the headache series

Jaw Injuries and Muscle Strain

TMJ InjuryThe muscles, ligaments, and other soft tissues that surround the head, neck and jaw are all intricately related. Injury to any one of these areas can often have a ripple effect of pain or secondary injury to another area. Obviously, when you hit your head, it will probably hurt – both from the initial impact, and also from potential resulting injuries to the brain like concussion. But hitting your head can sometimes also create whiplash injuries in the neck and the jaw, and many people can still suffer from headaches even after the direct injury to the head has healed if the secondary whiplash injuries are not addressed.

Obviously, any time you or a loved one suffers a head injury of any kind – including direct blows to the jaw or neck – an emergency medical exam should be performed as soon as possible. Concussion and other injuries to the brain, as well as spinal injuries in the neck can be very serious and potentially life-threatening. If headaches persist once these conditions have been addressed or ruled out, then it may be time to pursue additional evaluations with a qualified dentist or chiropractic physician for potential secondary injuries due to whiplash in the jaw or neck.

What is Whiplash?
Whiplash occurs any time the head is suddenly and unexpectedly distorted from the neck, causing overextension of the muscles and ligaments that hold the neck and head in alignment. The most common incidences of whiplash happen in motor vehicle accidents. However, whiplash can also be caused by the specific motions of roller coasters and other amusement park rides, sports injuries, being punched or shaken violently, or even falling unexpectedly on ice or another slick surface.

Many of us are familiar with the concept of whiplash in the neck, but any time there is a head/neck whiplash injury, there is also a potential secondary injury of whiplash in the jaw. Just as the head can be suddenly jerked or “whipped” too far off the center of the neck, the lower jaw can also be whipped too far from the skull – often in the opposite direction of the whiplash movement of the head. This results in the additional over stretching of the ligaments of the jaw, often causing jaw pain, headache, earache, and sometimes even complete jaw misalignment. These injuries may also cause tiny tears in the ligaments and muscles, resulting in the eventual buildup of scar tissue.

Diagnosis and Treatment
Like neck whiplash, jaw whiplash may often take up to a week or longer after the initial injury to begin showing symptoms. Headache, neckache, and jawache are the most common symptoms to surface initially, but earache and toothache without infection are also not uncommon in patients with whiplash injuries to the jaw. A potential jaw whiplash may sometimes be diagnosed at an initial emergency exam following an accident or sports injury, but not always. Even with a diagnosis at the initial exam, however, the full extent of a jaw injury generally cannot be determined until all the symptoms begin to surface in the 7 to 10 days following the incident.

Treatment of jaw whiplash varies depending on the circumstances of the injury and the individual anatomy of the patient. Often a short-term, removable jaw splint may be necessary to help stabilize the joints and ligaments during the initial healing phases. Physical therapy, clinical massage, and/or chiropractic adjustment may also be involved. For those patients whose jaws have been permanently misaligned due to the whiplash injury, orthodontics or other restorative dental treatments may be necessary to restore proper chewing function without headache or jaw pain.

For more information on the treatment of jaw disorders and whiplash, or to inquire about an evaluation with Dr. Rich, please read Treatment and Services for TMJ Dysfunction, or call 503-228-6870.

Home Care
First of all, it is vitally important that any potential injury to the head, neck, or jaw is evaluated by a medical and/or dental professional before any kind of home care begins. Head injuries can be quite serious and should not be treated at home like a minor cut or bruise. Once a full evaluation by a licensed medical or dental professional has been performed to rule out any potentially serious injuries to the brain, spine, teeth, or jaw, some of the following home care treatments may be helpful in alleviating the head, neck, and jaw pain related to jaw whiplash during the initial healing phases.

If pain persists for more than 2 or 3 days without decreasing after trying some of these techniques, or you experience a sudden increase in pain, another evaluation with a dental or medical professional familiar with treating whiplash injuries to the jaw should be pursued as soon as possible.

  • Ice the neck, jaw, and/or shoulders for 20 minutes at a time several times per day. Always use a towel or cloth of some kind to protect your skin from frostbite. Alternate with heat in those areas, if desired.
  • Rest and refrain from too much physical activity, especially heavy lifting or aerobic activity.
  • Perform very slow and gentle jaw stretches as long as they do not induce pain. See Home Care for Your Jaw for instructions.
  • Gently massage the cheek and head muscles or have a partner help you.
  • Try over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen (Aleve). Do not exceed the dosages recommended on the bottle.
  • Switch to a softer diet and avoid excessive chewing. Avoid gum or hard/crunchy foods.

Deciding on Treatment
Whiplash of the jaw can not only be painful, it can also be complex to diagnose and treat. Generally, other injuries are also present, and a team of medical and dental practitioners may be necessary to address all your treatment needs.

Not all dentists are qualified to treat jaw injuries and whiplash disorders, so make sure that the dentist you choose to work with has significant training and experience with TMJ dysfunction and treatment.

For those patients living in the Portland Oregon area, Dr. Rich has been treating whiplash of the jaw and other TMJ disorders for more than 25 years. During that time, she has developed a strong network of complementary medical providers to help her patients receive all the treatment they need to feel better as quickly as possible. If you are suffering from jaw pain or dysfunction, please call 503-228-6970 for more information on scheduling an evaluation with Dr. Rich.


References:
U.S. National Library of Medicine: Impaired jaw function and eating difficulties in whiplash-associated disorders
Journal of American Dentistry: Reduced or painful jaw movement after collision-related injuries
U.S. National Library of Medicine: Jaw symptoms and signs and the connection to cranial cervical symptoms and post-traumatic stress during the first year after a whiplash trauma
Journal of Emergencies, Trauma, and Shock: Prevalence and patterns of combat sport related maxillofacial injuries


The Headache Series:
Introduction
Daily Headache Diary
Posture
Hydration
Overexertion
Food Triggers
Exercise, Rest, and Stress
Jaw Injuries and Muscle Strain
Hormones, Medication, and Environment


Print Options:
Jaw Injuries and Muscle Strain (information on this page only)
The Full Headache Series (entire series including Daily Headache Diary)
Daily Headache Diary (with instructions)
Daily Headache Diary Form (form only, no instructions)