Muscle spasm in jaw.
Muscle spasm in Jaw can be painful sometimes.It means spasm caused in the muscles present around the jaw. These muscles helps in opening ,closing , retraction, protraction and lateral movement of the jaw. Specifically present at the Tmj joints. Muscle spasm means involuntary action of muscle which can be harmful in many of the cases. It has a many underlying causes as well.
Causes of muscle spasm in jaw:-
It can cause due to many reasons.
-over use of muscle
So these can be the cause of muscle spasm in jaw.
. I Will start by discussing the Associated bones and some important landmarks. I will then discuss the joints itself and then the muscles of mastication .Finally, I’ll discuss jaw dislocation and how this is resolved . To be the first to know when we release new articles to understand the TMJ and the muscles of mastication. We must first consider the bones and the associated bony landmarks. The bones to consider are the temporal bone the sphenoid bone the zygomatic bone the maxilla and The mandible So let’s start with the mandible the Mandible has two superior processes the condyloid process and the coronoid process And between we have the mandibular notch Moving in fairly we have the neck The ramus and the angle anteriorly the body is located here.
More of the anatomy part of TMJ
Just lateral to that of the mental foramina which we can see here and here. The mental nerves exit here and provide sensory innervations to the chin and some of the mandibular teeth .The mental nodes are branches of the inferior alveolar nerve and consequently the mandibular division of the trigeminal nerve. The mandibular foramina and submandibular fossa are located on the internal aspect of the mandible .The submandibular gland is pushed up against a fossa Whereas the inferior alveolar nerve enters into the mandibular canal here via the mandibular foramen. So let’s now focus on the temporal bone The pointer wished the condyloid process of the mandible articulates with the temporal bone. Is that the mandibular fossa? When the jaw is low It is limited anteriorly by the articular tubercle here or Sometimes known as the articular eminence, which is a portion of the zygomatic arch Posteriorly we can see the external auditory meatus And posterior inferior to that of the mandibular fossa is the mastoid process Just for completeness, We can see the styloid process here .
So now we demand a bell back in with the model we can talk about the temporomandibular joint The TMJ is a synovial joints at the articulation between the condyloid process of the mandible and The mandibular fossa of the temporal bone in a region known as the infra temporal fossa the joint includes an articular disc that splits the TMJ into an upper compartment and A lower compartment and this is the articular disc here Gliding movements are permitted in the upper components such as protrusion and retraction as well as side to side movements In the lower compartments Rotational movements occur such as elevation and depression Depression of the jaw will only occur once a condyloid process has moved anteriorly within the upper compartments here The movement is limited anteriorly by the articular tubercle, which we can see on the model The TMJ will be dislocated if the condyloid process moved beyond the articular tubercle .
The TMJ is surrounded by joint capsule which we can see here and is further supported by some extra capsular ligaments The lateral temporomandibular ligaments, which we can see here attaches to the zygomatic arch And the posterior portion of the neck of the mandible this ligaments limits posterior movements of the mandible The medial ligaments include two sphenomandibular ligaments and stylomandibular ligaments both for which limits lateral movements Thus we know mandibular ligament runs from the ramus of the mandible to the sphenoid bone And the stylomandibular ligament runs from the ramus of the mandible to the styloid process .
Jaw surrounding muscles:-
Now I’ll move on to the muscles of mastication the pterygoid muscles are located medial to the mandible The medial pterygoid muscle has two heads: a deep head and a superficial heads The deep head is attached to the medial aspects of the lateral pterygoid plates, which is approximately here The superficial head attaches to the maxilla as well as the palatine bones Both heads run posterior inferiorly to reach a point to which they fuse approximately here This fused muscle will then insert onto the ramus of the mandible, which we can see here The lateral pterygoid is best seen on a lateral view of the model .So to see the pterygoids we must first remove the ramus of the mandible here .So now with the ramus removed we can see the superficial head of the medial pterygoid muscle. Up here, We can see the lateral pterygoid muscles with a superior head and an inferior head here .
Continued further ?
The superior head attaches to the roof of the infra temporal fossa as well as the lateral portion of the lateral pterygoid plates here the inferior head attaches to the lateral portion of the lateral pterygoid plates moving posteriorly. Both heads will fuse and will attach to the condyloid process of the mandible located approximately here .When the lateral pterygoid muscles out bilaterally they protrude the jaw. This movement is paramount to our opening of the mouth Unilateral contraction swings our jaw to the contralateral side Bilateral action of the medial pterygoid muscles close the jaw and will also assist in protrusion Unilateral contraction will swing the jaw to the contralateral side.
Further Muscle’s present around Jaw?
The fan-shaped temporalis muscle arises from the temporal fossa located here and the fibers attach onto the coronoid process of the mandible located here The anterior fibers run vertically and will assist in closing the jaw The posterior horizontal fibers, which we can see here will retract to the mandible The masseter muscle is located on the lateral side of the mandible just here It has two heads a superficial head and a deep head the attachments are the zygomatic bone and the zygomatic arch, which we can see Both muscles slope inferiorly to then attached onto the ramus and angle of the mandible here This muscle elevates the mandible to close the mouth All of the muscles of mastication are innervated by the mandibular division of the trigeminal nerve .
The jaw is most stable when it is closed and a tee far in occlusion Anterior dislocation is the most common form of displacement Anterior dislocation is opposed by the articular tubercle the lateral ligament and a contraction of medial pterygoid masseter and temporalis However, in the instance of anterior dislocation the condyloid process moves anterior to the articular process and the muscles of mastication muscle Spasm the combination of which prevents retraction of the mandible this muscle spasm Must be overcome by putting downward pressure on inferior molars and then guiding the head or the mandible back into the mandibular fossa.
Summary of the whole Tmj:-
So just a quick summary the temporomandibular joint is a synovial joint formed by the articulation of the condyloid process of the mandible and the mandibular fossa of the temporal bone .An articular disc sits within the joints which creates an upper and lower cavity. The upper cavity allows for gliding movements, whereas the lower cavity allows for rotational movements the muscles of mastication acts on the joints .The TMJ is most stable when the jaw is closed .
list of disorders present at Jaw:-
The TMJ is responsible for jaw movement and enables chewing, talking and yawning. Temporomandibular Disorders, or TMD, refer to a group of conditions characterized by pain in the jaw area andlimited movement of the mandible. TMD may be caused by problems in the joint itselfor in the muscles surrounding the joint. Problems in the joint include: arthritis, inflammationand internal derangements. When the problem is in the muscles, the condition is called myofascial pain syndrome.
Treatment for myofascial pain syndrome?
Myofascial pain syndrome is very common and can occur in patients with a normal temporomandibular joint. The syndrome is characterized by presenceof hyperirritable spots located in skeletal muscles called trigger points. A trigger pointcan be felt as a nodule of muscle with harder than normal consistency. Palpation of triggerpoints may elicit pain in a different location. This is called referred pain.Trigger points are developed as a result of muscle overuse.
What is nocturnal Bruxism?
Commonly, the muscles of chewing,or mastication, are overworked when patients excessively clench or grind their teeth unconsciouslyduring sleep. The medical term for this condition is “nocturnal bruxism”. A trigger pointis composed of many contraction knots where individual muscle fibers contract and cannotrelax. The sustained contraction of muscle sarcomeres compresses local blood supply,resulting in energy shortage of the area. This metabolic crisis activates pain receptors,generating a regional pain pattern that follows a specific nerve passage.
Treatment for trigger points in muscle
The pain patterns are therefore consistent and are well documented for various muscles. Trigger points in the masseter refer pain to the cheeks, lower jaw, upper and lower molar teeth, eyebrow, inside the ear and around the TMJ area. Trigger points in the temporalis are also associated with headache and toothache from upper teeth. The main culprits of myofascialpain in the TMJ area are the pterygoid muscles. Trigger points in medial pterygoid refer pain.to the TMJ region in front of the ear, inside the mouth and upper outside of the neck. They may also manifest as sore throat and difficulty swallowing. Pain from lateral pterygoid trigger points can be felt in front of the ear and on the upper jaw. Treatments aim to address bruxism, to relieve muscle spasm and release trigger points.
Treatment for muscle spasm in jaw:-
TMJ stands for temporomandibular joint whichis your jaw joint right there. And I’m gonna tell you today just some simple stretchesand strengthening exercises to get that TMJ feeling better. So we’re just gonna startoff, you want to start off gently with these exercises, you don’t want to push very hard because this joint is small and it can get irritated very quickly. The first one you wanna do is you’re gonna use the palm of your hand so you’re not pushing with your fingers,but you’re using just your palm. You’re gonna put your palm on one side, doesn’t matter becausewe’re gonna do both. And you gonna keep your mouth and teeth aligned. So the jaw staysin one spot, your teeth stay aligned so they’re not going back and forth like that. You’regonna keep it nice and still and you’re gonna push your palm in that way. And just holdit in place. A nice little 5 second push. Good.
See how my jaw’s not actually movingbut I’m just putting gentle pressure on one side. Then after your do that maybe 3-5 times,5 seconds a piece, then you’re gonna switch and do the same thing on the other side. Somake sure you don’t just do one side and not the other side cause you wanna keep it even.The next one really simply, open your mouth just a little bit and put yourfingers inside but make sure you don’t bite your fingers. You’re not biting, your keepingagain your jaw still and pushing pressure down this time. So put your fingersin your mouth on your bottom teeth, and just push down. See again my jaw’s not moving.I’m not stretching it open, I’m keeping it in one spot.
Further exercises to treat muscle spasm
Again just start off with about5 seconds of gentle pushing and do that about 5 times. The last one is to stretch out thejoin back here. You’re going to put your palm on your chin and just push straight back.Again you wanna make sure that your teeth are in alignment. If your teeth are over hereor over here and your moving it, you’re going to irritate that joint. So just palm on the cheek. And relax your jaw. And push straight back. So those are the exercises to strengthenand stretch out your TMJ joint if you’re having some pain in your jaw. Just start off withabout 5 seconds and then build your way up, but make sure your not pushing too hard. These are gentle stretches for that small joint in your jaw.
Further Treatment options include for muscle spasm in jaw: –
Stress management, behavior therapy,biofeedback – to encourage relaxation. – Dental night guards: Splints and mouth guards- to protect the teeth from damage. – Medication: pain relievers, muscle relaxants,botox injections. – Trigger points release techniques such as dry needling and “spray and stretch”.
If you have any questions, please leave them in the comments section. . Be safe. Have fun. And I hope you feel better soon!