The locking or clicking jaw (TMJ disc derangement)
The medical term ‘locked jaw’ (or trismus) and what most people experience as a ‘locking sensation of their jaw’ can be very different things. For the sake of this article we are focusing on the ‘locking sensation of one’s jaw’ related to the bones, muscles and the jaw connective tissue.
Help! My jaw is popping and locking
It is a scary feeling when your jaw suddenly clicks or locks, it feels like something is stuck and you’re somewhat right! When your jaw clicks, pops or locks you are experiencing a dysfunction with the jaw joint (TMJ) and a dysfunction of the little disc that lives inside the joint. This presentation is called ‘TMJ disc derangement’.
The jaw joint (TMJ-temporomandibular joint). Image sourced from ‘The TMJ Association’
The jaw joint (TMJ) is an inherently free/mobile joint that allows us to speak, swallow and chew effortlessly. But with an increase in mobility comes an increase in demand for stability and thus the TMJ is heavily influenced and dependent on the surrounding connective tissue.
When one’s jaw locks, the articular disc, a small slippery fibrous disc that lives in the jaw joint, is being pulled into a position that restricts jaw movement. Similar to when a sock gets caught under the door when you’re trying to open it.
When the jaw clicks it is the sound of the disc quickly sliding back into place. Similar to a door that has a loose hinge and it somewhat moves in a jerky noisy fashion when you open it.
So why does this disc get stuck and how can you ‘unstick’ it?
Why is my jaw (TMJ) stuck or clicking?
As mentioned earlier, the TMJ is a joint with a lot of freedom. When there is an imbalance in the surrounding connective tissues the joint and the disc can be pulled out of alignment. This is caused by a muscular spasm around the jaw joint. So let’s look at three factors that can cause this:
1. Surrounding connective tissues
The muscles, ligaments and joint capsule surrounding the jaw joint all omit force on the jaw joint. A tight surrounding muscle can act like a pulley and can tug the TMJ and disc out of place. In the same vein, a restrictive adhesion (a tight spot) on the jaw joint capsule could prevent movement in a particular plane thus leading to clicking or locking of the jaw.
2. Postural alignment
Because the TMJ can move so freely, it will compensate for other asymmetries and imbalances within the body. The TMJ always wants to return to midline. The most amusing example of this would be how a chicken always keeps its head level regardless of the body position. When a chicken is rotated or side bent it will move its head so that its eyes will stay level. Our jaw is similar, if we for example had our body turned to the left the jaw will compensate and swing to the right. Or if our head drifts forwards our jaw will compensate and drift backwards.
3. Dysfunctional habits
Our body is clever and will find solutions to problems it is presented with. For example, if we had a painful tooth, our body would instinctively avoid chewing or using that area because it hurts. Then lets say you go to the Dentist and they fix your painful tooth, but our habit of chewing to avoid the painful tooth may still remain. So perhaps once our tooth is fixed we need to reintroduce a chewing pattern to utilises both sides of the mouth.
We find that habits tend to stay with us until our body is shown an easier, nicer and faster alternative.
Important side note: There are other medical conditions such as tetanus and cancers that are associated with locked jaw but for the purpose of this article we are focusing on the locked jaw causes of musculoskeletal origins (the muscles and bones).
What can I do about my clicking or locked jaw?
Sometimes treatment for locked jaw falls outside the realm of Osteopathy and a more invasive treatment is required. However treatment for TMJ disc derangements like popping, clicking or locking of the jaw is ideally an escalating scale- starting from non invasive reversible treatment, and this is where Osteopathic management can be helpful.
In relation to the three headings above, we can target our treatment to address issues with the surrounding connective tissues, postural alignment and dysfunctional habits. Usually one area will be more prominent/dysfunctional and this is the area where one’s treatment should commence. We have created a short video to help manage your locked jaw, it includes three DIY exercises.
The video advice below is broad general advice, please keep in mind that an individualised approach will always work best as an assessment and hands on treatment are both important factors for the best management of clicking, popping or locking jaws.