Temporo-Mandibular Joint (TMJ) Pain

“TMJ” pain is a common occurrence for many people, and it refers to pain or discomfort in the Temporo-Mandibular Joint (TMJ). This is the hinge that connects your temporal bone (the bone that forms the side of the skull) and your mandible (the lower jaw) in front of your ear, making it possible for you to open and close your mouth. Think of your jaw as a lever; the TMJ is vital because it supports that lever. When you bite down, you put force on the object between your teeth and on the joint. Even though it is only a small disc of cartilage, the TMJ separates the bones so you can talk, swallow, chew, kiss, etc. When it is damaged, it can cause a significant amount of pain.

What Are the Symptoms of TMJ Pain?

Common symptoms of TMJ pain may include:

  • Ear pain

  • Sore jaw muscles

  • Temple or cheek pain

  • Jaw popping/clicking

  • Locking of the jaw

  • Difficulty in opening the mouth fully

  • Frequent head and/or neck aches

  • Ringing in the ears (also called tinnitus)

Your pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles attached to the bones of the skull, face, and jaws. Pain can also be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.

A common focus of pain is in the ear. Many patients see an ENT (ear, nose, and throat) specialist, or otolaryngologist, convinced that their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the ENT specialist will consider the possibility that the pain comes from TMJ.

What Causes TMJ Pain?

In most patients, TMJ pain is a result of movement or displacement of the cartilage disc that causes pressure and stretches certain sensory nerves. Popping or clicking noises occur when the disk snaps into place when the jaw moves. In addition, the chewing muscles may spasm or not function efficiently, causing pain and tenderness. These actions or situations can also damage the TMJ:

  • Major and minor trauma to the jaw

  • Teeth grinding

  • Excessive gum chewing

  • Stress and other psychological factors

  • Improper bite or improperly positioned jaws

  • Arthritis

What Are the Treatment Options?

When you see your primary care physician or an ENT specialist about your TMJ pain, they will start with a detailed medical history and physical, looking to see how your teeth come together when you bite down. They will also examine how the joints and muscles around your jaw function. Depending on your case, your doctor may recommend trying simple, self-remedies to help relieve TMJ pain such as:

  • Resting your muscles and joints by eating soft foods

  • Not chewing gum

  • Not clenching or tensing your jaw

  • Relaxing your muscles with moist heat

In cases of joint injury, your doctor may recommend applying an ice pack soon after the injury to reduce swelling. Relaxation techniques and stress reduction, non-steroidal anti-inflammatory drugs, muscle relaxants, or other medications may also offer relief.

Other treatments for advanced cases may include an occlusal splint, or mouth guard, to prevent wear and tear on the joint, improving the alignment of the upper and lower teeth, and surgery. Your ENT specialist may also suggest additional consultation with your dentist and oral surgeon to help manage your TMJ pain.

What Questions Should I Ask My Doctor?

  1. The area around my jaw really hurts. My dentist said that nothing is wrong with my teeth and suggested that I might have an ear infection. What should I do next?

  2. Should I see a specialist?

  3. What can I do to prevent or treat TMJ pain without having to go back to the doctor?

  4. Is TMJ pain hereditary?

  5. How many people get TMJ pain?