TMJ Pain – What is it and How can it be treated?





12.09.24



By Free Motion Physiotherapy





The temporomandibular joint (TMJ), or jaw joint, is a synovial joint (joint between two bones) and is the most functional joint and frequently used in our body. This joint connects your lower jaw to your skull. It is used for talking, eating, yawning, kissing and sucking. This system is made up of the TMJ, teeth, ligaments and muscles.



Dysfunction of the TMJ can cause severe pain and disrupt quality of life. Disorders and pain in the TMJ area are common and physiotherapy can help alleviate symptoms and restore function. TMJ symptoms may be intra-articular (in the joint), inflammatory, degenerative or because of imbalances or over-activity of muscles in the area. TMJ pain can come from the jaw, teeth, sinuses, ears, neck and skull/temples. Sometimes TMJ problems feel like headache, toothache or earache. It is possible for the pain to get worse when eating and chewing food. You may also hear a clicking noise and feel that you lack the range to open your jaw fully. Associated neck stiffness, pain and headaches are also common with TMJ pain.



Reasons for TMJ pain:

  • Muscle overuse/clenching/grinding teeth
  • Dental problems
  • Sinus infection
  • Ear infection
  • Trauma/injuries to jaw or face
  • Neck stiffness


What Physiotherapy (and other medical professionals) can do for TMJ pain



  • At first the symptoms might be acute and inflammatory. Focus is on relieving pain, swelling or inflammation and muscle spasm. Treating muscles in the jaw as well as the neck (front and back).
  • Any associated neck pain and headaches will also be treated.
  • Once pain decreases it is important to restore jaw movement and alignment.
  • Posture correction is essential to addresses head, neck, shoulder and tongue position.
  • An exercise program is prescribed consisting of coordination, strengthening and range of motion exercises of the jaw and neck.
  • If the patient is clenching their jaw or grinding teeth while sleeping, this might be a sign of Sleep Bruxism. A discussion with their dentist would be ideal to determine whether a bite plate or mouth guard would be appropriate. This helps to relax jaw muscles and in turn reduces strain on TMJ.
  • Cavities or other teeth problems might cause discomfort and lead to uneven chewing. This needs to be addressed by their dentist.
  • Education on ways to reduce stress/strain on the TMJ is important. Avoid resting chin in hand, jaw clenching while awake, pencil chewing, nail biting, lip biting and wide mouth yawning. Avoid tough and chewy foods such as steak, chewing gum, toffee, large hamburgers, nuts and apples until symptoms have subsided.
  • Stress management
  • Muscle relaxants and anti-inflammatory medications may be used
  • Botox for Bruxism may be considered by a dentist or doctor.


Exercises you can do at home for TMJ pain:


1. Goldfish Exercise

Press your tongue to the roof of your mouth. Then place one index finger onto the left TMJ and the other index finger on your chin. Drop your chin while applying light pressure with each finger while keeping your tongue pressed to the roof of your mouth. Close your mouth after that. Repeat on the other side.



2. Mandibular stabilization exercise

With your jaw relaxed in neutral, hold your thumb below your chin and apply gentle pressure up against the bottom of the jaw as you open your mouth. Repeat this by moving your thumb left and right to different areas of the jaw.


3. Tongue up exercise

Gently touch your tongue to the roof of your mouth. Without letting go of your tongue, slowly drop your jaw down as far as you can. Then close your jaw, still not moving your tongue. Repeat the motion


4. Jaw range of motion

Slowly move your jaw side-to-side and forwards and back to improve mobility. Do not do this if your pain is too much, if you have a clicking jaw or a jaw that dislocates.



5. Chin tucks

Lie on your back with a small rolled up towel at the back of your neck/base of your skull. Tuck your chin and bring your head straight back into the towel. Keep your head straight, hold the tucked position for 5 seconds.



6. Front neck stretch

If you start with the left, rotate away from that side and towards the right. Tilting your head back slightly. Place your left hand (the side you are stretching) behind your back while performing the stretch. Hold for 6-10 seconds only. After each hold relax and turn your head towards the side being stretched before repeating.


Repeat on both sides.



7. Self-release of jaw muscles

Clench your jaw to find the muscles. Push on those muscles to find a tight or tender spot. Relax and open your mouth to pinch the muscle between the thumb inside the mouth and index finger on the outside. Try and keep your jaw relaxed and as closed as possible during the release. Apply pressure and hold for 10 seconds. Move to another spot as pain decreases.



8. Back of neck release

Place a peanut (fascia release tool) at the back of your neck just below your skull. Slowly tuck and untuck your chin or move your chin up and down to roll the peanut and release the back of your neck.


9. Relaxation exercise

Drop your tongue from the roof of your mouth, relax your jaw and open your lips slightly. Drop your shoulders and relax your neck. Close your eyes and take a deep inhale through your nose, hold, and exhale through your mouth. Repeat a few times.



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