You know when you’re at the bus stop and you haven’t seen a bus for ages and then three come along at the same time? So too it goes for the different types of injuries and conditions that we treat here at the clinic. One month we might treat lots of pregnant ladies with low back pain, the next it’s laptop users with rib injuries and the next it’s triathletes with patella mal- tracking issues. Some of this is seasonal (for example, we see a lot more shoulder injuries when Wimbledon is on) but often this is just plain old randomness.
Recently we went through one such random period where a lot of people were presenting to the clinic with neck pain and stiffness, and headaches. Often they were waking up with the symptoms in the morning. On further questioning, a lot of these patients had one thing in common, clenching or grinding their teeth.
Most of the patients were grinding their teeth at night time and their partners often heard them grinding when they were asleep. A few were also catching themselves doing it during the day. Some patients only discovered it after being referred to their dentist by their suspicious Osteopath to check for wear in their teeth. All of the patients were surprised to discover just how common this condition is, affecting up to 21% of the population.
Grinding or clenching your teeth is called bruxism. Bruxism is usually a symptom of worry or anxiety and begins usually during a period of stress such as exams or the start of a new job. Bruxism can also be a side effect of some psychotropic medication such as certain anti-depressants. In certain cases the grinding continues even when the stress or the medication is removed.
Most of the pain associated with bruxism comes from muscle tension in the neck, jaw and base of the skull. This is because the jaw is incredibly powerful and grinding uses not only the main jaw muscles but also accessory stabilising muscles which are located in the neck and the base of the skull. It is these muscles at the base of the skull that most commonly cause headaches. Some of this muscle tension can lead to stiffness in the joints of the neck and the heavy grinding directly affects the temperomandibular joint (TMJ or jaw joint) and the teeth. Over time wear and tear can occur in these structures.
Osteopathic treatment frees up the stiff joints and eases the tension in the muscles giving the patient relief from their pain. For long term management of the condition itself the patient should obtain a mouth guard from the dentist to protect the teeth from wearing down and to reduce some of the grinding at night by making it more difficult to clench the teeth.
Discovering the cause of the bruxism is important. If the patient is taking any medication for depression or anxiety the patient should contact their GP to confirm that the grinding is not a potential side effect of the drugs. There are prescription medications, such as busiprone, that have been shown to reduce grinding in clinical trials for chronic sufferers. Like all medication the side effects must be outweighed against the potential benefits.
In most cases the symptoms are stress related, and so managing this stress is very important. Advanced hypnotherapy can produce very positive results in this regard. Meditation and exercise can also help with high stress levels.
For most people, getting through the stressful period of time is enough to stop the grinding and with a few Osteopathic treatments, the symptoms settle down completely.
Chances are that either you or someone you know will suffer from bruxism related symptoms at some stage in life, although most people don’t seem to talk about it much or make the connection when they are waking up with headaches. It is important to know that with Osteopathic treatment and management of the condition, the comfort and quality of life of sufferers of this under discussed complaint can be vastly improved.
For more information check out www.bruxism.org.uk
Geoffrey Hogan (M.Ost)
Registered Osteopath – Farringdon Osteopaths