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TMJ and Jaw Pain: Physical Therapy in Brooklyn for Clicking, Clenching and Headaches

By Dr. Jack Engelberg, PT, DPT · · 4 min read

Clicking when you chew, a sore jaw in the morning, tension headaches around your temples, or difficulty opening wide enough to bite into a bagel can all point to a temporomandibular disorder, often called TMJ or TMD. Jaw problems are common and frequently connected to stress, clenching and neck posture. Many people don't realize that physical therapy can be part of treating jaw pain, often working alongside a dentist or physician.

What Is TMJ Disorder?

The temporomandibular joint (TMJ) connects your lower jaw to your skull, just in front of each ear. You have one on each side, and they work together every time you talk, chew, yawn or swallow. Each joint has a small disc that helps it glide smoothly.

Temporomandibular disorders (TMD) are a group of conditions affecting the jaw joints, the chewing muscles, or both.

Common Symptoms

  • Pain in the jaw, in front of the ear, or in the temples
  • Clicking, popping or grating sounds with jaw movement
  • Limited mouth opening
  • The jaw catching or locking open or closed
  • Pain with chewing, talking or yawning
  • Headaches, especially in the morning
  • Ear fullness or pain without an ear infection
  • Neck and shoulder pain

Clicking on its own, without pain or locking, is common and often doesn't need treatment.

What Causes TMJ Problems?

TMJ problems usually involve a combination of factors:

  • Clenching or grinding (bruxism) — often during sleep or under stress
  • Muscle tension — in the jaw, neck and shoulders
  • Stress and anxiety
  • Habits — gum chewing, nail biting, chewing on pens, or resting your chin in your hand
  • Disc displacement — the disc inside the joint shifts out of its normal position
  • Arthritis in the jaw joint
  • Injury — a blow to the jaw or a whiplash injury
  • Neck posture — forward head posture may change muscle tension around the jaw
  • Prolonged mouth opening — for example, during long dental procedures

How Physical Therapy Helps

Conservative care, including self-management, exercise and manual therapy, is generally recommended before more invasive treatments for most TMJ disorders.

Evaluation

Your therapist will measure jaw opening and movement, assess the jaw and neck muscles, listen and feel for joint sounds, and evaluate your neck and posture. They'll ask about habits, sleep and stress. Your therapist may coordinate with your dentist, especially if a night guard is being considered.

Treatment May Include

  • Education — understanding the condition and what aggravates it
  • Manual therapy — gentle soft tissue work for the chewing muscles and mobilization of the jaw and neck
  • Jaw exercises — controlled opening, coordination and gentle strengthening
  • Relaxation and habit awareness — identifying daytime clenching and teaching a relaxed jaw position
  • Neck and posture work — because the neck and jaw are closely linked
  • Home program — short exercises you can do throughout the day

What You Can Do at Home

  • Rest your jaw. Keep "lips together, teeth apart, tongue resting gently on the roof of your mouth."
  • Choose softer foods during flare-ups, cut food into small pieces, and avoid very chewy or hard foods.
  • Avoid gum chewing and nail or pen biting.
  • Support your jaw when yawning by placing your fist under your chin.
  • Use warmth — a warm compress on the jaw muscles for 10 to 15 minutes can relax them.
  • Check in on clenching. Set reminders during the day to notice and relax your jaw.
  • Manage stress with walking, breathing exercises or other strategies that work for you.
  • Sleep on your back or side, rather than on your stomach with your jaw pressed into the pillow.

When to See a Physical Therapist

Consider an evaluation if:

  • Jaw pain lasts more than a couple of weeks
  • You have limited mouth opening
  • Your jaw catches or locks
  • You have frequent headaches with jaw or neck tension

See a dentist or physician promptly if your jaw locks and won't open or close, if jaw pain follows an injury, if you have swelling, fever or ear drainage, or if jaw pain comes with chest pain or shortness of breath (call 911).

Frequently Asked Questions

Do I need a night guard?

A dentist can tell you whether a night guard is appropriate, often for grinding at night. Many people benefit from combining a guard with therapy and self-care.

Can TMJ cause headaches?

Yes. Tension in the jaw and neck muscles can contribute to headaches, particularly around the temples.

Will my jaw clicking go away?

Clicking without pain is common and often doesn't require treatment. If it comes with pain or locking, it's worth an evaluation.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

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About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

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