TMJ disorders and pain: causes, treatments, and exercises for relief

You probably don’t think about your jaw much — until it hurts. The temporomandibular joint (TMJ), located just in front of each ear, plays a vital role in everyday activities like chewing, speaking, and yawning. When your TMJ becomes a source of pain, it’s often classified as a temporomandibular disorder (TMD). 

“TMD is an umbrella term for different things that can cause pain in your TMJ,” explains Sam Mink, PT, DPT, a physical therapist at Hinge Health. “TMDs can include arthritis, nerve pain, and muscle restrictions, among other issues.”

Although TMJ pain can make even simple actions, like eating or smiling, feel uncomfortable, there are plenty of ways you can manage TMJ pain, restore jaw function, and feel better. Targeted exercises and physical therapy can play a big role in your treatment. Read on to learn more about TMJ pain and how to treat it with tips from Hinge Health physical therapists.

What are TMJ disorders?

Temporomandibular joint disorders (TMDs) include a variety of conditions that affect the TMJ and surrounding muscles. The TMJ itself acts as a hinge, enabling your jaw to open and close smoothly. When it becomes irritated, it can lead to symptoms such as jaw pain, stiffness, and difficulty with movement.

TMDs can pose more than just a physical problem — they can also have a profound emotional impact. “If TMJ pain starts to limit the range of motion in your jaw, it can be really detrimental,” says Dr. Mink. “It can limit your ability to talk, eat, and even laugh without pain.” 

TMDs can also lead to secondary issues like tension or tight spots in your jaw muscles, headaches, or discomfort when sleeping.

Managing TMDs often requires a multifaceted approach. Through physical therapy, targeted exercises, and lifestyle adjustments, it’s possible to relieve pain and improve jaw function. These treatments not only address the physical symptoms of TMDs but also help improve emotional well-being by restoring your ability to eat, talk, and laugh without discomfort. 

Causes of TMJ pain

TMJ pain can occur from a combination of factors, often linked to the muscles, joints, and surrounding structures that support your jaw. Everyday habits, physical tension, injuries, and even genetics can play a role in triggering or worsening TMJ symptoms. 

• Neck and shoulder tension. Your neck and shoulder muscles are closely connected to your jaw through shared muscle groups, such as the sternocleidomastoid and trapezius. When these muscles are tight, they can pull on surrounding structures, creating extra strain on the muscles and ligaments that support your jaw. This tension can alter jaw movement or alignment, making it harder for the joint to function smoothly and leading to pain or stiffness.

• Posture. While there’s no such thing as perfect posture, certain positions, like rounding your shoulders while working at a computer, can contribute to TMJ pain. This position forces you to jut your chin up to see in front of you, which can strain your jaw muscles. “We don’t expect people to avoid this position altogether, but changing positions frequently throughout the day helps a lot,” says Dr. Mink. 

• Overactivity. Activities that overwork your jaw muscles — like talking for extended periods, yelling at a concert, chewing tough foods, or even dental appointments — can trigger pain flares.

• Bruxism (teeth grinding or clenching). Grinding or clenching your teeth places extra pressure on the TMJ and surrounding muscles. “This is one of the most common causes of TMJ pain,” says Dr. Mink. Many people do this subconsciously, often during sleep or when they are stressed or anxious.

• Jaw injuries. Trauma from sports, falls, or accidents can damage the TMJ and lead to pain or functional limitations.

• Misaligned bite. When your upper and lower teeth don’t fit together quite right, your jaw may have to work harder during movements like chewing or speaking. This can strain the joint and lead to pain over time.

• Genetics and pre-existing conditions. Some people are more prone to TMJ pain due to genetic factors or pre-existing conditions like arthritis. These factors can affect the structure or function of your jaw, making it more susceptible to pain, inflammation, or stiffness. “While you can’t change your genetics, being aware of these factors can help guide treatment,” explains Dr. Mink.

Symptoms of TMJ pain

TMJ pain can show up in a variety of ways. The symptoms are typically musculoskeletal in nature but can affect other areas as well. 

• Jaw pain and tenderness. This is the most common TMD symptom. Discomfort may radiate to nearby areas, such as your cheeks, temples, or neck.

• Jaw stiffness and reduced range of motion that makes movements like opening and closing your mouth and protracting and retracting your jaw (jutting out and in) difficult. 

• Clicking, popping, or grinding sounds when opening or closing your mouth. 

• Difficulty chewing or discomfort while eating. 

• Jaw locking. 

• Headaches or migraines. 

• Neck and throat pain. “Neck pain can cause TMJ pain, and the TMJ can cause neck pain,” notes Dr. Mink.

• Ear pain or a feeling of fullness in your ears. 

These exercises, recommended by Hinge Health physical therapists, target the muscles around your jaw, neck, and shoulders to help reduce TMJ pain. Strengthening and stretching these areas can improve posture, ease tension, and address imbalances that may cause your jaw to compensate for weakness or tightness elsewhere. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for TMJ pain

Managing TMJ pain often starts with conservative approaches. “TMJ pain is often chronic in nature,” says Dr. Mink. “It can be acute, and if you treat it quickly, it may go away in a few weeks and stay away. But for many people, TMJ pain can come and go over a long period of time.” Treatment is aimed at alleviating symptoms and building strength and resilience in your jaw to help prevent future pain flares.

• Physical therapy and jaw exercises. Targeted exercises help improve jaw mobility, reduce muscle stiffness, and release tension. “Moving the muscles and increasing blood flow to your jaw is key to improving function,” says Dr. Mink. You can do many TMJ exercises on your own, or you can work with a physical therapist for personalized guidance. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. Seeing a PT in person can also provide the added benefit of manual therapy, such as joint mobilizations or soft tissue techniques, which research published in the Journal of Clinical Medicine shows can be highly effective in treating TMJ pain. 

• Posture adjustments and movement snacks. Sitting in one posture for too long can exacerbate TMJ pain, especially if you tend to round your shoulders forward. Dr. Mink advises frequent position changes rather than trying to maintain a “perfect” posture all day. “Frequent movement is more helpful than any single ideal position,” he explains. 

• Massage. Massaging your cheeks and jaw area can help relieve muscle tension around the TMJ. Use gentle, circular motions with your fingers to target tight areas. “I typically tell people to do this for two to three minutes at a time, three to four times a day,” says Dr. Mink. “You can also use massage as a preventive measure if you’re about to do something you know triggers a pain flare for you.” For deeper relief, a physical therapist can perform intraoral massage, a technique where they isolate and massage the muscles inside your mouth. “This can be a really effective treatment for some people,” says Dr. Mink.

• Dry needling. “Research shows that dry needling can be highly effective, especially when TMJ pain stems from muscle tightness or trigger points,” explains Dr. Mink. It is typically performed by a physical therapist and involves inserting thin needles into specific muscle areas to release tension, improve blood flow, and reduce pain. 

• Mouthguards. Mouthguards (worn at night) can prevent teeth grinding and clenching, which are major contributors to TMJ pain. Mouthguards aren’t necessary if you don’t grind your teeth. “Sometimes, you don’t know if you grind your teeth if you do it at night, though. So it may be worth trying a mouthguard when you sleep to see if it makes a difference for you.” 

• Hot or cold compresses. Heat helps relax tight muscles, while ice is better for reducing inflammation and numbing pain. “Both are good options, but if you have muscle stiffness, heat is usually more effective,” advises Dr. Mink. Because there’s not a lot of tissue in your cheek to absorb the hot or cold, these treatments work pretty quickly. “I recommend heating or icing for about five to 10 minutes at a time, and wait an hour between sessions.” 

• Soft food diet. Temporarily switching to softer foods (think: smoothies, mashed potatoes, steamed carrots, scrambled eggs, cottage cheese) can minimize strain on your jaw and give it time to heal. 

• Stress management techniques. Stress often leads to jaw clenching or tightening of facial muscles. Techniques like diaphragmatic breathing, mindfulness practices, meditation, or counseling can help manage stress and prevent flare-ups.

• Desensitization for nerve pain. Though less common, nerve-related facial pain from conditions such as trigeminal neuralgia can influence TMJ pain. Desensitization involves gradually exposing the sensitive area, such as your cheek or jaw, to textured surfaces like a microfiber cloth. Over time, this repeated exposure helps "train" your nerves to become less reactive, reducing sharp or uncomfortable sensations. 

PT tip: Practice jaw awareness

One simple but effective way to manage TMJ pain is to increase your awareness of how you use your jaw throughout the day. Many people unknowingly clench their jaw or press their tongue against the roof of their mouth when stressed or focused. This can worsen tension and pain. Dr. Mink suggests setting a reminder on your phone or placing sticky notes in your workspace with cues like “Relax your jaw” or “Check your tongue.” When you see the cue, take a moment to release any tension in your jaw, let your tongue rest gently at the roof of your mouth, and allow your teeth to separate slightly. This small, mindful adjustment can help reduce strain on your TMJ and keep your jaw muscles more relaxed over time.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Herrera-Valencia, A., Ruiz-Muñoz, M., Martin-Martin, J., Cuesta-Vargas, A., & González-Sánchez, M. (2020). Efficacy of Manual Therapy in Temporomandibular Joint Disorders and Its Medium-and Long-Term Effects on Pain and Maximum Mouth Opening: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 9(11), 3404. doi:10.3390/jcm9113404

2. Dib-Zakkour, J., Flores-Fraile, J., Montero-Martin, J., Dib-Zakkour, S., & Dib-Zaitun, I. (2022). Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disorders. Medicina, 58(2), 256. https://doi.org/10.3390/medicina58020256Dib-Zakkour, J., Flores-Fraile, J., Montero-Martin, J., Dib-Zakkour, S., & Dib-Zaitun, I. (2022). Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disorders. Medicina, 58(2), 256. doi:10.3390/medicina58020256

3. Shankar Kikkeri, N., & Nagalli, S. (2022, July 9). Trigeminal Neuralgia. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554486/

4. Gębska, M., Bartosz Dalewski, Łukasz Pałka, & Łukasz Kołodziej. (2023). Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a randomized control trial (RCT). Head & Face Medicine, 19(1). doi:10.1186/s13005-023-00385-y

5. Kapos, F. P., Exposto, F. G., Oyarzo, J. F., & Durham, J. (2020). Temporomandibular disorders: a Review of Current Concepts in aetiology, diagnosis, and Management. Oral Surgery, 13(4). doi:10.1111/ors.12473

6. Korczeniewska, O. A., Kohli, D., Dabek, K., Diehl, S. R., & Benoliel, R. (2023). Genetics of musculoskeletal (TMD) and neuropathic orofacial pain: a narrative review. Frontiers of Oral and Maxillofacial Medicine, 0. doi:10.21037/fomm-22-12

7. Maini, K., & Dua, A. (2023, January 30). Temporomandibular Joint Syndrome. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551612/

8. Smith, S. B., Maixner, D. W., Greenspan, J. D., Dubner, R., Fillingim, R. B., Ohrbach, R., Knott, C., Slade, G. D., Bair, E., Gibson, D. G., Zaykin, D. V., Weir, B. S., Maixner, W., & Diatchenko, L. (2011). Potential Genetic Risk Factors for Chronic TMD: Genetic Associations from the OPPERA Case Control Study. The Journal of Pain, 12(11), T92–T101. doi:10.1016/j.jpain.2011.08.005