By Casondra Mortimer, DPT, Harrisonburg, VA Center
TMJ stands for the temporomandibular joint, which connects one side of your mandible (lower jaw) to your skull. Temporomandibular dysfunction (TMD) is the umbrella term used to describe what happens when the joint and/or muscles used for chewing become inflamed, stuck or painful.
TMD affects more females than males and generally affects people between the ages of 20 and 40 who have a history of clenching and grinding their teeth (bruxism), dental work, trauma to the jaw or face, increased anxiety or stress, or poor posture.
Symptoms include pain in the jaw, ears, face, neck and upper back. Some patients may have difficulty opening or closing their mouths, deviations in jaw movement, or popping, clicking or grinding sounds in the joint when yawning, talking, or eating.
A symptomatic TMJ may limit daily, social, or work-related activities. Lifestyle behaviors that could contribute to TMJ discomfort or TMD include:
- Increased stress and anxiety. Increased stress is one of the main contributors to TMD pain, often causing clinching of the jaw or grinding of the teeth. To relieve stress, you may want to consider getting more sleep; taking 5 to 10 minutes throughout your day to practice diaphragmatic breathing; exercising; participating in a yoga class; or simply walking around the office for a few minutes and recording your stress triggers in a journal or diary.
- Slouched posture. The neck and jaw are intimately connected; thus, a slouched posture associated with desk work and the use of cellular devices can place undue stresses on the cervical spine (neck) and musculature and affect the position of the mandible. Rounded shoulders commonly accompanied by a forward head position can place the condyles of the jaw bone deeper into their joint sockets. Poor posture may alter the length tension relationship of the masticatory muscles that help open and close the mouth. Joint malalignment and muscle imbalances may lead to increased joint compression, which may be the source of pain. One way to correct posture is to place a rolled-up hand or beach towel in the small of your back while you sit at a desk or drive. This should cue you to sit up tall and correct your neck and shoulder positioning.
- Oral habits. Chewing on gum or writing utensils, nail and lip biting, and clinching and grinding teeth are among the habits that may lead to overuse of the TMJ muscles and result in microtrauma of the joint or the soft tissues (such as the ligaments, tendons, and muscles) that surround and support the joint. If you grind your teeth at night, try wearing a mouth guard to bed or sucking on candy mints instead of chewing gum.
- Diet. Healthy eating habits are not just for weight management and proper nutrition but also for optimal TMJ function. Some foods, although healthy, may cause undue compression forces or fatigue of the TMJ: steak, nuts, stringy vegetables (such as celery), and certain breads. Large bites that require excess mouth opening also may add stresses. Eating softer foods or taking smaller bites may reduce overuse of the TMJ and possibly discomfort.
- Excessive mouth opening. Your mouth should be able to open at least three finger widths or 40 centimeters. However, excess mouth opening can occur with yawning, singing, or even laughing. To help reduce excessive mouth movement, use the width of three of your fingers or place your fist between your chin and breast bone before opening your mouth.
If you have other questions regarding the TMJ or need help determining specific lifestyle triggers of TMJ pain, contact a physical therapist with your concerns. You can learn more about how we treat TMJ discomfort by visiting our TMJ Rehab page.
Chang, C. L., Wang, D. H., Yang, M. C., Hsu, W. E., & Hsu, M. L. (2018). Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint. The Kaohsiung Journal of Medical Sciences.
Glaros, A. G., Marszalek, J. M., & Williams, K. B. (2016). Longitudinal multilevel modeling of facial pain, muscle tension, and stress. Journal of dental research, 95(4), 416-422.
Jaeger, J. O., Oakley, P. A., Moore, R. R., Ruggeroli, E. P., & Harrison, D. E. (2018). Resolution of temporomandibular joint dysfunction (TMJD) by correcting a lateral head translation posture following previous failed traditional chiropractic therapy: a CBP® case report. Journal of physical therapy science, 30(1), 103-107.
Klasser, G., & Greene, C. (2017). Screening orthodontic patients for temporomandibular disorders. Clinical Dentistry Reviewed, 1(1), 8.
Lampa, E., Wänman, A., Nordh, E., & Häggman‐Henrikson, B. (2017). Effects on jaw function shortly after whiplash trauma. Journal of oral rehabilitation, 44(12), 941-947.
Lobbezoo, F., List, T., Michelotti, A., Nixdorf, D. R., Peck, C. C., Raphael, K., … & Breckons, M. (2017). Self-management programmes in TMD: results from an international Delphi process.