Head, Neck and Jaw Pain Management
The treatment of chronic pain of the head and neck is a difficult diagnostic puzzle. In an acute injury, the pain is at the site of origin, in a chronic condition however, the brain and body have instigated a variety of compensatory mechanisms that may drastically alter the degree and location of symptoms. Diagnostic postural balance tests are used to prioritise treatment and identify the origin of the presenting symptoms, which may involve: muscle pain of the head, neck or back; dizziness or vertigo; migraine; pain in the arms, hands or shoulders; sleep deprivation; swallowing difficulty; and many other symptoms.
Chronic pain of the head and neck regions is often a symptom related to TMJ syndrome.
The TMJ, or temporomandibular joint, attaches the mandible (lower jaw) to the skull. Jaw movement is controlled by a complex balance of several muscles and ligaments. Many of these muscles also attach to the neck and shoulders and are important in stabilising the head (think of a 15lb bowling ball) on the cervical spine or neck. Acute whiplash-type injuries or chronic conditions such as a bad bite or aberrant breathing and swallowing habits all result in postural compensation of the head and neck, causing these stabilising muscles to be constantly activated.
Coincident with muscular protection systems is a neurological alarm called the autonomic nervous system (the ANS). The ANS protects the body by turning on or off all the involuntary services the body requires to maintain ‘homeostasis’ or balance. This includes blood pressure, blood sugar levels, breathing rate and muscle activity. When this system is constantly in alarm mode its ability to maintain homeostasis is compromised, leading to pain and other systemic medical conditions.
Orthopostural dentistry involves an initial focus on stabilising or balancing the head on the cervical spine. Studies show that 94% of head posture compensation is a result of jaw joint dysfunction. Jaw stabilisation is achieved using acrylic molar splints at night. For many patients this restoration of structural balance is all that is required for pain to be alleviated and the stomatognathic system to be returned to normal function. For patients in a more ‘compensated’ or denatured state, more complex treatment may be required, such as further structural (cranial) release; a focus on biochemical factors; associated evaluation of emotional input; and other allied modalities. Experience has demonstrated to us that it is important to treat each of these further compensations in priority – much like peeling an onion – and a systematic, closely monitored approach is required.