Why do I wake up with tightness in my jaw?

Have you noticed that you have pain in your cheeks and jaw every morning when you wake up?

This is usually due to grinding your teeth at night, or bruxism.

Bruxism commonly occurs during sleep, but it can also occur during the day. Although most sleep bruxers have good quality sleep and no specific sleep disturbance, 20% of them report morning facial pain and/or tightness with little sleep disruption (Lavigne et al 1999).

If this is you, then you are in the 20%! Lucky you!

You may find it interesting that there is little sleep disruption —- I agree as most conditions (neck pain, back pain, hip/shoulder pain, etc) DOES wake up persons when symptoms get very bad, but I find with bruxism, sleep typically isn’t disturbed.

I also find clinically that this pain causes headaches and in some instances, the headaches go away within a few hours but I have had several cases of the headaches never ending during the day, which then leads to irritability, inability to complete a job or even take care of kids!

So, why do I have this condition?

The pain from bruxism is thought to be due to exertion and overloading of the muscles, resulting in pain to the temporomandibular joint (TMJ), the dental structures (i.e teeth) and/or the muscles, such as the masseter, temporalis and pterygoids (Mehta et al 2000)

The cause can be multifactorial. It may be related to stress and other psycho-physiological factors, including anxiety or depression. There are relationships between bruxism and headaches, as well as neck pain. Usually bruxism is the effect, but not the cause of the symptoms.

We recommend consulting with a dentist, orofascial specialist or physical therapist that specializes in TMD to work together to determine all triggers and establish a plan to address each one.

How do I find out if I grind my teeth at night?

Most people who grind their teeth during sleep are not aware of their habit and reporting is based on observations made by family members or significant others.

There are tests to confirm sleep bruxism diagnosis, but this requires polysomnographic and audiovisual recording. This is expensive and usually not necessary.

The only practical clinical tool available during the evaluation of a patient with TMD. We recommend you asking your dentist or seeking out a physical therapist who specializes in TMD. Usually a detailed history taking and physical examination can confirm if bruxism is causing your tightness in jaw and pain in the morning.

How can Physical Therapy treatment help me?

Physical therapy is commonly utilized in the treatment of patients with TMD and TMJ pain, toward the general goals of:

• reducing adverse loading and pain to the jaw and neck.

• facilitating a return to full, pain-free function of the jaw and neck.

Manual therapy is a common procedure to help you. At PhysioFit of North Carolina, we utilize several manual therapy procedures, including:

• joint mobilization / manipulation

• fascial manipulation / mobilization

• myofascial (soft tissue) release

We also use techniques to improve range of motion while at the same time eliminating pain. These techniques are intended to allow for pain free motion of the jaw and depending on presentation, has the ability to be applied as home exercises. The exercises are then specific and tailored to you, and not just exercises you find online!

If you are having TMJ pain, contact us to see how we can help you or even speak with your dentist to let them know there are options available in your local community.