Jaw Pain with Ryan Corkal

Mark: Hi, it’s Mark from TLR. I’m here with Ryan Corkal of Body Works Sports Physiotherapy in North Vancouver, Canada. We’re going to talk about jaw pain. Ryan you’re fairly new to Body Works aren’t you? What are the symptoms of jaw pain other than it hurts?

Ryan: Yeah, so the symptoms of jaw pain. There’s a lot of different things that could be associated with jaw pain symptom-wise. So kind of the most obvious symptom would be pain in the jaw itself. So the joint line for your jaw is kind of right in front of your ear here. So a lot of the time people could get kind of like dull, achy pain in that area. Or they could get a pretty sharp pain in that area as well. So a lot of the time that would be associated with like the joint itself.

But people could also experience lots of different symptoms that they might not associate with jaw pain right away either. So that could be pain, like more so felt in the ear up in the temple here. Kind of lower down into the jaw in this area. A lot of the time headaches can be associated to jaw pain. And you could also experience things like clicking and clunking type sensations around the ear. So those would be some of the main things symptom wise.

Mark: So when somebody comes in, how do you diagnose, which of those is causing what, because I’m sure there’s a little bit of difference between what those indicate.

Ryan: Definitely. Yeah. So we do like to do a thorough assessment when we do see our jaw patients. So that would include an assessment of course the jaw itself, but also the neck because they’re so close in proximity to each other that often we find dysfunction in both areas. So in terms of the jaw, certain things we’ll do is look at the range of motion and strength and a tightness through certain muscles.

And then in the neck, we’ll look at kind of the same thing. So we’re looking at neck range of motion, strength, that kind of thing as well. There’s some different tests that we could do to kind of try to reproduce some of the symptoms that patients might experience. So when we get to their jaw moving in certain directions, or we kind of palpate in certain areas, this will reproduce some of their pain and try to help us make a specific diagnosis.

Mark: So would it be fair to say that this is probably split between kind of traumatic you know, you’ve been hit in the jaw somehow or fallen and hit your jaw and overuse or stress.

Ryan: Absolutely. And the traumatic ones are typically a little bit easier to diagnose, right? Because someone’s kind of gone through this trauma. A lot of the time they’re presenting at the emergency room or urgent care or they’re having x-rays done. Maybe diagnosing a fractured jaw or something like that. Maybe not, but then we still know that they had some trauma to that joint.
So it’s a little bit harder when people are coming in with more vague kind of symptoms. And we don’t know exactly what it’s related to. So that’s when we need to do more of our assessments in terms of both the neck and the jaw and get kind of a better idea of exactly what’s going on. And a lot of the time that’s more related to kind of repetitive strain injuries, posture, things like that.

Mark: And what’s a typical course of treatment. Once you find something, what are the more typical treatments that you help folks with?

Ryan: Yeah, so I will say the first thing is if somebody is experiencing a new onset of jaw pain it’s always a good idea for them to go see their dentist. It doesn’t necessarily need to be before they come see us for an assessment. But pretty early on, they should see their dentist because a lot of the time jaw pain is related to patients clenching their teeth. So they’re clenching and grinding their teeth. This could be either at night or during the day.

So often it could be hard for the patient to tell if they are clenching their teeth, especially if it is throughout the night. So when they go see their dentist, they’ll actually look at their teeth and they could tell by kind of the wear pattern, if they think that they’re clenching their teeth a lot. And in that case, the dentists often will actually make a mold and get them a night guard. So it’s kind of like a retainer that they put in their mouth and that’s going to help protect their teeth, but it’s also going to just help eliminate the grinding and the clenching a little bit.

And that’s going to put less strain on those muscles because when patients are grinding their teeth a lot, they’re getting a ton of tension in these muscles. That’s going to lead to things like headaches, jaw pain, that kind of thing. So always a good idea to go see your dentist first of all, then we’re going to see them for their assessment at physio as well. So in terms of treatment that we can offer, there’s quite a few things.

And it does depend on what type of disorder that the patient has with their jaw. So if someone has a really stiff jaw, they can’t open it very well. So we would call that hypomobile. Then we’re going to do things like going into kind of the mouth and applying some gentle mobilizations. So that’s going to help relieve pain and that’s going to help get that jaw moving a little bit better.
Another treatment option that we have a lot of the time, we’re going to have a lot of tightness through these muscles. So we’re going to get in, we’re going to do kind of some massage work, some soft tissue, occasionally acupuncture could help kind of release some of those muscles a little bit. So that’s another option.

A big thing that we always do is education with our patients because we could do all the treatment we want with our patients, get them feeling a little bit better, but if they’re still going home and they don’t have great posture. They’re doing certain habits that are leading to their pain. It’s just going to kind of come back. So we do do a lot of educating with our patients.

And then another big one is just setting them up with the home exercise program. So there’s exercises we could do to show them just to retrain the movements of their jaw. How they can get in there and do the muscle releases on their own. How they could retrain their posture that kind of thing. So lots of options in terms of treatments.

Mark: And typical again, it’s a huge range. Depends on how long someone’s put up with it or how traumatic it was, of course. But what’s a typical course of treatment. How long does it take till they’re feeling better?

Ryan: Yeah. So kind of, with your average patient, I would say between four to six weeks, usually I’ll see them for. Usually after like two to three sessions, I would say most patients have some sort of significant relief in symptoms. Then the bulk of them will be able to kind of manage on their own after four to six weeks, I would say.

There is the occasional patient that will have symptoms that last longer. For whatever reason. Our treatment might not be working super well with them. In those cases sometimes we kind of just bounce them back to their dentist. There’s different treatment options. They could try like Botox injections, where they’re actually having Botox injected into some of the muscles and that could really help with some of those kinds of stubborn cases. So in those cases that could last months just like any other condition, really.
Mark: Sure. And what about with the stress that we’re all under with the pandemic and all that? Is this a little bit more of a common issue that you’re seeing?

Ryan: Absolutely, yeah. So as soon as I noticed a couple of years ago when COVID started and we went through kind of our first big lockdown, then my clinic was closed for about a month when I was working in Winnipeg.
And when we reopened, we definitely noticed a bit of an uptick and patients coming in with jaw pain. For a couple of reasons, I think one just because they’re going through a lot of stress and when you’re in a stressful time in your life you do do more clinching and you have more tightness in those muscles.

So that’s starting to cause some issues with the jaw for a lot of people. As well a lot of people started working from home, so they don’t necessarily have the most ergonomic set up for their workspace. So for example, if you’re usually at work in your office, if you have a good chair and a good computer set up, and then you start working from home and you’re maybe working at a kitchen table on your laptop then we’re getting our computer sitting a lot lower and our head is kind of falling into this slouched forward position.
And that could put a lot of stress on the neck and jaw. So we’ve yeah, definitely noticed an increase in TMJ patients in that case.

Mark: So if you have somejaw pain in north Vancouver, the guy that go see is Ryan Corkal at Body Works Sports Physiotherapy. You can book online at body-works.ca. Or you can give him a call604-983-6616. Don’t wait, get in there and get it looked after. You’ll get feeling better a lot sooner, and you’ll have less stress in your life. Get some expert help. Thanks Ryan.

Thank you. Thanks Mark.