Temporomandibular disorders (TMD) are the second most common musculoskeletal condition leading to pain and disability in the US, according to the National Institute of Dental and Craniofacial Research.

Only low back pain leads TMD in this category.

Sun Physical Therapy specializes in TMD treatment. We work together with dentists and healthcare providers in helping patients reduce pain and improve function.


The temporomandibular joint (TMJ) of the jaw links the mandible, or lower jaw, to the skull. Its proper alignment and function is key for everything from facial symmetry and appearance to mouth opening and chewing. Problems involving the joint fall under the category of temporomandibular dysfunction, or TMD. They can include disc dysfunction, muscular spasm and pain, and arthritis.

The signs of dysfunction include:

  • Pain (including jaw pain)
  • Headache (including pain behind the eyes, in the temples, at the forehead, and at the base of the skull)
  • Earache and/or ear symptoms such as ringing and buzzing
  • Localized soreness or muscle spasm
  • Limited motion
  • Changes in occlusion or malocclusion, defined as alterations in the way the teeth make contact when the jaw is closed
  • Intermittent locking of the jaw, difficulty opening the jaw
  • Bruxism, clenching
  • Feeling poorly rested
  • Clicking and/or popping
  • Sensitive teeth
  • Joint sounds

Causes of TMD include:

  • Trauma
  • Joint hypermobility
  • Stress/parafunctional activity such as clenching or grinding
  • Issues regarding occlusion (alignment and contact of the upper and lower teeth.)
  • Posture and alignment factors

Physical therapy treatment of TMD can take place at any time – from early onset of pain to the point when the condition is considered chronic.

Dentists and patients should consider seeing a physical therapist for conservative treatment of TMD in such instances as:​

  • When other conservative options, such as rest or NSAIDs, have not reduced pain
  • When there is simultaneous neck pain
  • When postural alignment is suspected to be contributing factor
  • When the practitioner determines PT will be an appropriate adjunct to dental or medical care

Research has found that conservative treatment can be effective in as many as 50% of TMD cases.

During the initial evaluation, your therapist will take a detailed summary of your relevant clinical history. The evaluation will include a detailed analysis of relevant joints and soft tissues in the head, neck and back. Then the therapist will discuss your treatment options and establish a plan of care. Physical therapy treatment often includes a combination of manual therapy, exercise, and patient education aimed at decreasing pain, improving mobility (if restricted), improving function, and preventing future recurrence.

Manual therapy techniques include superficial and deep massage, assisted stretching, joint mobilization and manipulation, and trigger point dry needling.

The following is a list of strategies, recommended by The American Academy of Craniofacial Pain, for addressing TMD symptoms while awaiting professional care:

  • Use ice pack for pain and muscle spasm. Apply a small ice pack to the temple area and side of the face for 10 minutes, 3 to 4 times per day.
  • Follow a soft diet, avoiding crunchy, thick or chewy foods like apples, hard breads, and steak.
  • Avoid chewing gum.
  • Cut food into smaller pieces to make it easier to chew.
  • Follow the rules of “lips together, teeth apart,” ensuring a relaxed position of the jaw.
  • Sleep on your back when possible. Consider using a rolled towel under your neck to support your cervical spine.
  • Avoid sleeping on your stomach.
  • Avoid sitting with your chin resting on your hand.
  • Protect your yawns by placing your fist under your lower jaw to prevent an extra wide opening.
  • When talking on the telephone, do not support the receiver with your shoulder.
  • Practice good posture.
  • Keep your head up, chin out, shoulders squared and back straight.
  • Support your lower back when sitting.

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