Temporomandibular Joint Pain (TMJ)


Article by J. Miller, A. Clarke

What is Your Temporomandibular Joint?

temporomandibular joint pain

Your Temporomandibular Joint or TMJ is the most used joint in the body. Your TMJs (jaw joints) are involved with eating, talking, breathing and, probably most importantly, expressing our feelings and emotions. When things go wrong with your TMJ it is known as Temporomandibular Disorder (TMD).

TMJ Dysfunction Symptoms

You may or may not experience jaw pain or tenderness with TMJ dysfunction. The most common symptoms include:

  • jaw clicking
  • jaw popping 
  • grinding 
  • limited jaw opening, or jaw deviation while opening (which you can observe in a mirror)
  • an inability to fully clench your jaw.

TMD sufferers are often teeth grinders or clenchers.  TMD can cause jaw headaches, ear pain, dizziness and upper neck pain. Some TMJ patients report pain or inability to eat, talk or sing. Tinnitus or ear ringing can be associated with TMJ dysfunction. (Vierola et al 2012)

What Causes Temporomandibular Disorder?

TMJ dysfunction is considered a multifaceted musculoskeletal disorder. 

The most common causes of TMD include:

  • Masticatory muscle dysfunction, 
  • Derangement/displacement of TMJ articular disc
  • Bruxism: nocturnal grinding of teeth leads to increased pressure in TMJ and asymmetrical movement.
  • Occlusal Problems: Poor bite, Asymmetrical or Retrognathic (underbite, overbite) .

Contributory factors include:

  • Mandibular malalignment secondary to occlusal appliance or orthodontic treatment.
  • Removal of wisdom teeth,
  • Prolonged mouth opening eg dental procedure, 
  • Poor cervical posture, 
  • Myofascial pain, 
  • Neuropsychological factors,
  • Stress, and 
  • Whiplash and other less common causes include: trauma (e.g., blow to the chin), infection, polyarthritic conditions, tumors, and anatomical abnormalities.

TMJ Dysfunction Classifications

The common presentations of TMJ dysfunction may be classified into three clinical diagnostic groups:

  • Jaw muscle disorder characterised by painful movement.
  • Articular disc displacement.
  • Arthralgia or arthritis. 

(Dworkin SF, LeResche L., 1992)

How is TMJ Dysfunction Diagnosed?

TMJ dysfunction can be diagnosed by your TMJ physiotherapist, a physiotherapist with advanced training in jaw dysfunction, your dental practitioner or oral maxillofacial surgeon. TMD is a clinical movement dysfunction diagnosis. They may recommend dental X-rays, CT scan or MRI to further investigate your condition.


TMJ Assessment

During your TMJ examination, your Craniofacial or TMJ Physiotherapist will assess your:

  • jaw range of motion, 
  • muscle tension and length, 
  • TMJ co-ordination and movement pattern. 

Your TMJ Physiotherapist will be able to identify if your problem is an opening issue. 

TMJ Opening problems include:

  • Muscle disorder,
  • TMJ (joint) disorder: hypermobility, stiffness or arthritis,
  • TMJ disc displacement disorder: intermittent or permanent lock, or a
  • cervical spine posture issue.

TMJ Closing problems include:

  • a locked open joint, which can be manipulated open, or an 
  • occlusion problem, which may require a bite assessment from your dentist.

What is the Best Treatment for TMJ?

The best treatment for TMJ does vary based upon the clinical diagnosis, the TMJ dysfunction and the chronicity.

As a general rule TMJ opening disorders (how the jaw moves when opening or closing) are more likely to be successfully treated with jaw movement improvement techniques such as massage, dry needling/acupuncture, muscle stretch/relaxation/coordination exercises or joint capsule stretching techniques that are provided by your physiotherapist.

Your dentist is usually involved in the management of TMJ closing disorders such as bruxism (teeth grinding) due to the addition of teeth occlusion. In some cases, an occlusion splint or bite plate may be recommended.

If you are unsure what treatment direction is best for you, we recommend that you seek the advice of your TMJ physiotherapist for pain, clicking or lack of motion when opening your mouth your dentist for problems when you clench your teeth. Either way, seek the advice of your TMJ health professional who will refer you on to the most relevant health professional suitable for your TMJ condition if they feel it is in your best care.

After your TMJ assessment, your physiotherapist will commence corrective treatment if appropriate. TMJ physiotherapy is normally very successful for the treatment of TMJ opening disorders due to the problem being a movement disorder that is affected by your muscle and joint control.

What is the Cause of Jaw Clicking?

Clicking jaw is a sign of articular disc displacement, which is commonly treated by a TMJ physiotherapist. Clicking can occur during jaw opening, closing or both directions. Please seek the clinical assessment of TMJ physiotherapist for a specific diagnosis and treatment plan.

TMJ Treatment Prognosis

Prognosis is favourable in the vast majority of patients treated conservatively and symptoms may improve without treatment. (Michelotti A, 2010).

Field 2012, found that with conservative TMJ physiotherapy treatment, 75% of the TMD group resolved their condition within 3 months, which is certainly consistent with our clinical results. The vast majority improve within a few weeks of commencing TMJ treatment. This compares to a more sluggish resolution in the non-physiotherapy treatment group studied by Rammelsberg in 2003, who found that spontaneous resolution occurs in a 33% of TMD sufferers over a 5-year period.

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Locked Jaw Treatment

Locked jaw can be both temporary or permanent. Your TMJ physiotherapist is usually able to unlock your locked jaw via gentle manipulation. Should manipulation fail, you may require an Oral Surgeon to perform a manipulation under anaesthesia or another surgical procedure known as an arthrocentesis (joint washout). In chronic cases, open surgery may be required to identify or remove any physical obstructions, in permanent locked jaw, but this is relatively rare.

TMJ Physiotherapy Treatment & TMJ Exercises

TMJ exercises and treatment may include:

  • Posture improvement and neck treatment
  • Relaxation exercises
  • Muscle lengthening or jaw muscle massage
  • TMJ joint mobilisation
  • TMJ movement pattern and timing correction
  • Passive, active-assisted, active exercises
  • TMJ stabilisation exercises
  • Dry needling or acupuncture.

Your specific TMJ exercises will be prescribed following a thorough TMJ assessment by your TMJ physiotherapist.


Every case of TMJ dysfunction is different. Please check with your Craniofacial or TMJ physiotherapist for their professional opinion. on what treatment plan is best for you.

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TMJ Dysfunction - What to Avoid?

Until you seek the advice of your TMJ physiotherapist we recommend the following:


  • uncontrolled, wide-opening eg yawning,
  • biting hard foods eg carrots, apples,
  • eating burgers or hard rolls,
  • chewing gum, 
  • nail biting,
  • jaw leaning,
  • stress, and
  • clenching pens, pencils, pipes or cigars.

More info about TMJ Treatment Professionals.

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TMJ or Jaw Pain Treatment Options

  • Early Injury Treatment
  • Avoid the HARM Factors
  • What to do after a Muscle Strain or Ligament Sprain?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Biomechanical Analysis
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Deep Neck Stabilisation Exercises
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Strength Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • FAQs about TMJ Dysfunction or Jaw Pain

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why Does Heat Feel So Good?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Musculoskeletal Physiotherapy?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What is the Correct Way to Sit?
  • What to expect when you visit PhysioWorks?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
  • Potential Causes of TMJ or Jaw Pain

  • Cluster Headaches
  • Cramps
  • Facet Joint Pain
  • Migraine
  • Muscle Strain
  • Neck Headache
  • Rheumatoid Arthritis
  • Temporomandibular Joint Pain (TMJ)
  • Tension Headache
  • Wry Neck
  • Online Products for TMJ or Jaw Pain

    Jaw Injuries

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    Last updated 11-Oct-2019 02:55 PM

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