Thanks in part to greater numbers of studies evaluating bodywork’s efficacy, our society is increasingly recognizing massage therapy’s therapeutic value for painful conditions. Thus, bodyworkers must be prepared to field just about any type of pain complaint. When it comes to a client reporting he or she has lockjaw, therapists benefit from having an understanding of what that means and how to treat it – including differentiating the dangerous type of lockjaw that stems from tetanus.
What Is Lockjaw?
A case of proclaimed lockjaw is usually extremely painful and frightening. This condition implies that a person temporarily (and in some cases, permanently) loses his or her ability to open and/or close the mouth. Lockjaw affects the fifth cranial nerve (the trigeminal nerve), which is responsible for sensory and some motor functions for the mandible. Technically, lockjaw describes tetanus, a serious bacterial infection that affects the body’s central nervous system.
Found all over the world in soil, dust and some animal feces, tetanus is caused by the Clostridium tetani bacterium. Entering the body through any type of wound, tetanus spores produce a neurotoxin that attach to the nerves near the wound and can spread to the spinal cord. Tetanus symptoms typically appear about a week after the initial infection – and stiffness of the jaw muscles (trismus) is usually the first symptom. Additional symptoms may include a stiff neck, shoulder or back, trouble swallowing and/or breathing, fever, spasms (violent) that can spread to the abdomen, arms and thighs, sweating, high blood pressure and rapid heartbeat. The earlier these symptoms appear, the more likely the infection is to be fatal. Although tetanus occurs around the world, it is rare in the United States, primarily because of vaccination practices.
A bodyworker who sees a client with trismus should rule out tetanus prior to commencing with a session. This includes:
- Looking for any other tetanus symptoms (stiff neck or back, fever, spasms, sweating, etc.)
- Inquiring about a recent wound (the classic tetanus example is stepping on a rusty nail).
- If there is a recent wound, checking with the client to see if he or she has had a tetanus booster within the past five years.
If you suspect lockjaw from tetanus infection, fast emergency medical treatment could save your client’s life.
If a tetanus infection has been ruled out, there are many other (less dangerous) things that can cause lockjaw, including:
- Muscle and Soft Tissue Inflammation – This is common following dental procedures or impacted wisdom teeth where the tissue around a tooth becomes inflamed, putting stress on the trigeminal nerve.
- TMJ – Temporomandibular joint syndrome can cause lockjaw, especially with constant teeth grinding and clenching.
- Drug-Related – Some medications list jaw immobility as a side effect, especially drugs used for psychiatric illnesses. In addition, MDMA and certain amphetamines are known to cause trismus.
Bodywork for Non-Tetanus Lockjaw
Upon ruling out tetanus, bodywork can help those with lockjaw from TMJ or muscle and soft tissue inflammation. However, since lockjaw can be a serious problem, sustained and/or severe bouts should be referred to a physician. Sound strategies to help ease inflammation and restore range of motion to the mandible, include:
- Heat – Applying a hot pack (careful to not burn the area) can help relax the frozen jaw muscles.
- Aromatherapy – Using the essential oils of Roman and German chamomile along the jaw, cheekbone and around the ear can provide pain relief and reduce inflammation. Since direct application of essential oils can irritate the skin, they may be mixed with a carrier oil.
- Cranial-Sacral Therapy – This style of bodywork initially developed as an osteopathic technique can ease congestion around the trigeminal nerve, thus easing jaw restriction.
- Myofascial Release – Applying myofascial release techniques on the face and neck regions can release lockjaw tension. Strain-counterstrain and gentle stretching are especially useful to ease trismus.
- Shiatsu – Stimulation of certain acupressure points can restore circulation to the structures surrounding the jaw. Stomach 6, Stomach 7, Triple Burner 17 and Gallbladder 3 are all known to help ease lockjaw.
We expect our jaw to open and close at will. Losing that freedom is typically a painful and frightening experience. As long as tetanus is ruled out, bodyworkers have a great number of tools to help unlock a seemingly frozen jaw. By applying heat, essential oils, cranial-sacral therapy, myofascial release and shiatsu, bodywork practitioners can effectively help their affected clients open wide without stiffness and pain.