How Physical Therapy for TMJ Can Relieve Your Jaw Pain

The Temporomandibular Joint is a part of the body that often gets overlooked and underappreciated given its frequent role in many aspects of our lives. The Temporomandibular Joint is the joint where the jaw bone attaches to the rest of the skull near the ears on both sides of the face. This joint is the pivot point that allows our mouths to open and close for all of our everyday activities including eating, drinking, and talking. When people have issues related to their TMJ, they can experience significant pain in front of the ear, pain in muscles of the cheek, pain along the length of the jaw, headaches on the side or back of the head, and even pain that feels like it is in the ear. This can cause issues with chewing, yawning, talking, or even at rest and sleeping. Issues related to the TMJ can also make it hard to open the mouth fully making it difficult to bite food, talk, yawn, and more. When people have issues with their TMJ, on one side or both sides, it is referred to as Temporomandibular Dysfunction or TMD. It is surprising how common TMD is but how infrequently it is addressed and treated. Across numerous surveys, roughly 35% of people experience TMD but only 5-10% seek treatment. This doesn’t have to be the case.

We have 2 Temporomandibular Joints that connect the lower jaw to the rest of your skull where a combination of rotation and sliding happens in the joint to allow full motion in opening and closing of your mouth. People can begin to experience TMJ disorders for a number of reasons including prolonged elevated levels of stress leading to prolonged high tension held in the muscles around the TMJ, teeth grinding during the day or while sleeping, arthritis, or traumatic injuries like getting hit by something on the side of the face causing an injury to the area. Sometimes, after a lot of dental work people will also report TMJ discomfort and pain that can need attention to relieve after having their mouth open for a long period of time. The most common symptoms of TMJ disorders include jaw pain, clicking in the TMJ with jaw movement, and difficulty with opening the mouth fully. It can feel like the jaw isn’t moving smoothly or evenly and can cause pain during or after moving the jaw. Addressing any symptoms like these mentioned as early as possible helps decrease the time needed to get back to feeling better and prevents worsening of symptoms. Dealing with TMJ disorders for a long time typically requires more and longer treatment to address the symptoms and root of the issues.

The best way to treat TMJ is with physical therapy because it will help alleviate symptoms while also targeting the root causes of TMJ pain. Physical therapists will do a full evaluation of the jaw to identify the cause of the dysfunction and develop a plan with you to resolve the issue. It is very common for people to use mouth guards or Botox injections to treat TMJ but these only mask the symptoms. The holistic nature of physical therapy allows therapists to not only treat symptoms but the cause of the issues, and restore normal jaw function, reduce inflammation, and improve muscle strength. Every person is going to have a slightly different experience and the initial evaluation allows physical therapists to develop a personalized treatment plan based on your unique condition. This personalized holistic approach saves time, improves success of treatment, and helps you feel better faster. 

Physical Therapists have many tools and ways to help treat TMJ disorders. There are a variety of hands-on manual therapy techniques to mobilize the affected joint and nearby muscles to improve the amount and quality of movement of the jaw, decrease stiffness, and decrease discomfort. PT’s can use joint mobilizations, soft tissue work, dry needling with electrical stimulation, cupping(myofascial decompression), and joint manipulation to help treat TMJ disorders. PT’s can teach you gentle stretching exercises that will help improve the flexibility of the jaw muscles so you can maintain the improvements from the manual therapy in between visits. As treatment progresses, your PT will build a program of strengthening exercises for the muscles that support the TMJ to improve their capacity and prevent future pain and dysfunction. This will likely include exercises to strengthen the muscles of the neck and upper back as well as some exercises directly for the muscles involved with movement of the jaw. As you work on these exercises, they will help you address other factors that commonly affect TMJ pain and sensitivity such as posture and relaxation. Often, we say “your next posture is your best posture” and that is true but with TMJ disorders, the common slouched position with the head pushed forward closer to the laptop screen with rounded shoulders places more strain on the structures and tissues involved with TMJ related pain. Your therapist will teach better positions and ways to correct your posture to alleviate TMJ symptoms. Taking time each day to focus on relaxation such as meditation or deep breathing or progressive muscle relaxation can help reduce tension in the muscles around the TMJ and reduce stress related TMJ pain. If you’re not sure where to start your physical therapist will be able to guide you on how to get started. Putting all of these different aspects together helps physical therapists to treat you holistically and address every factor that may be contributing to TMJ disorders. 

It’s a shame that more people don’t pursue physical therapy for treatment of TMJ disorders because the benefits are incredible and eliminate the need for additional invasive treatments like surgery or numerous injections. Physical therapy helps provide long term pain relief and improved jaw function. This helps you return to living life without having to think about your TMJ or feeling pain with the basic activities we often take for granted. With physical therapy treatment, many people avoid getting risky surgeries for the TMJ or injections that often don’t fix the issues people experience. Once you have TMJ disorders under control with physical therapy, it is much easier to manage symptoms over time with a consistent physical therapy routine that your PT will teach you. With minimal effort, you will be able to maintain your improvements and manage any symptoms that present in the future. The benefits you experience with physical therapy helps to improve your overall quality of life by reducing pain and discomfort with everyday activities. 

When you go to physical therapy, your first session will be the initial evaluation where the PT will ask you questions about symptoms behavior, map out where you feel the symptoms you are experiencing, and perform an assessment of the areas involved. Once they have their diagnosis for you, they will talk with you about your goals for physical therapy and write out a plan on how you will work together to achieve your goals and help you feel better. When looking at jaw motion in the assessment, they will likely ask you to open and close your mouth while laying on your back with their hands on the TMJ on both sides. They will ask you to move your jaw in a couple different directions to assess the amount of motion available and what provokes your familiar symptoms. As they do this, they will ask you about the symptoms you experience before, during, and after the different parts of the assessment. With gloves on, they will also place their finger or thumb on the inside of your cheek to assess the tension of the muscles near the TMJ and assess joint mobility. Depending on the results of the assessment, they may also take a look at your neck mobility and movement because there can be some overlap of where symptoms are coming from. Your PT will provide you with feedback about posture from the seated portion of the evaluation to begin that aspect of addressing a potential cause of your TMJ disorder. At Onward, every patient gets a full hour uninterrupted with their physical therapist for every session and many patients start out coming once per week for typical TMJ presentations. Patients at Onward are able to come once per week and experience significant improvement because of the effectiveness of the therapists but also because of the specific home program the therapists provide to the patients. It is very important that patients experiencing TMJ disorders complete the home exercises between sessions to solidify the improvements made during sessions but also make improvements between each session. Some people can feel uncomfortable with the thought of having their PT put a finger in the mouth or other aspects of treatment but all of the evaluation tests and treatment options are safe and highly effective. Therefore, the upside is high and the risk is low because it is a noninvasive treatment option. The surgeries used for TMJ disorders have a much higher risk of complications and do not always fix the problem. 

So if you find yourself dealing with a TMJ disorder, jaw pain, clicking in the jaw, or difficulty and pain with chewing, kissing, talking, and eating, physical therapy can help you reduce pain and symptoms and address the root cause for long term improvement. Physical therapists will do an evaluation of you and your symptoms and develop a plan specific to you. They will use a variety of ways to help alleviate symptoms and address issues that cause TMJ disorders. A physical therapist should be your first phone choice when dealing with jaw pain so you can access timely and effective treatment. By calling a physical therapist first, you will save time and money.