Why hasn’t anyone told me my TMJ problems could be coming from my neck?
For over 30 years, researchers have described a strong link between TMJ (temporomandibular joint) disorders and physical injuries in the neck.
Unfortunately, the link between the neck and the TMJ is still widely unknown in Australia.
As a result, many people who experience chronic TMJ or neck problems never realise that there is a link between the two
And worse they may not end up receiving the care that they need and continue to suffer needlessly.
“It was just a fender bender and I felt fine afterward. So what’s the big deal?”
One of the most common ways that people can suffer neck injuries is due to a motor vehicle accident (MVA) or “fender bender.”
Even “low speed” collisions < 40 kph are enough to cause significant injury.
Consider the following. If you were to tie your hands behind your back and fall face-first on the ground, do you think that might hurt?
Of course, it would! Well, the speed of gravity IS the equivalent of 40kph! So if it would hurt when you hit the ground, do you think it could also hurt if you are inside of a car?
“But I didn’t feel any pain when I was in the accident. And the hospital said I was okay.”
True, you may not have any broken bones, bleeding, or even bruises. However, that does not mean that you can’t have damage deeper on the inside where you don’t have nerve pain receptors, which means that you can’t feel the damage.
Furthermore, even if the injury doesn’t cause a fracture does not mean that it can’t cause your joints to shift and lockout of position. Even if it is only a couple of millimetres, over an accumulative period of time, this micro-damage can ultimately lead to much bigger problems.
Think of it as an avalanche. At the top of the mountain, it is only a small thing. But at the bottom, it can be a big thing.
The same thing goes with how tiny problems as a result of an injury like a car accident can accumulate and cause problems that you might never have thought were connected.
How can neck whiplash lead to TMJ problems?
Whiplash doesn’t have to be caused by fender benders or car accidents either. A whiplash injury is any example of trauma that causes your neck to snap one way and then the other:
- Sports tackles
- Falls on a trampoline or dance floor
- Falls off a bike, horse, or motorcycle
- Roller coasters
- Heavy metal concerts
- Bungee jumping
The potential list is endless! Nevertheless, the principle is simple:
A physical injury that affects the structural integrity of your neck can affect your health in many unforeseen ways.
So how is a neck whiplash injury potentially be related to a TMJ problem?
It has to do with the relationship between the alignment of the top vertebrae in your neck - the C1 (atlas) and C2 (axis) vertebrae - and the TMJ. Without getting overly technical, there are a number of unique anatomical relationships that exist between the upper neck, also known as the upper cervical spine, and the TMJ.
- The shape of the joints in the jaw (called condyles) correspond with the share of the joints between the skull and C1 (also called condyles)
- The orientation of the TMJ is constructed to be perpendicular to the plane of the C2 vertebra
- The orientation between the C1 and C2 vertebrae (which accounts for 50% of your ability to rotate your neck) corresponds with the direction and degree of rotation between your TM joints.
In a nutshell, the position of the TMJ affects the alignment of your neck … and the alignment of your upper neck affects the alignment of your TMJ.
What types of TMJ problems could actually be neck related?
In addition to the physical link, there is also a neurological link between the TMJ and the upper part of the neck, which could have been injuries in a previously undiagnosed neck injury such as a car accident or fender bender.
The nerve centres that control and coordinate the position of your TMJ descend through the brainstem and into the upper part of the neck.
Because the C2 vertebra especially can have such a powerful influence and produce physical tension that may affect the spinal cord, many TMJ disorders can potentially be related to a problem in the upper neck:
- Clenching or tight jaws muscles
- Grinding your teeth (aka bruxism)
- Headaches or migraines
- Trigeminal neuralgia
- Myofascial pain (e.g., fibromyalgia)
- Balance disorders including dizziness or vertigo.
Why hasn’t my doctor or dentist told me about this link between the TMJ and upper neck?
Odds are, they aren’t familiar with it.
In fact, many times these problems aren’t commented on with standard x-rays, CTs, or MRIs because there aren’t any signs of broken bones. So the report comes back saying that “everything is normal” despite you feeling so strongly that things are NOT normal at all!
The reason is that these relationships between the joints are not usually studied in great detail.
First, every human being is constructed differently on the inside and the outside. If not, we would all look identical!
So when it comes to being able to see these nuances between the alignment in the upper neck and the TMJ, most images are not taken from the angles to see what is actually happening in the individual.
As a result, many of these problems between the alignment of the TMJ and the upper neck can go undiagnosed.
And second, that is the reason that there are sub-divisions within different professions that consider these unique factors between the head, neck, and TMJ.
- Upper cervical chiropractors. A unique approach to chiropractic that does not use any spinal manipulation, twisting, or cracking focuses on correcting the alignment of the C1 and C2 vertebrae in order to facilitate the body’s own normal healing process. In Australia, this is a very rare approach to healthcare with only a smaller number of upper cervical specific chiropractic doctors in the entire country.
- Dental Specialists. Certain types of dentists focus on how TMJ disorders affect the health of the brain, neck, and entire body. Especially in the USA where this type if work is more common, many of these dental specialists work directly alongside the upper cervical chiropractors to ensure the highest probability of success.
- Head, neck, and jaw physiotherapists (including vestibular physiotherapists). Once the structural alignment in the upper beck and TMJ are addressed, physiotherapy may also be useful in helping to release the muscle tension and improve your posture that has built up over such a long period of time to make sure that the structural alignment work is able to have the greatest potential for long term success.
Where can I find more information about upper cervical care and TMJ?
Especially when it comes to TMJ conditions, particularly when the alignment of the upper neck is involved, there is seldom (if ever!) a “one size fits all approach.”
Any approach to addressing cervical and TMJ issues usually requires an individualised approach requiring a team to help. I mean, if it was just a simple matter, surely you wouldn’t be needing to read this article!
So I hope that this article may have provided you with additional valuable information so that you can explore the full range of possibilities to help you.
Indeed, many TMJ problems are complex in nature, which is why it can be difficult getting the right information. Even we have much still to learn! We nevertheless hope and do the best we can through our experiences and things learned helping people with TMJ problems and upper neck issues as best as we can.
On this note, if you have any specific questions or then would like more information about how what we do in our practice may be able to help you if you are experiencing a TMJ issue, we would like to hear from you.
Upper Cervical Chiropractic and TMJ Brisbane
Our practice, Atlas Health, is the premier upper cervical chiropractic centre in Brisbane.
Serving the greater Brisbane and south-east Queensland communities, our purpose is to help people suffering complex and chronic health conditions - including TMJ - to discover long term solutions so that they can get back to enjoying the quality of life that they desire most.
Our principal chiropractor, Dr. Jeffrey Hannah, is an Advanced Certified practitioner with the Blair upper cervical technique. He is an international lecturer, author, and recognised leader in the field of upper cervical specific care.
So if you would like more information about how we may be able to help you, we would recommend that you check out a few more articles and videos that we have published on other pages of our website here, AtlasHealth.com.au, so that you can have a better understanding about the role of your upper neck in health and in TMJ conditions.
And then, if it just makes sense and resonates with you, we would encourage you to reach us directly.
We are happy to offer a complimentary 15-minute over-the-phone consultation directly with Dr. Hannah so that you can discuss your condition and ask any questions that you may have so that you can decide if upper cervical chiropractic may be right for you.
We make it as simple as possible. You can click the Contact Us to send us an email, or you can call us direct at 3188 9329.
We look forward to hearing from you and will do our best to assist.
Atlas Health Australia - “Hope, healing, and wellbeing from above-down, inside-out.”
Burgess JA, Kolbinson DA, Lee PT, Epstein JB. Motor vehicle accidents and TMDS: assessing the relationship. J Am Dent Assoc. 1996 Dec;127(12):1767-72; quiz 1785. doi: 10.14219/jada.archive.1996.0138. PMID: 8990747.https://pubmed.ncbi.nlm.nih.gov/8990747/
Calixtre LB, Oliveira AB, de Sena Rosa LR, Armijo-Olivo S, Visscher CM, Alburquerque-Sendín F. Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and headache in women with TMD. A randomised, controlled trial. J Oral Rehabil. 2019;46(2):109-119. doi:10.1111/joor.12733. https://pubmed.ncbi.nlm.nih.gov/30307636/
Chinappi AS Jr, Getzoff H. The Dental-chiropractic cotreatment of structural disorders of the jaw and temporomandibular joint dysfunction. J Manipulative Physiol Ther. 1995 (Sep);18 (7):476–81. https://www.ncbi.nlm.nih.gov/pubmed/8568431
Delgado de la Serna P, Plaza-Manzano G, Cleland J, Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial. Pain Med. 2019 Oct 29. pii: pnz278. doi: 10.1093/pm/pnz278. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/31665507
Cuenca-Martínez F, Herranz-Gómez A, Madroñero-Miguel B, et al. Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Med. 2020;9(9):E2806. Published 2020 Aug 30. doi:10.3390/jcm9092806. https://pubmed.ncbi.nlm.nih.gov/32872670/
Ferreira MP, Waisberg CB, Conti PCR, Bevilaqua-Grossi D. Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders. J Oral Rehabil. 2019;46(12):1177-1184. doi:10.1111/joor.12858. https://pubmed.ncbi.nlm.nih.gov/31292981/
Garcia R Jr, Arrington JA. The relationship between cervical whiplash and temporomandibular joint injuries: an MRI study. Cranio. 1996 Jul;14(3):233-9. doi: 10.1080/08869634.1996.11745973. PMID: 9110615. https://pubmed.ncbi.nlm.nih.gov/9110615/
Giacalone A, Febbi M, Magnifica F, Ruberti E. The Effect of High-Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review. Cureus. 2020;12(4):e7682. Published 2020 Apr 15. doi:10.7759/cureus.7682. https://pubmed.ncbi.nlm.nih.gov/32426194/
Greenbaum T, Dvir Z, Reiter S, Winocur E. Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects. Musculoskelet Sci Pract. 2017 Feb;27:7-13. doi: 10.1016/j.msksp.2016.11.010. Epub 2016 Dec 11. https://www.ncbi.nlm.nih.gov/pubmed/28637604
Grondin F, Hall T, von Piekartz H. Does alter mandibular position and dental occlusion influence upper cervical movement: A cross-sectional study in asymptomatic people. Musculoskelet Sci Pract. 2017 Feb;27:85-90. doi: 10.1016/j.math.2016.06.007. Epub 2016 Jun 15. https://www.ncbi.nlm.nih.gov/pubmed/27847242
Grushka M, Ching VW, Epstein JB, Gorsky M. Radiographic, and clinical features of temporomandibular dysfunction in patients following indirect trauma: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Dec;104(6):772-80. doi: 10.1016/j.tripleo.2007.02.025. Epub 2007 Jun 29. PMID: 17604661. https://pubmed.ncbi.nlm.nih.gov/17604661/
Häggman-Henrikson B, Rezvani M, List T. Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil. 2014 Jan;41(1):59-68. doi: 10.1111/joor.12123. Epub 2013 Dec 30. https://www.ncbi.nlm.nih.gov/pubmed/24443899
Kim JR, Jo JH, Chung JW, Park JW. Upper cervical spine abnormalities as a radiographic index in the diagnosis and treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Oct 25. pii: S2212-4403(19)31536-6. doi: 10.1016/j.oooo.2019.10.004. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/31780398
Knutson GA, Moses J. Possible manifestation of temporomandibular joint dysfunction on chiropractic cervical x-ray studies. J Manip Physiol Ther. 1999 (Jan);22(1):32-7. https://www.ncbi.nlm.nih.gov/pubmed/10029948
Losert-Bruggner B, Hülse M, Hülse R. Fibromyalgia in patients with chronic CCD and CMD - a retrospective study of 555 patients. Cranio. 2017 Jun 5:1-9. doi: 10.1080/08869634.2017.1334376. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/28580880
Westersund CD, Scholten J, Turner RJ. Relationship between craniocervical orientation and the center of force of occlusion in adults. Cranio. 2016 Oct 20:1-7. doi: 10.1080/08869634.2016.1235254. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/27760504