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What is a TMJ Flare Up?

  • What is a TMJ Flare Up
    What is a TMJ Flare Up?
    • Ann C McCulloch
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    What is a TMJ flare up and how do you treat it?

    A TMJ flare up is when new temporomandibular joint (TMJ) pain symptoms develop or when old symptoms suddenly worsen. The cause of TMJ flare ups depend on whether the underlying disorder is driven by inflammatory joint disease or muscle pain. Once you know the cause, the treatment plan becomes more clear.

    Here’s what you need to know about TMJ flare ups and how to treat them.

    What Is A TMJ Flare Up?

    The causes of a TMJ flare up can be as mysterious as the origin of temporomandibular disorders (TMDs), but the type of TMD a person suffers from can offer some clues as to what is going on. The two basic types of TMDs are those related to the joint itself (“intra-articular” disorders) and those related to the muscles and tissues surrounding the joint (“myofascial” pain disorders).

    How can you tell the difference?  Generally, when there is joint clicking, popping, or cracking sounds and point tenderness over the joint itself, the problem is intra-articular. Alternatively, when there is facial pain, muscle tenderness, or headache symptoms, the problem is more likely a myofascial disorder. That being said, a complete medical workup is usually needed to precisely identify the underlying disorder if the symptoms don’t improve within two weeks.

    With intra-articular disorders, the driving mechanism is believed to be inflammation.  This is because chemical markers of inflammation are present in the joint fluid in people with intra-articular TMDs. Inflammation of the lining of the joint is called “synovitis”, and it is seen in both trauma to the joint and in arthritic TMJ conditions. When people with intra-articular TMDs experience TMJ flare ups, there is a good chance that there is increased inflammation in the joint.

    When TMJ pain is from a “myofascial” disorder, the driving mechanism is not as clear. “What we do know is that behaviors such as teeth grinding, jaw tension, stress, or increased exertion (gum chewing, for instance) can contribute to masticatory muscle pain and spasm. These are the likely culprits for TMJ flare up when the underlying disorder is myofascial,” explains Bradley Eli, DMD, MS, a specialist in orofacial pain and TMJ disorders.

    What Causes A TMJ Flare Up?

    Taking this all into consideration, here is a list of inciting factors that might contribute to a flare up. You can usually figure out what kicked things off if you consider your recent history and the type of your underlying TMD.

    • Eating hard foods
    • Stress or anxiety
    • Increased exertion of the jaw (chewy foods, gum)
    • Pro-inflammatory foods (high sugar, processed foods)
    • Dehydration (decreases joint lubrication)
    • Poor posture (jaw protrudes forward)
    • Infection (either local or whole body, like the flu)
    • Trauma (jaw pain after a car accident, direct blow to the jaw, biting something hard)
    • Dental visits (either from tooth pain or from sustained jaw opening)
    • Bruxism (jaw tension, jaw clenching, and teeth grinding)
    • Vitamin D deficiency (associated with muscle pain)
    • Pro-bruxism medications (notorious offenders are stimulants and antidepressants)
    • Nail biting or Pen chewing
    • Weather changes
    • Hormones (hormonal changes can be pro-inflammatory)

    TMJ Flare Up Symptoms

    The symptoms of a TMJ flare up typically include a worsening of your already existing symptoms, but they can also manifest as new symptoms that you have never noticed before.  Here is a list of the most common TMJ flare up symptoms:

    • Tenderness around the TMJ
    • Decreased range of motion of the jaw
    • Cracking or popping sounds with jaw motion
    • Intense band-like headaches
    • Ear pain – usually dull, aching, non-specific pain
    • Neck and Shoulder tightness or tenderness
    • Swelling around the TMJ area
    • Jaw tension or clenching

    How Long Do TMJ Flare Ups Last?

    The length of a TMJ flare up will vary from person to person, depending on the underlying condition and the inciting factor. Sometimes symptoms can flare up for a couple of hours, but flare ups can also last days to weeks. The important thing is to treat symptoms right away, because with TMJ disorders, pain begets more pain. What this means is that when pain pathways become triggered, the neurons involved become increasingly hyperexcitable, and this sets the stage for more pain.  This process is referred to as “pain amplification” in the landmark OPPERA (Orofacial Pain Prospective Evaluation and Risk Assessment) study on chronic orofacial pain.

    TMJ Pain Relief

    The treatment for TMJ flare ups must be tailored to accommodate the features of the underlying TMD. An optimal approach will be one that is multi-modal, such as the HEALS protocol for TMJ self-care.

    • H: Hot/cold therapy – Alternating hot/cold is usually the best for pain relief.
    • E: Exercises – Gentle exercises to increase the range of motion of the jaw.
    • A: Analgesics – Nonsteroidal anti-inflammatory drugs (NSAIDS) are preferred.
    • L: Lifestyle – Good sleep hygiene and stress reduction.
    • S: Stress and Strain Reduction – TMJ friendly diet, use of an intraoral appliance.

    All of the components of the HEALS protocol are included in the Speed2Treat Home Healing Kit. Start your journey towards TMJ pain relief today!

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