Why Does My Jaw Hurt and Can Physical Therapy Actually Help?
By: Hannah Hatcher, PT, DPT
Got jaw pain? Waking up in the morning with your jaw feeling tight? Get pain or hear a clicking sounds with chewing food, yawning, or talking? Any symptoms in conjunction with your jaw pain such as headaches, neck and shoulder pain, or dizziness? You might have what is called temporomandibular joint disorder (TMD).
What is Temporomandibular Disorder?
In short, TMD is a plethora of conditions disrupting the normal function of the “jaw joint” and its supporting structures. For the physiology nerds who need the complex vocabulary, stay tuned. The term TMD was adopted by the American Academy Dental Association in the 1980’s to include pathologies affecting the temporomandibular joint (TMJ), masticatory muscles, and closely related structures.(1) Based off of epidemiological studies an estimate of TMD occurs in 35% of the population, but only 5-10% actually seek help.(2,3,4) To overcome chronic conditions of TMD a collaborative approach is usually necessary of both dental practitioners and physical therapists.
The temporomandibular joint (TMJ) is the " jaw joint" which is a very complex synovial, condylar and hinge joint connecting the mandible bone to the temporal bone. The joint is held together by soft tissue structures such as ligaments, tendons, the joint capsule, and cartilage. These soft tissue structures alone assist in the movement and stability of the joint allowing normal function of talking, breathing, and chewing controlling the 5 main motions of mandibular elevation, depression, right and left deviation, retraction, and protraction.(6)
How Do TMJ Disorders Happen?
The most common ways TMD occurs is overuse of the masticatory musculature in activities involving grinding and clenching of teeth, nail biting, and gum chewing. overactivity also occurs via muscle guarding in response to conditions to TMJ such as joint inflammation, sinusitis, and dental pathology. Overstretching of the jaw during a dental procedure can also cause capsular difficulties by repositioning the disc within the joint causing popping and clicking to occur with mouth opening and closing. A less common cause of TMD would be direct blow to jaw due to a fall, accident, or physical trauma.(5)
Can Physical Therapy Help with My Jaw Pain?
Yes! A good physical therapist can help differentiate between whether the pain is capsular or extra capsular via a diagnostic criteria which usually falls within 3 categories being: 1) Masticatory muscle group related, 2) joint related involving displacement of the disc resting between the joint, and 3) joint related due to arthritic changes.(7,8) Usually there is a combination of the three especially with greater chronicity. Physical therapy can address the pain and inflammation, and mobility limitations of the joint and its surrounding structures. Manual therapy performed by a licensed therapist along with guided corrective exercises can improve the movement and function of the jaw to get back to eating, sleeping, and talking pain free.
At Specialized Physical Therapy we will take a holistic approach to treating TMD by also screening for headaches, the cervical and thoracic spine, its alignment, and surrounding soft tissue of the neck which can contribute to the dysfunction at the jaw. If needed, all therapists on staff are also certified in functional dry needling which has shown to be a fantastic adjunct in treatment of TMJ to reset and retrain the muscles contributing toward the symptoms.(9)
So What Do I Do Now?
Below are a few corrective postural exercises with some TMD exercises your physical therapist might prescribe. Remember, every person and their injury are unique. Manual treatment and exercises will vary tailored to an individual’s particular needs. If you feel overwhelmed in trying to tackle the root of your jaw pain alone don’t hesitate to contact Specialized Physical Therapy to work alongside a qualified physical therapist for guidance through your pain to progress back to normal and pain free function!
- Report of the president’s conference on the examination, diagnosis, and management of temporomandibular disorders. J Am Dent Assoc. 1983;106:75-77.
- Nassif NJ, Al-Salleeh F, Al-Admawi M. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males. J Oral Rehabil. 2003
- Okeson JP. Management of Temporomandibular Disorders and Occlusion. 7th ed. St Louis, MO:Mosby/Elsevier; 2013.
- Pedroni CR, De Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporo-mandibular disorders in university students. J Oral Rehabil.
- O’Sullivan Susan Pt, et al. Physical Rehabilitation. Seventh, F.A. Davis Company, 2019.
- Wright, Edward F., and Sarah L. North. “Management and Treatment of Temporomandibular Disorders: A Clinical Perspective.” Journal of Manual & Manipulative Therapy, vol. 17, no. 4, 2009, pp. 247–54. Crossref,
- Look JO, John MT, Tai F, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. II: reliability of Axis I diagnoses and selected clinical measures. J Orofac Pain.2010;24:25-34.
- Schiffman EL, Truelove EL, Ohrbach R, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. I: overview and methodology for assessment of validity. J Orofac Pain. 2010.
- “Physical Therapy Approach in Conjunction with Dry Needling on Health Related Quality of Life in Patients with Temporomandibular Disorder: A Randomized Control Trial.” Indian Journal of Public Health Research & Development, 2020. Crossref, doi:10.37506/ijphrd.v11i7.10077.