TMJ dysfunction is a silent perpetrator of pain and discomfort for approximately 75,000 Hong Kong residents every year, impacting their quality of life and overall well-being. If you’re experiencing jaw pain or tooth grinding (bruxism) and it’s not getting better, physiotherapy can help. Here’s what you need to know.
What Is TMJ Dysfunction?
The temporomandibular joint (TMJ) is one of the most complex joints in the human body. It allows for the movement necessary to chew, speak, and yawn. The joint is located where the jawbone meets the skull in front of each ear.
TMJ dysfunction occurs when this joint becomes irritated, inflamed, or misaligned, leading to pain and movement restrictions. The TMJ usually acts like a sliding hinge, but when it malfunctions, it can lead to difficulties in chewing, jaw locking, and even changes in dental alignment. Often, TMJ is accompanied by bruxism, which refers to involuntary teeth grinding or jaw clenching, usually during sleep.
As those with the problem will tell you, the impact of TMJ dysfunction extends beyond physical discomfort. It can cause stress, frustration, trouble sleeping, and even make you self-conscious in social situations.
What Causes TMJ Dysfunction and Bruxism?
There is usually no single cause of TMJ dysfunction but a range of contributing factors that trigger or exacerbate the condition. These include:
- A jaw injury, such as a direct blow to the jaw, head, or neck during an accident, fall, or sports activity, can lead to inflammation, misalignment, and damage to the TMJ and related muscles.
- Teeth grinding and clenching, which repeatedly exerts excess pressure on the jaw muscles and TMJ.
- Psychological stress and anxiety are significant risk factors for both TMJ dysfunction and bruxism, as they often lead to unconscious jaw clenching, especially at night.
- Slouching and other poor postural habits, particularly in those who work at desks for long hours, can strain the neck and jaw muscles, leading to dysfunction.
- Dental misalignment, such as a poor bite (malocclusion) or missing teeth, can put excessive stress on the TMJ.
- Inflammatory conditions such as osteoarthritis or rheumatoid arthritis can contribute to joint damage in the TMJ.
Common Symptoms of TMJ Dysfunction and Bruxism
Many people with TMJ dysfunction experience a combination of the following symptoms:
- Jaw pain or tenderness that worsens with chewing or talking
- Clicking or popping sounds when opening or closing the mouth
- Locking of the jaw, making it difficult to open or close the mouth fully (or limited jaw movement)
- Headaches, particularly in the temples or forehead that may radiate from the jaw
- Neck pain and stiffness, as TMJ dysfunction can contribute to muscle tension in the surrounding areas
- Toothache or increased tooth sensitivity, often from the pressure of grinding
- Ear pain or ringing (tinnitus), as the TMJ is located near the ear canal
- Facial fatigue or tension, feeling like the jaw is constantly overworked
- Facial swelling from associated inflammation
How Is TMJ Dysfunction Diagnosed?
If you’re experiencing symptoms of TMJ dysfunction, a physiotherapist, dentist, or doctor can assess your condition through:
- A physical examination of jaw movement, muscle tenderness, and joint noises
- Dental evaluation to check for teeth grinding patterns, bite alignment, or wear on the teeth
- Imaging tests, such as X-rays or MRI scans, to assess joint health if symptoms are severe
How Is TMJ Dysfunction Treated?
The treatment of TMJ dysfunction and bruxism depends on the severity of symptoms and the underlying cause. A multidisciplinary approach often yields the best results.
Physiotherapy Treatment for TMJ Dysfunction
Physiotherapy plays a crucial and effective role in managing TMJ pain with the goals being reducing pain and stiffness, restoring function, and teaching you management strategies you can continue to use throughout your days. Techniques we may use include:
- Manual therapy and joint mobilisations using hands-on techniques to improve TMJ alignment and release muscle tension.
- Strengthening and stretching the jaw and neck muscles improves function and reduces strain.
- Addressing poor posture that may be contributing to jaw pain.
- Myofascial release and other soft tissue therapies help release tension in the facial, neck, and jaw muscles.
When you visit us for jaw pain or suspected TMJ dysfunction, we begin by taking a detailed history of your symptoms, lifestyle, and contributing factors. Your physiotherapist will then ask about pain patterns, jaw mobility, and habits like teeth grinding or clenching.
A thorough assessment follows, where your physiotherapist will examine how your jaw moves, identify restrictions, and pinpoint the source of your discomfort. This includes assessing the surrounding muscles in your jaw, neck, and shoulders, as muscle imbalances often contribute to TMJ dysfunction.
We’ll review your treatment plan and agree on the best course of action. Then, we can implement techniques like gentle joint mobilisation, targeted massage, or dry needling to release muscle tension. You’ll also receive a personalised exercise plan to strengthen and stretch key muscles and education on posture, stress management, and jaw relaxation techniques. The goal is to relieve immediate symptoms and equip you with strategies to maintain long-term relief and prevent recurrence.
Dental Interventions
A dentist may recommend specific treatments to protect the teeth and reduce strain on the TMJ, such as a mouthguard, splints or other devices that help relieve pressure on the jaw. They may also make adjustments to your bite, such as orthodontic treatment or reshaping teeth, to reduce joint stress.
Stress Management
Since stress is a significant contributor to bruxism and TMJ dysfunction, stress management techniques can help you achieve greater comfort and less pain. These techniques range from relaxation techniques such as deep breathing, meditation, or mindfulness practices to cognitive-behavioural therapy (CBT) for those who experience stress-related jaw clenching and lifestyle modifications such as reducing caffeine intake or improving sleep hygiene.
Dietary Modifications
Soft foods can also help reduce strain on the jaw joint during flare-ups. Cut food into small pieces and avoid hard, chewy, or sticky foods to help prevent excessive TMJ stress.
Exercises To Help With TMJ Pain
Chin Tucks
- Sit or stand tall with your back straight and shoulders relaxed.
- Gently pull your chin straight back, as if trying to create a slight “double chin.”
- Keep your head level—don’t tilt it up or down.
- Hold the position for up to 5 seconds, then relax.
- Repeat 8–10 times.
Relaxed Jaw Exercise
- Lightly rest the tip of your tongue on the roof of your mouth, just behind your front teeth.
- Let your teeth part slightly so your jaw muscles can relax.
- Breathe deeply and hold this relaxed position for a few moments.
Goldfish Exercise (Assisted)
- Place the tip of your tongue on the roof of your mouth.
- Use one index finger to gently touch the TMJ (just in front of your ear).
- Place the other index finger lightly on your chin.
- Slowly open your mouth halfway, letting your lower jaw drop down.
- Close your mouth gently while keeping your tongue in place.
- Watch in a mirror to ensure your movement is smooth and straight.
- Repeat 6–8 times, 4–6 times per day.
Goldfish Exercise (Unassisted)
- Keep your tongue lightly pressed to the roof of your mouth.
- Place an index finger on each TMJ (the area in front of each ear).
- Slowly open your mouth partially, then close it gently.
- Make sure your jaw moves in a straight line.
- Repeat 6–8 times, 4–6 times per day.
When To Seek A Physio
If you’re experiencing jaw pain, headaches or neck pain that are affecting your daily life, we recommend booking in with a physiotherapist experienced in treating TMJ dysfunction.
Here at PhysioCentral, our physiotherapists are experienced in treating TMJ dysfunction and can develop a personalised treatment plan to relieve your symptoms and make you feel more comfortable.
Book your appointment by calling us at +852 2801 4801 or book online here.