And today I’m going to go over the definition, the etiology, and using facial motor points to treat TMJ. And then in part two, I will go over using scalp acupuncture and submuscular needling to treat TMJ.
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Hi, my name is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and neuromuscular facial acupuncture classes internationally. I just completed my first book. It is called Treating the Face and it is a comprehensive guide. It’s a hardcover book. It’s a comprehensive guide to treating the face, both for cosmetic and neuromuscular Conditions.
I’m currently on the faculty at Yosan University on the doctoral faculty. And prior to that, I worked at, I was on faculty at the Maryland University of integrative health from 2003 until 2021.
Sorry, I having trouble getting going to the next slide. There we go. So these are the different chapters in my. book and it’s a full color book and some of the images that will be in today’s presentation are from my book. So today we’re going to talk about this is part one of a two part lecture on treating TMJ.
And today I’m going to go over the definition, the etiology, and using facial motor points to treat TMJ. And then in part two, I will go over using scalp acupuncture and submuscular needling to treat TMJ. So what is TMJ? TMJ is short for temporomandibular joint pain. It is also kind of part of TMD is another way of referring to it for temporomandibular disorders, and these are any issues that arise from any jaw pain, jaw problems that come from the muscles surrounding the jaw and can cause problems opening and closing the jaw.
And the temporomandibular joint, or TMJ. for short, is the actual hinge joint that connects the mandible to the temporal bone of the skull. So we’re going to go through, as I mentioned, the definition, and then we’re going to talk about motor points. is the temporal bone right here, and this is the mandible.
And here is the joint that we were discussing. And here’s a blow up of that. So you can see where this condyle goes into the temporal bone and there’s a disc here and there’s various nerves that are attached to it. What can happen through grinding the teeth? or injury or stress, which can cause tension.
People can develop temporomandibular joint pain or TMJ for short.
TMJ can manifest as many different things, not just in the jaw area. People can have pain behind their eyes, different issues with their eyes. They can have limited ability to open their mouth, clenching, grinding. They can have sore teeth. They can get headaches because of the location of the temporal muscle.
They can have issues with their ears, vertigo, dizziness, ear pain neck pain, and of course pain in the jaw and clicking and popping of the jaw. So as acupuncturists, we can do some local treatments with acupuncture and treat the channels that are involved. And so some local points might be stomach five, stomach six, you might treat gallbladder four, SI 19, Sangio 17, Tai Yang.
And then using some distal points, like large intestine 4, which is a command point for the face and jaw. Sand jaw 5, gallbladder 41, which are the master couple point of the young way my. And if they have constrained liver qi and they’re grinding their teeth, you could do liver three and liver four and you can combine some other points such as gallbladder 34, which can help to supplement liver three.
But one of the things that I have found in my practice to be really beneficial when treating TMJ are facial motor points. Facial motor, what facial motor points are, they are the most elect, they’re located in the muscle. They’re the most electrically excitable part of the muscle where the motor nerve bundle is attached.
And specifically, it’s the skin region where the muscle is most accessible to electrical activity. excitement at the lowest intensity. So you can actually measure them. Motor points are not trigger points, trigger points, or tender points, or ashi points, that when you press on them the person is tender.
And fortunately for us, when we’re looking at the face, many motor points are also acupuncture points. When you’re trying to figure out what motor point to use when treating the face, you have to determine what muscles are affected, and then you would look at the motor point on the face. That muscle.
When needling motor points on the face, it’s a good idea to use some ornicogel and a very thin needle. You don’t want to be using a really heavy gauge needle because stimulating the needle could possibly cause some bruising.
Here is an image I took from an old this is an old medical text and they actually outlined all the different motor points on the face and neck. This is from the late 1800s, which I thought was very interesting. Motor points have been used for quite some time. Here is a picture of a nerve and going into the muscles.
So we have the sensory nerve and then we have the motor nerve and the motor point. is, as I mentioned, the most electrically excitable part of that muscle.
There are many motor points on the face. We’re not going to talk about all of them. We’ll just be focusing on a couple, because when we’re thinking about TMJ, the muscles that are involved are going to be the masseter. and the temporalis.
So here’s the temporalis muscle as you can see, and here is the acupuncture point gallbladder A. The motor point for the temporalis is just anterior, it’s one cun anterior to gallbladder A, and you would use a perpendicular insertion. The goal is to go into the muscle, but not through the muscle. The temporalis works with the massetere.
Here’s the massetere to move the mandible up and down and by when a person has TMJ, the temporalis can get very tight and by releasing this motor point, it can relax the entire side of the head and face. and jaw.
Another muscle with motor points that we would use for TMJ is the masseter and here is an image from my book of the masseter and then the it has two motor points and one of them is small intestine, six. And the other one is just below stomach seven, it’s just inferior to stomach seven, and it is level with the earlobe, and you would needle this about a half to one soon deep, because you’re going through the flesh and the fatty area of the face right here.
And this is really wonderful for jaw pain as well. Now this is demonstration of what can happen when you needle a motor point properly. This is not the masseteer or the temporalis, but it was a good display of what happens when you needle a motor point. So, I wanted to show this. Where’s my Ah, there we go.
So this person had had Bell’s palsy and they had a lot of trouble pursing their lips and so this is actually muscle on the chin and you can see when I stimulate the needle, see if I can get that to go again, when I stimulate the needle This is in the mentalis. When I stimulate the needle, how it really jumps, it’s already moving on its own.
And then once I stimulate it, it really causes the muscle to jump.
So next time we are going to talk about other ways of treating TMJ using scalp acupuncture and submuscular needling. And I want to thank the American Acupuncture Council for this opportunity. You can go to facialacupunctureclasses. com and let’s see, I have a slide here. Sorry. You can go to facialacupunctureclasses.
com and you can learn more about some of the classes. That I teach. Thank you so much.