Temporomandibular Joint (TMJ) Pain & What to Do About It

Temporomandibular joint (TMJ) or jaw pain is a very common condition – actually the second most common musculoskeletal condition after low back pain. It affects around 12% of the population or 38 million people.1 It typically affects more women than men, often between the ages of 35-45 years of age, but may occur at any age. Interestingly, 70% of patients with TMJ pain also have neck pain2 and there is a lot of overlap between both conditions and treatment.

The temporomandibular joint is where the mandible (or jaw bone) meets the temporal bone (part of the skull, forms the temple). You can find the joint on yourself by gently pressing just in front of the ear below the bony ridge of the cheekbone. There are a lot of muscles that attach in this region that help you open and close your mouth. They can become tight or irritated. There is also a small disc of cartilage that lies between the two bones of the temporomandibular joint and moves with the joint. In some people, the disc can cause clicking as the person opens and closes the mouth. This may or may not be painful.

Common Symptoms:

  • Pain or stiffness in the jaw, often first thing in the morning
  • Pain through the temples or frequent headaches
  • Pain with chewing gum, hard or tough foods
  • Pain opening mouth or moving jaw forward or to the side
  • Pain with talking, kissing or yawning
  • Frequent clenching or holding the back teeth together
  • Ear fullness or ear pain

If you are experiencing TMJ pain, there are several things that you can start working on to reduce your pain.

  1. Be aware of clenching your teeth during the day. Your back teeth should only be touching when you are chewing, as holding your back teeth together all day overworks the muscles and may cause pain.
  2. A good, relaxed position for the jaw is with a slight space between your top and bottom front teeth with your tongue gently resting (not pressing) on the roof of your mouth. This allows the muscles to relax.
  3. Posture has a huge effect on your jaw pain. A slumped position with a forward head changes the position of your jaw and increases how much the neck and jaw muscles have to work. Check your posture frequently during the day, especially while sitting.
  4. People often clench their teeth when they are stressed. Frequently take a look at how you’re holding your teeth and consciously work on relaxing the muscles of the face and jaw.
  5. Avoid sleeping on your stomach or resting your head on your hand during the day or while on your phone. The increased pressure directly over the jaw can cause pain.
  6. Focus on soft foods and avoid things that are excessively hard or chewy (including gum) to allow your muscles to relax.

Treatment:

Your dentist or physical therapist can help you with improving your jaw pain and function. Other treatment strategies may include:

  • Soft tissue mobilization, massage, dry needling and other manual therapy techniques to the neck and jaw musculature and joints to improve mobility and decrease feelings of tightness and pain.
  • Exercises to improve mobility and strength for improved posture and body mechanics.
  • Gentle electric stimulation, heat and relaxation exercises.
  • Oral appliance or a night splint to decrease clenching or grinding at night.

Pain through the jaw can be exhausting and affect someone’s personal, social and work lives. Most people will improve with treatment, so if you are experiencing frequent pain through your jaw, don’t hesitate to call your physical therapist. Spinal Dynamics & Body Dynamics of Wisconsin has several physical therapists that are specially trained in treating this condition. We can help you with strategies to reduce your pain and improve your function. We can also assist you in finding a dentist experienced in treating temporomandibular dysfunction if needed. Let us know if we can help.

Sources:

  1. Dworkin SF, Huggins KH, Leresche L, et al. Epidemiology of Signs and Symptoms in Temporomandibular Disorders: Clinical Signs in Cases and Controls. The Journal of the American Dental Association. 1990;120(3):273-281. doi:10.14219/jada.archive.1990.0043.
  2. Ciancaglini RG, Testa M, Radaelli G. Association Of Neck Pain With Symptoms Of Temporomandibular Dysfunction In The General Adult Population. Scandinavian Journal of Rehabilitation Medicine. 1999;31(1):17-22. doi:10.1080/003655099444687.