These neck problems may come in the form of neckmuscle spasm(50% of cases according to a 2015 study published in theJournal of Physical Therapy Science Research), reduced flexibility (20% according to the same study), or plain ‘ole pain, which the authors noted at 30%.
And the reverse may be true, as well. The study mentioned above found that poor neck posture may well be a cause of jaw dysfunction and pain.
The Temporomandibular Joint
The TMJ is perhaps the most complicated joint in the human body. Even though it’s small, it has many intricacies to its architecture, from the unique shapes of the articulating bones to interwoven connective tissue that forms the surrounding capsule and enters the joint itself.
The TMJ also features a disc, which unlike spinal discs that serve as shock-absorbing cushions, is there to stabilize the joint. The muscles and ligaments of the TMJ that keep the joint in place work with the disc to both stabilize and help move it.
To help you comprehend exactly where the temporomandibular joint is located and how it’s constructed, you can break this compound word down into two parts, each of which refers to the bones that comprise the joint. Let’s deconstruct this name so that you can make some sense of the anatomy involved.
Temporal Bone
The first part, temporo, refers to the temporal bone. The temporal bone is located on either side of your skull towards the bottom (near your ear).
One thing that may help you find your temporal bones is to put your hand on your temple. The temporal bone is located just underneath that, so if you slide your hand just a little way down until you feel hard bone, you’ve found the upper bone of the TMJ.
Mandible
The second part of the word is mandibular, which refers to the bony structure that moves up and down, and to a lesser degree, rotates during the act of chewing. The mandible is host to your bottom set of teeth. The mandible is considered to be the jaw bone. An interesting fact is that the mandible is the only bone in the face that can move.
The mandible is shaped like a U. At the top of the sides of the U, the bone forks (upward) into two separate points, called processes, which are extensions of bone that taper, to some degree, at the ends.
The front process is called the coronoid; a couple of key muscles attach to the coronoid process, but all in all, this area is not part of the TMJ. The back process is called the condylar process; it isthe part of the mandible that articulates with the temporal bone to form the TMJ.
TMJ Joint
The temporomandibular joint (TMJ), then, is the area where the temporal bone and the condyle of the mandible come together. It’s asynovial joint,which means there’s a capsule made of tough fibers surrounding both bones and space in between.
Also inside this space is a specific type of fluid aptly named synovial fluid, plus a disc that helps keep the joint stable and the movement the joint makes in good integrity.
Two types of movements occur at the TMJ: hinging and gliding. This combination further classifies the joint as ginglymoarthrodial.
And as with pretty much any joint in the body, a number of muscles act on the TMJ; as you will see in the next section, muscles that become too tight or out of balance relative to one another is one way TMJ dysfunction may result.
Two Main Types of TMJ Dysfunction
TMJ dysfunction is one category of a much larger group of problems that are commonly referred to as TMJ disorder. Along with the causes talked above below, TMJ disorder may result from trauma, postural issues, dental issues, or a psychiatric condition.
Protrusive Jaw Opening Pattern
First the dysfunctional jaw movement. This TMJD is called “protrusive jaw opening pattern,” and can occur when the set of muscles normally tasked withhelping to open your jaw becomes so strong that they take over the job entirely.
What’s supposed to happen is that muscles that operate this joint—opening and closing the mouth—contract in a certain order such that the condyle first does a rotation movement (in the cup-like area of the temporalis bone with which it meets) and then the lower jaw is moved forward (protracts).
But in protrusive jaw opening pattern, these helper muscles, which are called the lateral pterygoids, aresotight, they instigate a change in the normal order of component movements that occur in mouth opening. This not only makes the lateral pterygoids even tighter, but it can lead to problems with the disc that’s located inside the joint.
Disc Displacement With Reduction
The most common TMJ problem related to the disc inside that joint is called disc displacement with reduction.Normally, the position of the disc depends on its shape as well as the degree of pressure that is put on it. The shape of the disc is something you’re born with, and therefore is rarely, if ever, a medical problem.
Disc displacement with reduction is the first of three stages of disc displacement. With disc displacement with reduction, you’ll likely hear joint noises when you open and close your jaw, and bringing your lower jaw (mandible) forward reduces these noises.
You may also get pain when you chew, yawn, talk, or if (and when) you grind your teeth. Opening your mouth may be difficult, too, but this is not always a symptom. Without treatment for disc displacement with reduction, this TMJ problem may progress to the second and possibly third stages.
Stage two is disc displacementwithoutreduction where, like before, you get clicking and popping in the joint. This time, though, the joint may from time to time lock up, and you may also have some intermittent problems when opening your mouth.Stage three is where the problem becomes chronic.
You should be on the lookout for “red flags,” which are symptoms that may indicate nerve involvement or damage, or a more serious TMJ condition.
Red FlagsRed flags include numbness, swelling, nosebleeds or sinus drainage problems, unexplained weight loss, hearing problems, constant pain (not related to your jaw), or symptoms that simply don’t respond to any TMJ treatment with which you may be engaged.If you have any of these, be sure to discuss them with your healthcare provider and/or the physical therapist who is treating you.
Red Flags
Red flags include numbness, swelling, nosebleeds or sinus drainage problems, unexplained weight loss, hearing problems, constant pain (not related to your jaw), or symptoms that simply don’t respond to any TMJ treatment with which you may be engaged.If you have any of these, be sure to discuss them with your healthcare provider and/or the physical therapist who is treating you.
Red flags include numbness, swelling, nosebleeds or sinus drainage problems, unexplained weight loss, hearing problems, constant pain (not related to your jaw), or symptoms that simply don’t respond to any TMJ treatment with which you may be engaged.
If you have any of these, be sure to discuss them with your healthcare provider and/or the physical therapist who is treating you.
A Global Approach to TMJD
This means that a misalignment in your TMJ that starts with extra-tight lateral pterygoids, for example, can easily affect the conditions of other muscles that both respond to and influence the position of that joint, and the position of your head, neck, and upper body.
In this way, themuscle tensionor weakness and movement dysfunction that starts at the TMJ is transmitted to your neck, shoulders, upper back, and possibly your lower back.
A wise diagnostician will evaluate not only your TMJ but at least the posture and positioning of the neck and shoulders, as well.
Akyphosisis basically a rounded upper back. When the upper back rounds over, the head, being connected via the spine, is taken downward. In order to see and interact with the world in front of you, you’ll likely bend the back of the neck as a way of lifting your head and probably stick your head forward, as well.
All this may put your jaw at a mechanical disadvantage, which in turn can add to your TMJ troubles.
A Word From Verywell
Addressing your upper body posture (with non-surgical methods) will likely help improve your jaw biomechanics and range of motion. TMJD treatment may help relieve some or all of your pain, as well. Without treatment, you may be setting yourself up for a cycle of dysfunction that is communicated back and forth between the jaw and the neck and shoulders.
One of the benefits of physical therapy is to interrupt this loop and instead allow soft tissues to get back to their normal lengths. This may help restore the appropriate sequence of movement in your jaw, offering positive healing effects to the disc as well as your upper body posture.
Treatment may include manual therapy to release tight muscles, stretching and strengthening exercises to help establish goodposture(especially in the upper body), and a bit of education around how to keep these positive gains going.
Your therapist may also teach you a self-care routine that involves the progressive isometric strengthening of your jaw muscles.
Frequently Asked Questions
Pain from TMJ dysfunction is often described as a dull ache that occurs at the joint or spreads to the temple, lower jaw, back of the neck, ear, or face. The muscles around the jaw and neck are typically tender to the touch. TMJ pain can be confused with an earache, and it can sometimes cause tinnitus. Other symptoms include popping or cracking of the jaw, automatic jaw clenching, teeth grinding, eye pain, shoulder, arm, and back pain, poor sleep, and dizziness.
Yes, problems with the temporomandibular joint can cause neck pain. In fact, some experts estimate 70% of neck complaints can be traced to TMJ dysfunction.Neck issues associated with TMJ include muscle cramps or spasms, stiffness, reduced flexibility, and pain.
Yes, problems with the temporomandibular joint can cause neck pain. In fact, some experts estimate 70% of neck complaints can be traced to TMJ dysfunction.
Neck issues associated with TMJ include muscle cramps or spasms, stiffness, reduced flexibility, and pain.
Neck pain from TMJ is treated with a multi-prong approach. To address the immediate symptoms of pain, you can take over-the-counter pain relievers such as ibuprofen and apply moist heat to the aggravated muscles. Your doctor may also prescribe a muscle relaxer or antianxiety medication to relieve muscle spasms.Long-term care focuses on treating the jaw joint. This includes jaw rest, sticking to soft foods, not chewing gum, stretching exercises for the jaw and neck, and massage. If TMJ is associated with teeth grinding or clenching (bruxism) a night mouth guard can help.
Neck pain from TMJ is treated with a multi-prong approach. To address the immediate symptoms of pain, you can take over-the-counter pain relievers such as ibuprofen and apply moist heat to the aggravated muscles. Your doctor may also prescribe a muscle relaxer or antianxiety medication to relieve muscle spasms.
Long-term care focuses on treating the jaw joint. This includes jaw rest, sticking to soft foods, not chewing gum, stretching exercises for the jaw and neck, and massage. If TMJ is associated with teeth grinding or clenching (bruxism) a night mouth guard can help.
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10 Sources
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