#124 What is “Joint Splinting” and why is it so Important when Treating TMD/TMJ

Joint Splinting is the descriptive term used by orthopedic surgeons to explain how damage and chronic inflammation within the body’s joints create pain distant from the joint itself.  

When a joint becomes damaged due to acute or chronic trauma, it stimulates inflammation within the joint.  Inflammation is the body’s response to any kind of damage. In most instances, inflammation successfully heals the damage. A good example is the red line seen on both edges of a cut on your finger seen two or three days after the unfortunate incident followed by a healed scar within a few weeks.  In this case, the inflammation was fully successful in healing the trauma. 

Inflammation is a very complex process with hundreds of cellular and biochemical processes occurring in succession and simultaneously necessary to accomplish healing.  Left to its own devices, the body is able to heal itself most of the time.  Without inflammation, once injured the body would never mend.   

Occasionally, inflammation is not effective in the healing process.  In this case, inflammation doesn’t give up and retreat from the area, but increases its strength and activity when healing doesn’t occur. The purpose of inflammation is to help the body survive, no matter the degree of difficulty. When inflammation occurs without healing, it is called chronic inflammation.  

Chronic inflammation within the joints of the body has a unique characteristic.  In an attempt to decrease movement of the affected joint, it sends a signal through the nervous system to the brain announcing the joint is damaged and not healing properly.  The brain in turn sends signals back down to the muscles that move the joint to tighten up and hold the joint still and motionless in order for the inflammation to better do its job without further motion and trauma.  The brain signals the muscles to splint the joint like a cast would splint a broken bone allowing it to heal. 

When muscles get the signal from the brain to tighten-up, the muscles that move the joint pull on the bone and stimulate the pain receptors located where the muscles attach to the bone. Patients then complain of pain distant to the joint.  The pain is located anywhere the muscles are attached to bone. 

In the case of TMD, it is impossible for a patient to survive very long without chewing, talking, and breathing thus continuing the uninterrupted motion and damage to the jaw joint.  If the patient is a chronic bruxer, (Clenching and Grinding), the effect of chronic motion is increased by an order of magnitude.  

When the jaw joint, (TMJ), does not heal after being signaled to hold the jaw still, the brain signals the muscles to hold the entire head motionless and patients complain of neck, upper back and shoulder pain. Neck pain is the second most common symptom of TMD. 

  Another example of joint splinting is “tennis elbow”.  When the elbow joint becomes inflamed secondary to repetitive arm motion, chronic inflammation in the elbow sends the signal to the brain and the brain returns a signal to tighten the muscles of the forearm. Patients then complain of forearm pain even though the inflammation is in the elbow.  This is the exact phenomenon that occurs with TMD/TMJ.  Tennis Elbow and TMD are the same disease observed in different joints. 

This phenomenon has been unknown to dentists because dentists don’t talk to orthopedic surgeons about TMD.  Dentists were taught in dental school that the TMJ is a very unique and complicated joint.  This is not true.  The TMJ operates like every other joint in the body.  This fact was only brought to light because the founder of TMJ services had a broad educational background and degrees in dentistry, medicine, cell biology/anatomy, and experience in research. The entire story can be viewed at www.urbanektmj.com