Headaches / TMJ

Temporomandibular Disorders (TMD)


Temporomandibular disorder (TMD), is a term that describes an entire group of disorders involving the temporomandibular joint or joints (TMJ).

The TMJs are the jaw joints. There is one on each side of your head just in front of your ear canals. Like many other joints in the body, they consist of:

  • Muscles that control joint movement,
  • Ligaments that hold the bones together,
  • Cartilage that provides a smooth surface for the bones to move on,
  • A disc that helps with proper movement, of the bones,
  • Elastic tissue that helps hold the disc in place.

One or more of the above tissues can cause symptoms. In fact, studies suggest that one third of the population at any one time experiences TMJ symptoms such as pain with chewing, yawning, or jaw opening. Women seem to have TMJ problems much more often than men and it is estimated that 3-6% of the population might benefit from treatment.

There are a variety of temporomandibular disorders. The muscles (myogenous), joint(s) (arthrogenous), or a combination of the two may cause pain.

Since physical therapists treat muscle and joint problems, they are ideally suited to address a TMD. Moreover, a majority of patients diagnosed with TMD, also have associated neck pain. Both respond well to treatment provided by a physical therapist. No other healthcare practitioner is better suited to address both the TMD and neck pain.

TMD may appear to be a complex condition and it shouldn't be. This website and your physical therapist can help to insure the following:

  1. You are properly educated,
  2. that your treatment is conservative, cost-effective, and reversible,
    goals are realistic,
  3. your examination is brief and meant to identify your source(s) of pain.

When a physical therapist performs the examination, they will be able to classify you as having one or more of the following:

  1. An inflammatory condition
  2. Limited jaw range of motion
  3. Excessive jaw range of motion
  4. Arthrogenous Disc Displacement
  5. Jaw muscle pain
  6. Neck pain causing related headaches (sometimes mistaken as TMD)

Once the involved structures are identified, the therapist will be able to provide you with the appropriate treatment.

If you would like to learn more about how our TMJ specialists can help you out, please give us a call.

What are Headaches?

Headaches, like back pain, are one of the most common of all physical complaints and can be one of the most frustrating to manage. Pain of any type that occurs in any part of the head is called a headache.

Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress.

A problem in the neck, head, or jaw--such as an injury or arthritis--can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.

How Does it Feel?

A tension-type headache typically begins at the back of the head and spreads to the top of the head and the eyes. You might feel an increase in facial pain along the cheeks near the jaw bone (temporomandibular joint dysfunction). People often describe a tightness, a sensation of someone tugging on their hair, or a feeling of wearing a tight cap. These headaches can worsen with specific positions--such as sitting at a desk--and may ease with rest.

How Can a Physical Therapist Help?

Your physical therapist will conduct a thorough examination that includes a review of your health history. Your therapist will ask you questions and will perform tests to determine the most likely cause of your headaches. For example, your therapist might:

  • Ask you:
    • to recall any previous injuries to your neck, head, or jaw
    • the location, nature, and behavior of your pain and other symptoms
    • to draw your areas of pain on a body diagram
    • Perform tests of muscle strength and sensation
    • Examine your posture when sitting, standing, and performing various activities
    • Measure the range of motion of your neck, shoulders, and other relevant parts of your body
    • Use manual therapy to evaluate the mobility of the joints and muscles in your neck

If it appears that you do have tension-type headaches, your physical therapist will work with you to design a plan of care to meet your goals. If the evaluation indicates that you may have a different type of headache--such as sinus, migraine, or cluster headache--your physical therapist likely will refer you to another health care professional for additional diagnostic tests and treatment.

Your physical therapist will work with you to correct the problems that are causing your pain and will help you learn to prevent headaches through simple changes in your posture and lifestyle:

Improve neck mobility. Physical therapists use a specialized technique called manual therapy to increase movement and relieve pain and to stretch the muscles of the back of the neck.

Improve your strength. Your physical therapist will teach you exercises to increase the strength of the muscles that help stabilize your upper back and neck to improve your posture and endurance and make it easier for you to sit or stand for longer periods of time without discomfort.

Improve your posture. Physical therapists will teach you to ways to improve your posture. Whether it is simply pushing your chest out or pulling your shoulder blades backward and together, slight modifications to everyday living can make a vast improvement in posture.

Modify your workstation or home office. Tips may include:

  • using a headset instead of a regular phone
  • adjusting your computer screen so that it is no lower than the level of your eyes
  • finding an appropriate desk chair
  • adjusting the position of your computer mouse