Most people would agree that earache is a really unpleasant experience. Whether it’s a continuous, dull ache or a sharp, searing pain, earache can be disorientating and debilitating.
Earache can be caused by the build-up of ear wax or air pressure, or it can be a symptom of an infection like tonsilitis. It’s widely believed that ear infections are the most likely cause of ear pain. However, the truth is that the most common cause of earache is actually TMJ ear pain.
The temporomandibular joint (TMJ) is a complex structure and disorders of this system can be very painful and troublesome. Read on to find out more about the causes of TMJ pain and treatment options available.
What Is the TMJ?
The TMJ is a ball and socket joint that connects the mandible and temporal bone – the jaw and part of the skull. It operates as a hinge and enables the movement of the jaw forward, backward, and from side to side.
The joint consists of a complex system of ligaments, bones, muscles, and a shock-absorbing cartilage disk. These elements work together to maintain a smooth and comfortable jaw movement.
Any malfunction of this joint is known as temporomandibular joint dysfunction. This can cause pain and discomfort in the ear canal, face, and surrounding parts of the head.
TMJ Ear Pain and Other Symptoms
Pain can occur if the disk which supports the joints erodes, moves out of alignment, or is damaged by a blow. The joint can also be damaged by wear and tear or degenerative conditions.
Some TMJ symptoms include:
- Pain in the ears or face after chewing, swallowing, talking or yawning
- Pain and tenderness in the jaw and surrounding area
- Popping or grating sensation or clicking sound on moving the jaw
- Difficulty opening the jaw as widely as normal
- A sudden and significant change in how the upper and lower teeth fit together
- Aching facial pain – this can radiate to the head and neck
- Locking of the joint, making it difficult to open and close the jaw
Causes and Risk Factors for TMJ pain
If you’re suffering from TMJ pain, you will most likely be wanting to know what has caused it. While the cause is often difficult to determine, there are a few factors that can lead to the onset of TMJ pain.
Degenerative conditions such as arthritis can cause erosion of the joint, leading to pain. Some connective tissue diseases also affect the TMJ.
Another obvious cause of TMJ pain is a blow or injury to the jaw or to another part of the head, which affects the TMJ structure. Any injury or trauma to the head or neck is likely to cause some damage to the jaw, with a risk of displacement of the TMJ.
A common cause of TMJ pain is bruxism – the habitual grinding or clenching of teeth. This can be caused by psychological triggers and puts pressure on the jaw muscles, leading to pain and tenderness radiating into the ear and other surrounding areas.
Excessive chewing of gum is also a risk factor for TMJ pain. Some people do this for years and never have any problems, but others do experience discomfort as a result.
Categories of Temporomandibular Joint Dysfunction
There are three main categories of TMJ disorders. Each has a different likely cause and treatment, so it’s useful to know which type might be causing your TMJ ear pain.
Derangement of Joint
This can include pain caused by a dislocated jaw or an injury to the surrounding area. It has been found that up to 25% of the population may have a milder displacement of the TMJ, called a malocclusion or improper bite, causing wear and tear to the joint and resulting in pain of varying degrees of severity.
Any form of arthritis may affect the jaw and cause TMJ pain, but the most frequent types involved are rheumatoid and osteoarthritis. Some rare tissue connective disorders and auto-immune diseases can also impact on the TMJ.
This form of TMJ disorder manifests itself as a deep aching pain in the muscles surrounding the TMJ. It is the most common type of TMJ pain and the easiest to resolve.
Treatment Options for TMJ Symptoms
There are various TMJ therapies available to help alleviate TMJ symptoms. The treatment recommended will depend on the severity of the symptoms and the likely cause.
For patients whose pain is due to clenching or grinding of the teeth, possibly caused by psychological triggers, relaxation and stress management techniques may be recommended. This could include yoga, meditation, and breathing exercises.
Using a mouth guard or other orthodontic device can help to reduce teeth grinding at night. This can ease the tension which contributes to TMJ ear pain.
Immediate pain relief can be gained by using over-the-counter medication, including anti-inflammatories and muscle relaxants to reduce facial spasms. Warm compresses on the jaw are also effective, and eating soft food can help to reduce pain while chewing.
TMJ exercises are effective to strengthen the jaw muscles, stretch and relax the jaw and reduce clicking and increase jaw mobility. Any significant injury affecting the jaw requires urgent medical attention, to restore the jaw to the correct position.
As a last resort, if conservative measures fail, there are surgical options available to treat TMJ pain. These include arthroscopic surgery to operate on the joint itself, or corticosteroid injections to reduce pain and inflammation.
How to Deal With TMJ Symptoms
The discomfort caused by TMJ ear pain is usually temporary and can be relieved with self-managed care or non-surgical treatments. Don’t assume that ear pain is caused by an infection – remember that temporomandibular joint dysfunction is the most common cause of earache.
Some people only experience a painless clicking sound and grating sensation on chewing or opening their mouths. If there is no pain or limitation of movement, it’s probably not necessary to see a doctor, but in the case of persistent pain and tenderness, you should seek medical advice.
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