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Jaw Pain (TMJ): Massage and Acupuncture Effective for Relieving Jaw Pain

Acupuncture points used for jaw pain

Experiencing pain while enjoying your tasty burger?  Waking up with a sore jaw? Can’t open and close your mouth as comfortably as you could?  Does your jaw make clicking noises? You may have temporomandibular joint (TMJ) syndrome/pain.  Do you often get temple headaches? More and more, I see many people walk into the clinic with a history of some sort of TMJ issue.  Let’s look at the anatomy of the jaw and figure out what’s going on.

TMJ Anatomy

Imagine a door that hinges, but is also a sliding door.  That’s the way our jaw moves. Rather than a one dimensional movement of close and open, our jaws move slightly forward then backwards.

There are many muscles of different shapes and sizes that help the jaw move the way it does.  The main muscles we can look at are also part of mastication/chewing. These muscles are:

    • Masseter
    • Temporalis
    • Medial pterygoid
  • Lateral pterygoid

What to expect with massage treatments

If you are looking to avoid any invasive surgery, massage therapy is a great way to treat the signs and symptoms of pain and range of motion along with the secondary symptoms. Treatment options include: external and/or intra-oral massage, cupping, or acupuncture. 

There are two ways that massage therapists will approach the TMJ.  Firstly through external massage (treating the external muscles of the jaw/mastication).  Secondly, through intra-oral massage (treating the internal muscles of the jaw/mastication).  Addressing both the external and internal anatomy is very important when treating the jaw. Intra-oral massage may seem scary, but it is one of the most effective ways to treat TMJ issues.  Don’t worry, therapists will always perform this technique with sterile gloves and with proper pressure and communication with the client.

Other modalities of treatment can include local cupping to the external muscles with local acupuncture needling to the same muscles surrounding the jaw.  With acupuncture some of the local points will help reduce muscle tension and soreness as well as improve circulation to the area. Make sure to stay updated with our feed to get a sneak peak on what acupuncture would look like on your jaw!

There can be many other reasons for why your jaw might be hurting.  If you have any further questions, please feel free to inquire with us today. Contact us to schedule your free 15 min meet & greet. 

By: Jonathan Chang (RMT)

References

Mayo Clinic Staff, TMJ Disorders. Aug 16, 2017, https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941

Facial Cupping

Did you know our very own Massage Therapist Rehab (RMT) does Facial Cupping?!

Did you know that facial cupping can:

    • Reduce pain and inflammation caused by sinusitis, Jaw pain and Bell’s Palsy
    • Increase lymphatic drainage and blood circulation
    • Increase oxygen rich blood cells
    • Reduce scars
    • Stimulate the production of collagen
  • Strengthen skin and connective tissue

It’s important to note that unlike regular cupping, facial cupping does not cause bruising, however slight redness of the face is normal.

FACT: Cupping is considered one of the oldest natural healing therapy around 1550 B.C. by the Egyptian, according to EBERS PAPYRUS (one of the oldest medical text book in the world)!

Contact us today to discuss if this treatment is right for you! Book your Free 15 minute meet & greet today!

Acupuncture as part of your Physio, Chiro or Massage treatment!

Did you know that several of our Registered Physiotherapists, Registered Massage Therapist and our Chiropractor are trained and certified to include acupuncture as part of your treatment plan!

What it does and what condition can it be useful for?

Acupuncture needles are placed at certain known points that have been shown to have an impact on certain conditions and pain. Acupuncture can impact blood flow and alter the release of neurotransmitters (1) that impact the bodies natural healing process. Several reported effects of acupuncture include improvements in low back pain (2), musculoskeletal conditions (1, 3) including neck, elbow, wrist and shoulder pain related to tendonitis and muscle strains. Acupuncture is also used for treating ankle sprains and knee pain.

What does it feel like?

You may or may not feel the needle when inserted. Even if you do it is generally not a painful feeling. However, everyone’s tolerance and perception of what is painful plays a role here.  After the needle is inserted some people describe a deep aching or heaviness locally or in the area surrounding the needle. Some report they don’t feel anything at all!…but still notice improvement in their symptoms.

The number of sessions and outcome of treatment varies from one individual to another. However, improvement is usually noted within 4-6 treatments provided over a period of 2-4 weeks.

Contact us to discuss if acupuncture is right for you! We offer free 15 minute consultations (in person or over the phone) to discuss your concerns and find the best treatment option for you.

References:

  1. Acupuncture. NIH Consensus Statement Online 1997 Nov 3-5; 15(5):1-34.
  2. Furlan, A.D., van Tulder, M.W., Cherkin, D.C., Tsukayama, H., Lao, L., Koes, B.W., Berman, B.M. (2005). Acupuncture and dry-needling for low back pain. The Cochrane Database of Systematic Reviews.
  3. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine. 2012;172(19):1444-1453.

Do you ever feel “trapped” by your traps?- The Neck Series Part III

Free stock photo of man, person, hands, relaxationMany of us often suffer from neck pain, headaches and much more all due to one of the biggest muscles the connect our neck and shoulders – the trapezius muscle.

Given the name, the trapezius muscle is trapezius shaped and has multiple attachments to our neck and shoulder blades.  It is one of the more superficial muscles that covers the upper half of our back.  It is responsible for moving our shoulder blades and the neck.  There are three different fibers to the trapezius– upper, middle, and lower fibers.  With our focus on the neck, we will dive into the upper trapezius fibers.The muscle has many attachments and mainly involves moving the neck and the shoulder blades.

 

Origin External occipital protuberance

Spinous processes of C7 to T12

Nuchal ligament

Medial superior nuchal line

Insertion Lateral third of the clavicle

Acromion

Spine of scapula

Action Lateral flexion

Lateral rotation

 

Both sides will bring the neck into extension

Nerve Innervation CN XI (accessory nerve; motor)

C3 and C4

 

Most common issues I come across involve and include:

  • Headaches/migraines in the front, sides, and back of the head
  • Pain in and around shoulder blades, eyebrow, and even around the jaw.

Most of the issues will either by directly affecting the muscle and the attachments or by trigger points causing referral pain (not local to the muscle).  The upper trapezius muscle is a pivotal muscle that can cause chronic problems over-time if not conditioned properly and taken care of.  From experience, most problems occur with improper alignment of your neck and shoulders over prolonged periods of time.  Going in to see your chiropractor might also be a great idea to help with the issues above!

Trigger Points in upper trapezius.

Stretches for upper trapezius:

  1. Set up in a neutral position making sure everything is straight and comfortable. Performing the stretch in a mirror for the first time may help determine your neutral alignment.
  2. Bring your arm over and on top of the opposing ear
  3. Gently pull the ear to your shoulder
  4. Hold for 30 to 60 seconds

 

It’s important to make sure you feel the stretch where you want to pain-free.  If you experience any sharp stabbing pains, make sure to stop the stretch.

 

Hope this stretch helps you out at work or wherever you are!  More muscles to come!

 

By: Jonathan Chang, RMT, SMT(cc)

 

References:

http://www.triggerpoints.net/muscle/trapezius

 

https://www.physio-pedia.com/Trapezius

 

To book you massage or ask us a question contact us today!

Remember to take care of you!

Neck Series Part II: All about this little unique neck muscle- sternocleidomastoid (SCM)

Welcome back for another neck series.  Did everyone give the range-of-motion test a try?  Did both left, right, front, and back sides feel even and pain-free?  Hope it did!

Below is a chart to compare your ranges.  Hooray for charts!

 

 

Cervical Spine Direction Degrees of Range (Approx. degrees)
Flexion 50
Extension 60
Lateral Flexion 45
Lateral Rotation 80

 

Today, we will be looking at one of the most unique muscles of the neck, the sternocleidomastoid (SCM).  This muscle is located in the front of your neck on both left and right sides and controls movements associated with the neck.  It has attachments on the sternum, clavicle, and temporal bone of your skull (mastoid process), hence the name sterno-cleido-mastoid.  To locate the muscle, simply rotate your chin to one shoulder and the SCM will simply pop out and become distinct in the front of your neck.  Palpate from behind the ear, down towards the front of the neck.  Here are the anatomical all-star stats for the SCM:

 

Origin

(where the muscle starts)

 Manubrium (sternum)

Clavicle (collar bone)

Insertion

(where the muscle ends)

 Mastoid process (behind the ear)
Action on C-spine

(movement it produces)

Bilaterally (both sides together)

  • flexion
  • extension

 

Unilaterally (one side only)

  • lateral flexion (ear to shoulder)
  • lateral rotation to opposite side (chin to opposite shoulder)
Nerve Innervation

Spinal accessory nerve (XI)

Sensory supply from C2 and C3

 

So why are we looking at this muscle?  The SCM is highly susceptible to something we call myofascial trigger points.  These points generally feel painful and very tender upon palpation.  You may even feel “knots” when palpating these muscles.  Trigger points form because the muscle is too overworked, stressed, and ultimately tight. Each muscle will have a unique referral pain away from the muscle itself.

http://www.triggerpoints.net/muscle/sternocleidomastoid

 

Most often, injury/dysfunction of this muscle typically comes from poor head-neck posture or from trauma such as whiplash.  Here are some common signs and symptoms you may be experiencing:

 

  • Neck pain
  • Headaches (occipital, temporal, frontal, or around the eyes)
  • Migraines with visual disturbances
  • Dizziness
  • Pain in upper chest

 

As massage therapists, when considering treatment goals, we want to make sure these trigger points are addressed and that everything is properly aligned.  Without proper alignment, the muscle will not be able to function optimally.  Here are some tips and tricks on treating your SCM:

 

  1. Stretch the muscle
  • Make sure your head and neck are properly aligned in a neutral position
  • Tilt your chin up slightly as if you are gazing at the stars.
  • Proceed to bring your hand over your head onto the temple
  • Bring your ear to your shoulder
  • Go slow and stretch only until you feel a nice pulling sensation along the side of the neck.  Hold the stretch for 30 to 60 seconds.
  • Make sure to avoid any unnecessary pain and keep your shoulders down.
  1. Self-release
    • Locate the muscle by first rotating the chin to one side.
  • Lightly pinch/grab the muscle belly

 

  • While holding onto the muscle, align yourself in a neutral position looking straight ahead.
  • Perform slow movements of ear to opposite shoulder repetitively
  • Self-releases should only be performed 20 to 30 seconds at a time with rest between sessions.

Give the stretch and self-release a try for yourself.  Hope you find some sort of relief with them!  Please stay tuned for more content including videos and more posts about the neck muscles.  Cheers!

By: Jonathan Chang, RMT, SMT(cc)

 

References:

http://thewellnessdigest.com/sternocleidomastoid-muscles-affects-head-eyes-sinus-ears-throat-pain-dizziness-whiplash/

https://www.physio-pedia.com/Sternocleidomastoid

 

Contact us today to book your massage!

Neck pain

Neck pain plagues us all. Whether we sit at a desk all day long or perform as a high functioning athlete, we all experience neck pain at one point in life. There are a dozen reasons as to why we experience neck pain. They can range from underlying conditions such as arthritis, biomechanical and postural inconsistencies, or you just slept on the couch wrong and kinked your neck. This first part of the series, we will start by looking at the general anatomy of the neck and the movement.

Anatomy of the neck

At its core, the neck is comprised of seven cervical vertebrae that house your nerves which innervate specific areas of your body. You can think of these bones as your car frame and the nerves as your electrical wiring for everything else. Between each bone you have discs that serve to function as shock absorbers and cushioning between those joints. These discs can be comparable to your car shocks that help whenever it runs over bumps. Layers of muscles, ligaments and other supportive structures serve to move the head and stabilize the joints between. Ligaments serve to provide support to structures, while muscles also act to stabilize and move the neck and shoulder in certain directions.

There are many muscles which range from being thin and small, to larger and thicker muscles. Most of these muscles either aim to 1) stabilize and/or 2) produce movements. The neck is able to produce movements of flexion (chin to chest), extension (chin to the sky), lateral flexion (ear to shoulder) and lateral rotation (chin to shoulder).

 

 

 

A quick check of how your neck is can be as simple as performing these movements and looking at how balanced each side is along with if you experience any pain local or away from the neck. Give it a try!

 

We experience pain whenever the body fails to balance the forces on our neck due to posture, or there is some underlying cause. Typically, as therapists we look at your signs and symptoms in addition to if there is pain with active or passive neck movement. All of the observations we make help us play detective to determine what exactly is the root cause of neck pain.

In our next post, we will look at some of the major muscles that we all have struggles with. We will go over some ways to stretch these muscles and exercise them. Till next time!

 

Jonathan Chang RMT, SMT (cc)

Contact us today to book your massage!

We’re hiring!

An opportunity has opened up to come and join our team here at JointAction Physiotherapy in Whitby!  We are a multidisciplinary clinic (Physiotherapy, Chiropractic and Massage Therapy) looking for an RMT (Registered Massage Therapist) who is eager to work in a team setting and appreciates the value that each profession can bring to helping a patient achieve their treatment goals.

Applicants must be registered with and in good standing with The College of Massage Therapists of Ontario. For more information please apply below.

Job Type: Part-time, must be willing to work evenings (to 7pm) and Saturdays (9am -1pm)

Job Type: Part-time

https://ca.indeed.com/cmp/JointAction-Physiotherapy-&-Wellness-Centre/jobs/Massage-Therapist-1be9618455087393?q=Registered+Massage+Therapist

 

 

Good Pain?? Bad pain!

good vs.badPatients usually find the term “good pain” odd…how can a pain be good? However, a “good pain” is often used to describe muscle aching you may experience during a long hold or after doing a few repetitions of a strengthening or resistance type exercise. For example, if you hold a squat and start feeling an aching in the thighs and gluteal muscles as a result of that long hold, or if you do leg raises in side lying and feel that aching in the gluteal muscles of the leg you are working out. Any type of muscle aching you experience after a workout: known as delayed onset of muscle soreness (DOMS) is an expected type of discomfort. Usually this type of “pain” or discomfort is relieved with moving those muscle groups and stretching. The idea is to keep the blood flowing to help the muscles heal after a strenuous workout.

 

Whereas a bad pain is usually described as aching or dull, stabbing, grabbing, sharp type of pain or even a referring, radiating, numbing and burning. This is usually experienced during, hours after or even the day after doing an exercise or activity that has caused injury. This is usually not relieved easily and tends to linger or come and go depending on the activity you are doing. For example, some people will only experience a sharp type of pain only mid-way through their run and may notice that they tend to get it earlier and earlier in the run over time which may indicate a worsening of the pain/cause.Studio shot of young man with pain in back

 

It is always best to seek a health professional’s opinion about pain that is consistent and interferes with your exercise routine or functional every day activities like walking, stairs etc. I would recommend you make note of the following to report to your health care professional which will help provide an idea on the potential cause of the pain:

  • What aggravates/causes your pain (i.e. stairs, walking, sitting, standing etc.)
  • What helps relieve your pain (i.e. walking, sitting, stretching, ice, heat etc.)
  • Type of pain (i.e. sharp, throbbing, aching, stabbing, burning, numbness)
  • Location of pain (i.e. take note of you experience any pain radiating down arm or leg)
  • Intensity and duration of your pain when you do get it

 

It’s important to note that you may not need a referral to see a Physiotherapist, Chiropractor or Massage Therapist UNLESS your extended health benefits plan requires one.

We also offer free 15 minute meet & greet which allow you the opportunity to meet the therapist and discuss your pain/concerns before booking an assessment. Contact us today!

 

By: Nelly Temraz, PT.