Answers to Questions about Chiropractic:
Can Chiropractic Adjustments Correct a TMJ Problem?

Samuel Homola, D.C.

Question

I recently started seeing a chiropractor to get help for my TMJ (temporomandibular joint) problem. This is pain and discomfort caused by the jaw. Since I began treatments, I have noticed some difference. I was told that treating TMJ will take a long time, and I am somewhat prepared for that. It is very emotionally draining, as the pain has just become intolerable. I am trying to be patient in gaining control of this pain and getting back on track with my life.

Since I have been going to the chiropractor, my ears have been popping a lot, every time I swallow. This is not normal for me. Could this be the result of chiropractic treatment? What should I be doing to fix it?

Answer

I don't know of much that a chiropractor could do for a TMJ problem other than use physical therapy modalities to relieve symptoms. Neck manipulation cannot possibly be helpful.

Several conditions can cause or mimic a TMJ problem. Arthritis can develop in a worn TMJ joint. Bone tumors, or inflammation in the inner ear or in a parotid gland, and so on, may have to be ruled out. If there is popping and cracking when you open and close your mouth or when you chew, the disk cartilage lining the TMJ joint might be fragmented or displaced. Surgical correction might be necessary if the joint locks or is painfully restricted. MRI or x-ray studies with dye injected into the joint space might be needed to detemine if a disk can be repositioned or if it must be removed. In rare cases, severe malocclusion caused by fractures or congenital deformity in the jaw joints can cause TMJ problems, requiring the care of an orthodontist. Poorly aligned teeth or ill-fitting dentures may cause jaw-clenching or tooth-grinding habits that inflame jaw muscles and contribute to the development of arthritis in the jaw joint.

Most TMJ problems cause restricted jaw movement with pain and popping sounds in the area of the ear, especially when chewing or when moving the lower jaw. A TMJ joint might pop or cause pain when you swallow because of muscle action, but when swallowing seems to affect your ears, it's a good idea to see an otolaryngologist.

Most TMJ symptoms resolve by themselves. If jaw pain with restricted movement lasts longer than three months, you could consult a dentist or an oral surgeon for a definitive diagnosis.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This article was revised on April 8, 2003.