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Skull of an adult
Skull of an adult
Causes of secondary headache
Causes of secondary headache

Temporomandibular joint (TMJ) syndrome
Definition:
Temporomandibular joint (TMJ) syndrome is a condition of facial pain in the joints of the lower jaw.

Alternative Names:
TMJ

Causes, incidence, and risk factors:

Temporomandibular joints (TMJ) connect the lower jaw (mandible) to the skull. Problems arising in this area may cause various symptoms such as headaches, popping sounds in the jaw, and facial pain.

The causes of problems are multiple, and can include congenital anomalies, arthritis, fractures, dislocations, and tension-relieving habits -- such as jaw clenching or tooth grinding behaviors (bruxism) -- which may cause muscle spasms in the jaw and dental misalignment. Nevertheless, physical examination may be normal.
Symptoms:
  • Headache
  • Jaw pain or tenderness of the jaw
  • Dull, aching facial pain
  • Biting or chewing difficulty or discomfort
  • Clicking sound while chewing or opening the mouth
  • Grating sensation while chewing
  • Decreased ability to open or close the mouth
Signs and tests:
A physical examination may reveal tenderness of the TMJ and connecting muscles. A dental examination may show malalignment of the bite. In some cases, physical examination is normal.
  • TMJ X-rays may show abnormalities, but can be difficult to read.
  • An MRI of the jaw area may occasionally be performed.
Treatment:
Treatment is based on determining the underlying cause of the problem and correcting it, if possible.

Reconstructive surgery of the jaw is rarely required. Abnormalities in alignment of the jaw can be corrected by different devices applied by dentists or orthodontists. Nonsteroidal anti-inflammatory medications (NSAIDS) help reduce inflammation in the jaw stemming from arthritis or other causes of inflammation.

Muscle spasms caused by tension may be relieved by moist heat packs to the face, soft foods that require less chewing, muscle relaxant medications, or devices to prevent clenching or teeth grinding at night. Relaxation exercises may also be effective.
Expectations (prognosis):
If the cause of the disorder can be determined, many cases respond to appropriate therapy.
Complications:
Calling your health care provider:
Call for an appointment with your health care provider if chewing or other movement of the jaw is painful, or if a headache develops that is persistent or prolonged and is not relieved by pain medication.
Prevention:
Stress control measures may help reduce jaw clenching or bruxism. Use safety measures to reduce the risk of fractures and dislocations. Other measures may not be preventable.
Review Date: 10/31/2001
Reviewed By: Ashutosh Kacker, M.D., Department of Otolaryngology, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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