TMJ Dysfunction
Jaw pain, clicking, or limited opening from temporomandibular joint dysfunction.
Temporomandibular disorders (TMD) are a group of conditions affecting the temporomandibular joints, the muscles of mastication, and associated structures. They are the second most common musculoskeletal pain complaint after low back pain, affecting an estimated 5–12% of the population (NIDCR). The upper cervical spine and TMJ share neurological connections via the trigeminocervical nucleus, which is why neck dysfunction frequently presents as jaw pain and vice versa.
Common findings include clicking, popping, or grating with jaw opening, pain in front of the ear or in the cheek and temple, difficulty fully opening the mouth, jaw fatigue with chewing, locking of the jaw, and associated tension-type headaches. Many patients also report ear fullness, tinnitus, or dizziness with no underlying ear pathology.
TMD is 2–4× more common in women, particularly between ages 20 and 40. Risk factors include nighttime bruxism (grinding), high stress and anxiety, whiplash and concussion history, forward-head posture, mouth breathing, and prolonged dental or orthodontic procedures.
A combined, root-cause approach.
A 2016 systematic review in Manual Therapy demonstrated that combined cervical and orofacial manual therapy produces significantly greater reductions in pain and improvements in maximum mouth opening than self-management alone. We release the masseter, temporalis, and pterygoid muscles (including intraoral work when indicated), adjust the upper cervical spine, dry needle persistent trigger points, and retrain breathing, tongue position, and posture to reduce daytime jaw load.
- Intraoral and external jaw release
- Upper cervical adjustments
- Dry needling
- Postural and breathing retraining
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