Let Loose
MEDICAL AND MENTAL HEALTH UPDATE
Let’s talk about your head.
And I’m not talking about mental health—or even your head as a metaphor for wellbeing or any bullshit like that. Today I’m literally talking about your head.
A lot of heads are hurting right now. I hear about it every day from patients. Mine hurts occasionally, too. Does yours?
Do your temples ache? Can you fully open your mouth without your jaw crunching or cracking? Try it right now. Can you even open your mouth all the way?
Let’s discuss a common “head case.”
Since the beginning of the pandemic, approximately once a week a patient will call me saying his or her ear hurts. “Doc, I think I’ve got an ear infection.” But it doesn’t add up.
“Have you been swimming?”
“No.”
“Any fever, chills, sinus pressure?”
“No.”
“Do you have any known COVID exposures or sick contacts?”
“No. I haven’t left my house since March.”
So what’s the diagnosis? When I examine the patient’s ear, it’s normal. The eardrum, ear canal, and adjacent lymph nodes are normal. But when I place two fingers on either side of the patient’s jaw (aka temporo-mandibular joint) and ask the patient to open and close his or her mouth, it’s clear what the problem is: TMJ dysfunction. Aka jaw tension and pain.
What’s the deal? The jaw is the strongest muscle in our body. Under stress (and often in our sleep), many of us grind our teeth or clench our jaw. Tense jaw muscles—plus resulting joint constriction—can cause pain that feels like the ear itself. Why? The nerves that supply sension to the jaw muscles also serve the middle ear.
How to treat it? Apply heat. Take Advil or Aleve. And consider getting a nightguard. Not the dunk-in-hot-water variety that your daughter uses to play field hockey. You need a fitted night guard, made by your dentist, to help relax your jaw during sleep.
And try these five exercises to relax the jaw muscles:
Chin tucks. Tuck your chin into your neck, hold it for at least 3 seconds, and extend it back out again.
Jaw stretches. Completely relax your jaw and then slowly open your mouth as far as possible.
Resistance on the chin. Put your thumb under your chin and place some resistance on the area. Holding resistance, slowly stretch your mouth open as far as it can go, hold it for approximately 3 seconds, and then close your mouth.
Relaxation. Close your eyes and slowly inhale for 5 seconds. Hold your breath for at least 5 seconds, and slowly exhale. Repeat 5 times.
Zig-zag stretches. Close your mouth. Shift your eyes to one direction, and extend and stretch your jaw in the opposite direction as far as possible. Do not move your head or open your mouth. Repeat on the other side.
Still not better? Try physical therapy. There are specialists who deal specifically with jaw tension and resulting ear or head pain. They can work miracles!
But you want the ultimate fix? It’s about managing our stress. (Check out, like, every other post I’ve written since March for ideas.)
To remind: when we’re under stress, our cortisol and adrenaline hormones surge. This triggers our jaw, neck, and back muscles to tense and grab. They clamp down around our bones like a bad hug—a death grip from your own body.
In other words, a fitted nightguard, heating pad, and physical therapist will help loosen up tight muscles, but the critter in the woodpile is STRESS.
For many of us, sitting and staring at screens all day is stressful and also accentuates bad posture. Our skeletons (and the souls that inhabit them) need more activity and motion than a pandemic lifestyle affords. When static, our bodies tense. When in motion, our bodies warm up and muscles grab less.
My advice?
Take breaks. Get up from your desk every 20-30 minutes, stretch your neck, jaw, and shoulders, and take some deep breaths. You’ll discharge adrenaline, release tension, and come back more focused and calm.
Limit caffeine. While caffeine does indeed sharpen our attention (and bathe our morning brains with a pleasant “life is worth living” feeling), when consumed in excess it can accentuate muscle tension. It can mimic anxiety symptoms (heart racing, palm sweating, shallow breathing). And it can promote the kind of hyper-focus that locks you into your desk chair, computer, and tense jaw posture.
Take a mental vacation from stress. Curl up with a good book or trashy magazine! Get lost in slapstick comedy! Browse through photos of your best vacation! Immerse yourself in music, and turn up the volume WAY UP!
Last night I needed an escape, to loosen some ligaments. So after work I took a long walk, called an old friend, told some stupid jokes at dinner that my kids couldn’t help laugh at, then pulled up THIS VIDEO for my brother Walter’s song “Down by the Singing Sea.” It always makes me smile. I highly recommend turning the volume up to ELEVEN and letting loose!
Finally, for a last hurrah of the week, join me and BBC’s Katty Kay tomorrow at 2 pm on Instagram live for a COVID news update and convo.
Otherwise I will see you next week! Until then, be well.