The temporomandibular joint or TMJ is located near the ear where the lower and upper jaw bones meet. The TMJ is one of the most complex joints in the body. The joint surfaces glide and hinge to create open/closure of the mouth as well as controlling side to side movement of the mouth.
Dysfunction with the TMJ is also known as TMD or temporomandibular disorder. TMD can cause referring pain into various parts of the neck, the side of the head, ear problems, and migraines. A full evaluation of the TMJ as well as the head, cervical spine (neck) and shoulders is recommended to determine any existing contributing factors to TMJ dysfunction.
Signs and symptoms of injury may include the following:
- Clicking, popping, and/or grinding (crepitus) in the jaw joint
- Tenderness or pain in the jaw joint
- Sore or painful muscles in the head, face, or neck
- Difficulty in chewing
- Fatigue of the jaw muscles after prolonged chewing or talking
- Difficulty opening and closing mouth fully
- Locking of the jaw in either the open or closed position
- Clenching or grinding the teeth
- Sensitivity of the teeth
- Nibbling or chewing on the inside of the cheek
- Deviation of the jaw when opening or closing the mouth
- Neck and/or head pain, headaches (tension, migraine-like, sinus)
- Tinnitus (ringing in the ear)
- Nausea or vertigo (dizziness)
Other factors that can affect TMJ dysfunction are personality type, stress levels, depression, teeth alignment, tension headaches and poor posture. A common posture that can facilitate TMJ dysfunction is a “forward head posture” and/or “shoulder blade winging”.
Goals of therapy aim to restore muscle balance, release tight structures and muscles, strengthen weak or inhibited muscles and education. For some people, restoring proper disc movement within the joint is crucial to reestablish. This reduces excessive movement, wear and tear within the joint.
The TMJ Association
National Institute of Dental and Craniofacial Research
APTA TMD Guidelines/Information