A typical story: a patient has been waking for months with a headache around the temples. She has seen a neurologist and had tests — all normal. Separately, she noticed her jaw cracks when she yawns, but did not connect it with the headache. Her dentist mentioned in passing that her teeth are worn.
Those are three symptoms of one problem.
What the temporomandibular joint does
It is the most heavily used joint in the body — working while eating, speaking and swallowing, roughly two thousand times a day. It is surrounded by the muscles of mastication, which are among the strongest in the body relative to their cross-section.
When those muscles work in constant excess tension, it is not only the joint that suffers. Pain radiates to the temples, the ear, the neck and the shoulders, because the chewing muscles are functionally linked to the muscles of the neck.
Symptoms worth connecting
- A morning headache — usually around the temples, present immediately on waking. Suggests clenching at night.
- Clicking and jumping when opening the mouth, particularly when yawning or biting.
- Limited mouth opening — normally three fingers laid sideways fit between the incisors. Less means restriction.
- The jaw deviating to one side when opening — visible in a mirror.
- Ear pain without infection, ringing, a blocked sensation.
- Worn, sensitive teeth, cracks in the enamel, tooth imprints on the tongue and cheeks.
- Neck and shoulder pain that does not settle despite back massage.
Where it comes from
Most often from stress and overload — clenching the teeth under tension, at night and during the day when concentrating. Posture adds to it: a head carried forward over a keyboard changes the tension of the suboccipital muscles and, indirectly, the position of the jaw.
Sometimes the cause is dental: a badly fitted crown or filling, missing teeth changing the bite, orthodontic treatment in progress.
What physiotherapy offers
I work with the muscles of mastication, including from inside the mouth, with the muscles of the neck and nape, with the mobility of the joint itself, and with a scar if there has been surgery. Added to that is learning the resting position of the jaw, home exercises, and catching the daily habits that keep the problem going: chewing a pen, chewing gum for hours, sleeping face down with the head turned.
Therapy combines well with dental and orthodontic treatment. A splint protects the teeth but will not by itself release overloaded muscles — which is why the best results come from combining the two.
A simple test to start with
Place your fingers in front of your ears and slowly open your mouth. Do you feel a jump on one side? Does the jaw wander sideways? Do three fingers not fit?
If so — and if you also wake with a headache — that is precisely the area I work in.
- tmj
- bruxism
- headache