter. While lying on your back place the rolled towel across the back of your neck. Push your head back towards the ground and hold it for 5 sec, then relax for 5 sec. Then repeat 4 more times.
- Next have a rolled up towel that is about 25-30 cm long and about 8 cm in diameter. Lying on your back and place the towel along the length of your spine between your shoulder blades. You can also place a low pillow under your head to make sure your neck is comfortable. Lying on the towel in this way allows your shoulders to relax back, and they also relax down. It allows your shoulder muscles and those between your shoulder lades to relax and release. This exercise helps release tight muscles but it also helps improve your posture, that why it’s good to get in the habit of doing this exercise even if you’re not feeling sore or tight.
- At work
Does sitting affect your health?
Within the last 30 years, our world has seen astounding advances in our technological capabilities, which has affected the way people carry out their daily lives. Nowadays, most people are required to spend the majority of their working day in an office environment sat at a desk in front of a computer.
Our bodies, however, were not designed to remain in one position for long periods of time; they were made to move. When we are sedentary, our body responds by burning fewer calories and slowing down our circulation. Such a lifestyle also leads to postural problems, which can develop into chronic health issues.
In a seated position, certain postural muscles, especially in our back and neck, start to become short and tight from being overworked. This then leads to issues such as upper or lower back pain, stiff shoulders, neck pain, tight hamstrings, headaches and migraines. The muscles that support our spine also become weak, like our gluteal and abdominal muscles.
Repetitive strain injuries, such as carpal tunnel syndrome, are also becoming more widespread and it is not uncommon for keyboard users to complain of wrist, arm and shoulder pain or discomfort.
I am sure the majority of us, including myself, will have experienced some or all of these above symptoms at some point in our lives.
So what can we do about it? Take time to get up and move about, as well as to stretch. Whilst seated, be aware of your own posture and at work try to change the nature of your tasks as often as you can. In addition, try to develop a regular exercise routine even as simple as walking for 30 minutes a day.
Massage therapy is also extremely effective in this situation to release and relax the muscles, as well as to reduce overall tension and fatigue found within the body. Regular massage sessions are thoroughly recommended to assist in maintaining good body health and well-being.
Stress can be a pain in the neck
Have you ever referred to something or someone in your life as a “pain in the neck”? You were probably more accurate than you realised. Any emotional stress (which can include rushing and being very busy) can result in the muscles across the top of your shoulders tensing up. Tense muscles will be uncomfortable. Then if this tension is prolonged, over a short time the muscles in surrounding areas including the neck muscles and between the shoulder blades will also become tight and painful.
Another response to stress is commonly clenching of the jaw or grinding teeth at night. This results in muscle spasms around the jaw, which also will cause muscle tightness in the neck, and hence neck pain and stiffness.
Poor or prolonged work posture can cause neck pain also. Work is commonly related to stress, and this together with a sustained posture over the course of the day will result in tight muscles around the neck and shoulders, resulting in pain.
Chiropractic care can help in several ways. Chiropractors can help release the tight muscles, as well as give advise on stretching and posture and activities to help maintain good muscular balance.
More more information, please read on, or contact Martina, our principal Chiropractor.