My Jaw Hurts. Where Does This Pain Actually Come From?

Written by:
Dr. Tia Totura
September 12, 2019

TMJ. What is it good for? Absolutely everything!

The temporomandibular joint (TMJ) is a fancy word for the space between your jaw and your skull. You have two of them, one on either side of your face.

The TMJ is a wonderful thing when it works correctly. It allows you to talk, eat, drink, chew, sing, laugh, yawn, and breathe through your mouth. You get the point, it does a lot. The joint itself is small but really strong. In fact, it can endure up to 250 pounds!

So how does something so strong get hurt so often? TMJ disorder (TMJD) actually ranks second only to low back pain, as the most prevalent musculoskeletal problem in the United States!

The most common reason for jaw problems comes from the joint enduring high forces when it's not supposed to. Meaning, unless you are chewing food, your TMJ should not be undergoing that much stress. Sounds simple, but it’s not. There are several things that can irritate the joint even when you're not chewing — and you’re probably not even aware of it.

The most obvious irritants are bruxism (teeth grinding), clenching, irregular bite, and occlusion. These are usually diagnosed by your dentist who can see irregular wearing of your teeth. Although, for many cases, the irritant may not be so obvious. In this article, we will explain how the underlying source of TMJD can actually be tied to the way you move!

Forces going through your TMJ can change, depending on where your head sits on your neck and shoulders. Sustained positions while driving, sitting at a desk, reading, and working on a computer can overload the joint. Repetitive head and jaw movements can also overload the joint. Not to mention your neck muscles and those in close proximity of the joint could fatigue, tighten and inflame. As you can imagine, muscle tightness adds further stress on the joint. Muscles in the neck and face also have referral patterns to the jaw which can make it seem like the joint itself is the source of pain, when it might not be.

“Okay, okay… I have bad posture but why doesn't the pain go away once I'm out of that position?” Well, it does. For the first couple hours, days, months or years. But if that same pattern is repeated over and over, this will eventually lead to dysfunction where those muscles can no longer relax. They could actually turn off (deactivate) because they can't take the abuse any longer. So now we have instability and weakness added to the picture.

That’s when the symptoms spread. Many TMJD sufferers have chronic neck pain, jaw pain and headaches as well as possible ear and tooth aches, tinnitus (ringing in ears), dizziness, jaw popping, locking or inability to open the mouth fully.

TMJ Signs and Symptoms

Besides posture, there is another silent villain that can play an unexpected role in TMJD. I’m talking about your shoulders, core, and even your pelvis!

The shoulder girdle often gets overlooked. All of the rotator cuff muscles attach to the scapula (shoulder blade) as well as muscles in the thoracic spine and guess what... muscles in the neck! So back up here Tia. You're telling me that when I move my arms it can be making my face hurt? The answer is yes. Weakness in the shoulder and irregular movement to the shoulder blade will affect the neck. Neck muscles will begin to over-activate when the shoulder is moving which will cause the neck to become irritable. This again will start the process of incorrect muscle sequencing and neck referral to the jaw.

Your pelvis and core also play a role as these muscles share the same myofascial chain (muscles connected by connective tissue) with muscles all the way up to your neck. Thinking about this connection is not to overwhelm you, but to show you how things are connected. Put simply, jaw pain can often be a symptom to something else not working right.

As you can see, identifying your source of jaw pain can be tricky. These are not the only causes of TMJD, but they are the most common especially with an insidious (unexplained) onset. But don’t let your jaw pain keep you from enjoying your favorite foods any longer! A physical therapist trained in TMJD can help determine the underlying cause of your condition. Physical therapy has proven to be a highly successful, conservative approach to treating TMJD.

Check out our TMJD page to learn more about this topic.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

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Dr. Tia Totura

Physical Therapist | Doctor of Physical Therapy
Tia Totura is a Doctor of Physical Therapy (DPT) who specializes in sports, general orthopedics, TMJ disorders and headaches. She works at Activcore in Denver, Colorado, located just one mile from the popular Cherry Creek Shopping District. As a former Division I swimmer and captain of the Women's Swimming and Diving Team at the University of Denver, Tia has a special interest in treating swimmers and other overhead athletes.
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