Table of ContentsView AllTable of ContentsWhat Is TMJ?CausesDiagnosisPhysical TherapyPreventionNext in TMJ Disorder (TMD) Guide8 Things That Make TMJ Worse
Table of ContentsView All
View All
Table of Contents
What Is TMJ?
Causes
Diagnosis
Physical Therapy
Prevention
Next in TMJ Disorder (TMD) Guide
This article explains what TMJ is, including the symptoms, causes, and diagnosis. It then describes how physical therapy can help manage symptoms of TMJ over the long term.
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Temporomandibular joint dysfunction is an umbrella term used to describe the pain and dysfunction of the muscles of mastication (chewing) and the temporomandibular joint (the joint that connects the jaw to the skull).
Symptoms of TMJ include:
The pain is usually described as dull and aching but can worsen and become severe with chewing, yawning, or clenching. This is especially true when you chew hard food.
TMJ pain tends to come and go but may be constant in some people. Jaw pain and stiffness are often worse in the morning just after awakening.
Some people with TMJ also experiencetension headaches, teeth or neck pain, diminished hearing,tinnitus(ringing in the ear), and dizziness during attacks.
What Causes TMJ?
TMJ is poorly understood, and there is no consistent profile among people who experience TMJ symptoms.
TMJ affects between 5% and 12% of the general population.It can occur at any age but is most common between the ages of 18 to 44. Females are affected four times more than males.
Fluctuations inestrogenlevels during menstrual cycles are regarded as major contributors to TMJ, accounting in part for why females are more affected.The use ofhormonal contraceptivesandestrogen replacement therapycan also trigger attacks.
Genetics may play a part as some families have a history of TMJ.
TMJ is thought to involve multiple factors that, together, contribute to jaw pain and restriction. These may include:
How Is TMJ Diagnosed?
Your healthcare provider may palpate (touch) your jaw joint and the muscles around it, feeling for tenderness or clicking while you open and close your mouth.
Your healthcare provider will also examine your jaw’srange of motion, looking for any deviations in movement. Sometimes your jaw may open well on one side and not the other, making your jaw move to one side as you open your mouth.
Occasionally an X-ray is taken to check if your temporomandibular joint has arthritic changes, and an MRI may be taken to examine the position of the articular disc in your jaw.
If your healthcare provider rules out TMJ, there may be other causes of your jaw pain. These may include:
Once a diagnosis of TMJ is made, you can begin treatment. Working with a physical therapist may be an option for you.
PT Evaluation
Yourfirst visit with a physical therapistwill involve a discussion of your symptoms, lifestyle, and activities that make your symptoms better or worse. This includes reviewing eating, sleep, and work habits,
Several tests will be performed to get baseline measurements that the PT will use to build a treatment plan. The tests aim to:
Once your evaluation is complete, your physical therapist will discuss the findings and work with you to develop a treatment plan involving in-office and at-home procedures.
Setting Physical Therapy Goals
How Can Physical Therapy Help?
If you have TMJ, your physical therapist (PT) can help decrease pain and restore jaw function using different non-invasive modalities (methods of treatment). Many of these are “hands-on” procedures and some can self-administered.
Your dentist or healthcare provider may be able to refer you to a PT qualified to treat TMJ. PTs who have completed a fellowship in temporomandibular disorders (TMD) and craniofacial pain (CP) are best qualified. Do not hesitate to ask for qualifications.
Here are some of the physical therapy modalities that may be used:
Heat or Ice Application
Cryotherapy can be done at home with a cold compress or a bag of frozen peas. This should be done for no more than 10 to 20 minutes, moving the compress around constantly to prevent frostbite. To further prevent frostbite, place a kitchen towel between the compresses and your skin.
Therapeutic Ultrasound
Therapeutic ultrasound is a treatment sometimes used for TMJ to improve joint mobility. It is a non-invasive procedure that uses ultrasonic waves to create vibrations and raise the temperature of tissues in a targeted area. Doing so can relieve pain and loosen tight muscles.
One study published in theJournal of Physical Therapy Sciencefound that therapeutic ultrasound used with home exercise provided greater pain relief and jaw mobility than exercise alone.
Soft Tissue Release
Your PT may use various massage techniques to treat TMJ pain. Also known as soft tissue release, massage therapy may be applied to your jaw muscles, facial muscles, or neck and shoulder muscles.
Examples of TMJ massage include:
Joint Mobilization
Mobilization is a technique used in physical therapy to manually move a joint to correct its position and alignment. In people with TMJ, it can help relocate a displaced articular disc.
The mobilizations can be a bit awkward and uncomfortable as some of the manipulations involve the placement of the PT’s thumb or finger in your mouth. Other mobilizations are performed on the outside of the jaw, exerting lateral (side-to-side) pressure.
These manipulations are performed with gloves on.
PT Exercises
Jaw exercises are arguably the most important part of a TMJ treatment program. Your PT will teach you exercises to correct jaw misalignment, often with a hand mirror so that you can check the position of your jaw. The goal of these exercises is to restore normal, pain-free jaw motion.
Examples of TMJ exercises include:
10 Best Exercises for TMJ Pain
Stress Management
Stress management techniques include:
Postural Control
Postural control techniques include:
How Is TMJ Prevented?
If you have TMJ there are certain things you should avoid that place undue stress on the temporomandibular joint, including:
To increase awareness and avoid teeth-grinding at night, ask your PT or healthcare about mouthguards and other oral devices that can help.
You should also wear a mouthguard and protective headgear during contact sports.
Summary
If you have temporomandibular joint disorder (TMJ), physical therapy can help reduce pain and improve jaw mobility. Your PT can help determine the cause of your pain and improve the way your jaw moves with exercise, joint mobilization, postural control, and soft-tissue release. Heat or cold application and stress relief techniques can also help.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matheson EM, Fermo JD, Blackwelder RS.Temporomandibular disorders: rapid evidence review.Am Fam Physician.2023;107(1):52-58.American Academy of Orofacial Pain.Orofacial pain specialty.National Institute of Dental and Cranial Research.Prevalence of TMJD and its signs and symptoms.Chisnoiu AM, Picos AM, Popa S, et al.Factors involved in the etiology of temporomandibular disorders - a literature review.Clujul Med.2015;88(4):473–478. doi:10.15386/cjmed-485Robinson JL, Johnson PM, Kister K, Yin MT, Wadhwa S.Estrogen signaling impacts temporomandibular joint and periodontal disease pathology.Odontology.2020 Apr;108(2):153–165. doi:10.1007/s10266-019-00439-1Moraes Furlan RMM, Giovanardi RS, de Oliveira e Britto ATB, de Oliveira e Britto DB.The use of superficial heat for treatment of temporomandibular disorders: an integrative review.Codas.2015 Mar-Apr;27(2):207-12. doi:10.1590/2317-1782/20152014148Moraes Moreira RMM.The use of cryotherapy in the treatment of temporomandibular disorders.Rev CEFAC.2015;17(2):648-655.Craciun MD, Geman O, Leuciuc FV, Bolubiac IS, Gheorghi D, Filip F.Effectiveness of physiotherapy in the treatment of temporomandibular joint dysfunction and the relationship with cervical spine.Biomedicines.2022 Nov;10(11):2962. doi:10.3390/biomedicines10112962Ucar M, Sarp Ü, Koca İ, et al.Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.J Phys Ther Sci. 2014;26(12):1847-9. doi:10.1589/jpts.26.1847Henry Ostrow School of Dentistry at University of Southern California .TMJ manipulations & mobilization treatments.Kim D, Cho M, Park Y, Yang Y.Effect of an exercise program for posture correction on musculoskeletal pain.J Phys Ther Sci. 2015;27(6):1791–1794. doi:10.1589/jpts.27.1791Bayattork M, Sköld MB, Sundstrup E, et al.Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials.J Exerc Rehabil. 2020;16(1):36-48. doi: 10.12965/jer.2040034.017
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matheson EM, Fermo JD, Blackwelder RS.Temporomandibular disorders: rapid evidence review.Am Fam Physician.2023;107(1):52-58.American Academy of Orofacial Pain.Orofacial pain specialty.National Institute of Dental and Cranial Research.Prevalence of TMJD and its signs and symptoms.Chisnoiu AM, Picos AM, Popa S, et al.Factors involved in the etiology of temporomandibular disorders - a literature review.Clujul Med.2015;88(4):473–478. doi:10.15386/cjmed-485Robinson JL, Johnson PM, Kister K, Yin MT, Wadhwa S.Estrogen signaling impacts temporomandibular joint and periodontal disease pathology.Odontology.2020 Apr;108(2):153–165. doi:10.1007/s10266-019-00439-1Moraes Furlan RMM, Giovanardi RS, de Oliveira e Britto ATB, de Oliveira e Britto DB.The use of superficial heat for treatment of temporomandibular disorders: an integrative review.Codas.2015 Mar-Apr;27(2):207-12. doi:10.1590/2317-1782/20152014148Moraes Moreira RMM.The use of cryotherapy in the treatment of temporomandibular disorders.Rev CEFAC.2015;17(2):648-655.Craciun MD, Geman O, Leuciuc FV, Bolubiac IS, Gheorghi D, Filip F.Effectiveness of physiotherapy in the treatment of temporomandibular joint dysfunction and the relationship with cervical spine.Biomedicines.2022 Nov;10(11):2962. doi:10.3390/biomedicines10112962Ucar M, Sarp Ü, Koca İ, et al.Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.J Phys Ther Sci. 2014;26(12):1847-9. doi:10.1589/jpts.26.1847Henry Ostrow School of Dentistry at University of Southern California .TMJ manipulations & mobilization treatments.Kim D, Cho M, Park Y, Yang Y.Effect of an exercise program for posture correction on musculoskeletal pain.J Phys Ther Sci. 2015;27(6):1791–1794. doi:10.1589/jpts.27.1791Bayattork M, Sköld MB, Sundstrup E, et al.Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials.J Exerc Rehabil. 2020;16(1):36-48. doi: 10.12965/jer.2040034.017
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Matheson EM, Fermo JD, Blackwelder RS.Temporomandibular disorders: rapid evidence review.Am Fam Physician.2023;107(1):52-58.American Academy of Orofacial Pain.Orofacial pain specialty.National Institute of Dental and Cranial Research.Prevalence of TMJD and its signs and symptoms.Chisnoiu AM, Picos AM, Popa S, et al.Factors involved in the etiology of temporomandibular disorders - a literature review.Clujul Med.2015;88(4):473–478. doi:10.15386/cjmed-485Robinson JL, Johnson PM, Kister K, Yin MT, Wadhwa S.Estrogen signaling impacts temporomandibular joint and periodontal disease pathology.Odontology.2020 Apr;108(2):153–165. doi:10.1007/s10266-019-00439-1Moraes Furlan RMM, Giovanardi RS, de Oliveira e Britto ATB, de Oliveira e Britto DB.The use of superficial heat for treatment of temporomandibular disorders: an integrative review.Codas.2015 Mar-Apr;27(2):207-12. doi:10.1590/2317-1782/20152014148Moraes Moreira RMM.The use of cryotherapy in the treatment of temporomandibular disorders.Rev CEFAC.2015;17(2):648-655.Craciun MD, Geman O, Leuciuc FV, Bolubiac IS, Gheorghi D, Filip F.Effectiveness of physiotherapy in the treatment of temporomandibular joint dysfunction and the relationship with cervical spine.Biomedicines.2022 Nov;10(11):2962. doi:10.3390/biomedicines10112962Ucar M, Sarp Ü, Koca İ, et al.Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.J Phys Ther Sci. 2014;26(12):1847-9. doi:10.1589/jpts.26.1847Henry Ostrow School of Dentistry at University of Southern California .TMJ manipulations & mobilization treatments.Kim D, Cho M, Park Y, Yang Y.Effect of an exercise program for posture correction on musculoskeletal pain.J Phys Ther Sci. 2015;27(6):1791–1794. doi:10.1589/jpts.27.1791Bayattork M, Sköld MB, Sundstrup E, et al.Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials.J Exerc Rehabil. 2020;16(1):36-48. doi: 10.12965/jer.2040034.017
Matheson EM, Fermo JD, Blackwelder RS.Temporomandibular disorders: rapid evidence review.Am Fam Physician.2023;107(1):52-58.
American Academy of Orofacial Pain.Orofacial pain specialty.
National Institute of Dental and Cranial Research.Prevalence of TMJD and its signs and symptoms.
Chisnoiu AM, Picos AM, Popa S, et al.Factors involved in the etiology of temporomandibular disorders - a literature review.Clujul Med.2015;88(4):473–478. doi:10.15386/cjmed-485
Robinson JL, Johnson PM, Kister K, Yin MT, Wadhwa S.Estrogen signaling impacts temporomandibular joint and periodontal disease pathology.Odontology.2020 Apr;108(2):153–165. doi:10.1007/s10266-019-00439-1
Moraes Furlan RMM, Giovanardi RS, de Oliveira e Britto ATB, de Oliveira e Britto DB.The use of superficial heat for treatment of temporomandibular disorders: an integrative review.Codas.2015 Mar-Apr;27(2):207-12. doi:10.1590/2317-1782/20152014148
Moraes Moreira RMM.The use of cryotherapy in the treatment of temporomandibular disorders.Rev CEFAC.2015;17(2):648-655.
Craciun MD, Geman O, Leuciuc FV, Bolubiac IS, Gheorghi D, Filip F.Effectiveness of physiotherapy in the treatment of temporomandibular joint dysfunction and the relationship with cervical spine.Biomedicines.2022 Nov;10(11):2962. doi:10.3390/biomedicines10112962
Ucar M, Sarp Ü, Koca İ, et al.Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.J Phys Ther Sci. 2014;26(12):1847-9. doi:10.1589/jpts.26.1847
Henry Ostrow School of Dentistry at University of Southern California .TMJ manipulations & mobilization treatments.
Kim D, Cho M, Park Y, Yang Y.Effect of an exercise program for posture correction on musculoskeletal pain.J Phys Ther Sci. 2015;27(6):1791–1794. doi:10.1589/jpts.27.1791
Bayattork M, Sköld MB, Sundstrup E, et al.Exercise interventions to improve postural malalignments in head, neck, and trunk among adolescents, adults, and older people: systematic review of randomized controlled trials.J Exerc Rehabil. 2020;16(1):36-48. doi: 10.12965/jer.2040034.017
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