Physical Therapy and the TMJ

What characterizes a TMJ disorder?

The primary characteristic of a temporomandibular joint (TMJ) disorder is pain in and around the jaw. Additional complaints may include popping/clicking, ringing in the ears, headaches, limited mouth opening, or a tendency for the jaw to “lock.”

There are two primary categories of TMJ dysfunction:

A joint or disc disorder involves impaired movement in the joint itself. Bony abnormalities due to congenital deformity or arthritic changes may contribute to joint dysfunction. More often, inappropriate movement of the articular disc is responsible for inability of the bony structures to roll and glide appropriately.

A masticatory or muscle disorder results from imbalance in the pull of muscles around the jaw. Unlike a joint or disc disorder, a masticatory disorder may not be associated with any pathology or structural abnormalities. Lifestyle habits such as stress responses, sleep hygiene, and posture contribute to maladaptive forces on certain muscles and tendons, resulting over time in microtrauma, altered movement patterns, and development of pain.

It is estimated that up to 25% of the population has pain associated with the TMJ, but only 3-4% actively seek treatment.

What can physical therapy do for TMJ dysfunction?

TMJ dysfunction ultimately results in functional limitations due to pain or impaired movement, regardless of its original cause.  Physical therapists specialize in restoration of movement patterns, including those of the facial region.

The goals of physical therapy treatment for TMJ may include:

  • Reducing acute pain and inflammation via modalities such as electrical stimulation
  • Decreasing compressive forces in the joint with manual therapy techniques
  • Improving motor patterns associated with talking and chewing via specific exercises
  • Promoting awareness of postural and lifestyle factors that contribute to TMJ dysfunction