An Overview of Physical Therapy for TMJ (2022)

If you have pain in your jaw on one or both sides, you may have a condition called temporomandibular joint disorder, or TMD. (You will also hear this referred to as TMJ.) Your jaw may hurt, the muscles of your face may feel like they are in spasm, and you may feel clicking and catching in your jaw. These symptoms may make eating and talking painful or impossible.

An Overview of Physical Therapy for TMJ (1)

There are many different treatments for TMD. You may benefit from medicine or massage, and some people even have surgery to correct the problem. Physical therapy for TMD is another option to help you relieve jaw pain. So what can you expect from PT for TMD, and how can a physical therapist help you if you have TMD?

What Is TMD?

Temporomandibular joint disorders, known as TMD, is a condition that can cause significant difficulty using your jaw. The condition is marked by pain in your jaw that limits your ability to comfortably open and close your mouth. You may also experience clicking or "catching" while chewing food, yawning, or talking.

Symptoms of TMD tend to come on gradually with no specific injury or event. You may notice the pain starts after eating hard foods. The pain typically is intermittent in nature, and it usually comes on after using your jaw to eat hard foods or opening your mouth wide, as you would during yawning.

Anatomy of the Temporomandibular Joint

Your temporomandibular joint is formed by the articulation of your mandible to the mandibular fossa of the temporal bone of your skull. There is a small piece of cartilage called an articular disc that resides between the two bones. When you open and close your mouth, the disc slides as your jaw bone rotates and glides forward and back, making movement possible.

Various muscles attach near your temporomandibular joint. These muscle help to open and close your jaw, allowing you to talk, eat, and swallow. (Your jaw is the most used joint in your body.) Several small ligaments attach the bones together, increasing the stability of the joint.

What Can Go Wrong?

What causes problems with your TMJ? How can things go wrong with the joint? There are many causes of TMD. These may include:

  • Displacement of the articular disc in the joint
  • Muscle spasms
  • Forward head posture
  • Stress
  • Clenching of your teeth (known as bruxism)

Whenever the joint is over-stressed, it can cause pain and joint movement dysfunction. This may lead to inflammation of the joint or of the muscles and ligaments surrounding the temporomandibular joint.

Diagnosis

If you are experiencing joint pain in your jaw, you should visit your dentist or healthcare provider. He or she can determine the cause of your pain and can properly diagnose your condition. Diagnosis of TMD is made largely by clinical examination.

Your healthcare provider may palpate, or touch, your jaw joint and the muscles around it, feeling for tenderness or clicking while you open and close your mouth.

(Video) Physical Therapy for Temporomandibular Joint Dysfunction (TMD)

Your healthcare provider will also examine your jaw's range of motion, looking for any deviations in movement. Sometimes your jaw may open well on one side and not the other, making your jaw move to one side as you open your mouth.

Occasionally an X-ray is taken to check if your temporomandibular joint has arthritic changes, and an MRI may be taken to examine the position of the articular disc in your jaw.

If your healthcare provider rules out TMD, there may be other causes of your jaw pain. These may include:

  • Tooth decay or cavities
  • Facial neuralgia
  • Neck arthritis

Once a diagnosis of TMD is made, you can begin treatment. Working with a physical therapist may be an option for you.

PT Evaluation

Your first visit with a physical therapist for your TMD will be an initial evaluation. Your PT will take time to discuss your condition. He or she will ask you questions about how your jaw pain started and what activities make your symptoms better or worse. He or she will also discuss eating habits and other activities that may be irritating to your jaw.

Your therapist will also ask about previous treatments you may have had for your TMD pain. A thorough review of your medical history may also be done.

During the physical therapy evaluation, several tests may be performed to get a baseline measurement of your TMD condition. Components of a PT evaluation for TMD may include:

  • assessment of posture
  • measurements of neck range of motion
  • measurement of jaw range of motion in various directions
  • palpation of structures around your jaw
  • measurement of the strength of your jaw and postural muscles

Once your evaluation is complete, your physical therapist will discuss with you the findings and make a plan of care to start treating your TMD. Be sure to ask questions about your condition and what you should expect from therapy. Your PT will also work with you to develop goals for your course of therapy.

Setting Physical Therapy Goals

PT Treatments

Your physical therapist may use various treatments for your TMD. These treatments are designed to decrease inflammation and pain, improve posture, improve jaw mobility, and help you regain normal function of your jaw. Treatments may include many potential methods for rehabilitating your joint.

(Video) TOP 3 EXERCISES FOR TMJ- Temporomandibular Joint Pain/Disorder

Application of Heat or Ice

Heat may be used on your jaw to relax muscles and decrease pain and muscular spasm. Ice is sometimes used for TMD to decrease inflammation and pain around your jaw.

Ultrasound

Ultrasound is a treatment used in PT to provide deep heat to tissues and improve cellular mobility. It is sometimes used in the treatment of TMD pain. One study in the Journal of Physical Therapy Science found that the addition of ultrasound in conjunction with home exercises provided greater pain relief and improved mobility when compared to exercise alone.

Caution should be used with ultrasound; many studies regarding its use in PT find that it often offers little functional improvement.

Massage

Your PT may use various massage techniques to treat your jaw pain. Massage may be applied to your jaw muscles, facial muscles, and neck and shoulder muscles. The goal of massage is to relax muscles and improve circulation to them, allowing for a normal motion to occur in your temporomandibular joint.

Temporomandibular Joint Mobilizations

Your therapist may utilize mobilizations to your jaw to help improve the mobility of the joint. Mobilizations can restore normal joint motion and may help relocate a displaced articular disc in your jaw joint. The mobilizations your therapist performs may be a bit uncomfortable; many involve your PT placing her thumb or finger in your mouth along your teeth to mobilize your jaw. (Don't worry, gloves will be worn for this procedure.)

Postural Instruction

Sitting or standing with a forward head and rounded shoulder posture may place excessive stress and strain on your jaw joint. If your PT assesses that your posture is contributing to your jaw dysfunction, he or she may instruct you in proper posture. Exercises like the slouch-overcorrect procedure may be used.

Scapular strengthening exercises may also be prescribed to improve your overall postural awareness.

Exercises for Your Scapula

Exercises

Exercise for your jaw is one of the most important components of your TMD treatment program. Your PT will likely prescribe exercises to improve that way your jaw opens and closes. He or she may have you use a mirror so you can see how your mouth and jaw are moving and so you can ensure that they remain in proper alignment while exercising. The goal of exercise for TMD is to restore normal, pain-free jaw motion.

If you have any questions about your rehab program for TMD, ask your therapist. He or she will likely be happy to help you understand your therapy program and make adjustments so you can get the most out of PT.

What to Avoid

If you have TMD, there are certain things you should avoid as part of your treatment program. These things—often referred to as parafunctional activities—are things that you may be doing that are not necessary for function but are placing undue stress on your TMJ. Parafunctional activities may include:

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  • chewing gum
  • biting pens or pencils
  • leaning your chin in your hand
  • eating hard foods

Avoiding these things can help take pressure and stress off your jaw joint and muscles and allow things to heal.

Timeline for Healing

Most cases of temporomandibular joint pain get better within six to eight weeks. Working with your PT and performing regular exercises can help in your recovery. Some cases may take longer, and some people continue with symptoms after treatment.

If this is the case, you should return to your healthcare provider for follow up care. Some patients benefit from other treatments such as wearing a mouthguard while sleeping or surgery for their TMD.

A Word From Verywell

If you have pain in your jaw, you may have temporomandibular joint disorder or TMD. Physical therapy can be a help modality of care if you have jaw pain from TMD. Your PT can help determine the cause of your pain and can improve the way your jaw moves. That way, you can quickly and safely get back to your normal activities.

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(Video) Management & Exercises for Temporomandibular Joint (TMJ) Disorder/Pain | Physical Therapy | Rehab

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0 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  • Gadotti IC, Lakow A, Cheung J, Tang M. Physical therapists' self-perceived adequacy of entry-level education and their current confidence levels with respect to temporomandibular disorders: A pilot study. Cranio. 2018;:1-8. doi:10.1080/08869634.2018.1525117

  • Ucar M, Sarp Ü, Koca İ, et al. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders. J Phys Ther Sci. 2014;26(12):1847-9. doi:10.1589/jpts.26.1847

(Video) Absolute Best TMJ Treatment You Can Do Yourself for Quick Relief.

FAQs

Can Physical Therapy correct TMJ? ›

Improving Jaw Movement.

Your physical therapist will teach you special "low-load" exercises that don't exert a lot of pressure on your TMJ, but can strengthen the muscles of the jaw and restore a more natural, pain-free motion.

How would you describe TMJ on a physical exam? ›

Characteristic findings on physical examination include the following:
  1. Limitation of jaw opening (normal range is at least 40 mm as measured from lower to upper anterior teeth)
  2. Palpable spasm of facial muscles (masseter and internal pterygoid muscles)
  3. Unilateral facial swelling.
  4. Clicking or popping in the TMJ.
Jan 14, 2022

What is the best way to get rid of TMJ? ›

TMJ Pain Relief: 8 Best Practices
  1. Maintain the resting position of your jaw. ...
  2. Correct your posture. ...
  3. Get a good night's sleep. ...
  4. Use a hot or cold compress. ...
  5. Reduce stress. ...
  6. Exercise your jaw. ...
  7. Take notice of bad habits. ...
  8. Avoid certain activities and foods.
Feb 26, 2022

How long does it take for physical therapy to work for TMJ? ›

Most cases of temporomandibular joint pain get better within six to eight weeks. Working with your PT and performing regular exercises can help in your recovery. Some cases may take longer, and some people continue with symptoms after treatment.

Can physical therapy make TMJ worse? ›

“A physical therapist can work the muscles, but without advanced knowledge of the teeth, they could actually be making the TMD worse, or causing damage to the teeth.”

How many times a day should you do TMJ exercises? ›

Do not do this exercise more than recommended for the first week – five minutes, twice a day, for a week. After this first week, do the exercises as often as you can. This will help to strengthen the ligaments around your jaw and relax the muscles which close your mouth.

How I cured my TMJ naturally? ›

Natural TMJ Pain Remedies
  1. Eat Soft Foods. One of the best ways to start finding relief from TMJ pain is by simply just eating softer foods. ...
  2. Learn Stress Management. One of the top causes of TMJ is actually stress. ...
  3. Wear a Bite Guard. ...
  4. Limit Jaw Movements. ...
  5. Try Acupuncture or Massage Therapy. ...
  6. Use Heat or Cold Therapy.
Dec 5, 2019

How do you document normal TMJ? ›

Listen for crepitus or grinding and clicking or popping sounds. The degree of mandibular opening is measured using the distance between the incisal edges of upper and lower anterior teeth. Opening of less than 35 mm is considered abnormal in an adult.

How do you do a clench test? ›

Give Yourself the Clench Test

Squeeze your teeth hard and note the following: Do your teeth feel like they fit together? Is there no contact between some teeth? Are your bottom front teeth pushing excessively on your front top teeth?

How do you perform a TMJ test? ›

TMJ Exam - YouTube

What is the best muscle relaxer for TMJ? ›

What is the best medication for TMJ?
Best medications for TMJ
FlexerilSkeletal Muscle RelaxantOral
Mobic (meloxicam)Nonsteroidal anti-inflammatory drug (NSAID)Oral
Botox (onabotulinumtoxina)Skeletal muscle relaxantInjection
Piroxicam (feldene)Nonsteroidal anti-inflammatory drug (NSAID)Oral
3 more rows
Oct 5, 2020

What deficiencies cause TMJ? ›

Conclusion. In patients with temporomandibular disorders, increased parathyroid hormone levels in response to vitamin D deficiency was significantly more prominent. These data suggest that, in patients with temporomandibular disorders, vitamin D deficiency should be assessed and corrected.

What is the best doctor to see for TMJ? ›

Most often, a dentist who specializes in TMJ disorders is actually your best choice. There are multiple forms of TMJ disorder treatment. Fortunately, dental specialists like Dr. Phillips have specialized knowledge of the jaw and the temporomandibular joint and can prescribe the correct treatment.

How long does it take for jaw muscles to heal? ›

If jaw pain is treated within a week, the chances of it healing successfully within four weeks is much greater. Patients who haven't been treated early have reported pain years after the initial injury. Jaw joint and muscle strain/sprain isn't uncommon but it's often underreported, misdiagnosed, and misunderstood.

What does TMJ therapy consist of? ›

Your treatment plan may consist of any combination of methods and modalities, including jaw exercises, soft tissue massage, joint mobilization, myofascial techniques, electrical stimulation, or ultrasound.

How do you rebalance your jaw? ›

Open your mouth as wide as you comfortably can, and hold for 5-10 seconds. Place the tip of your tongue on the roof of your mouth. Glide your lower jaw out as far as it will go and then back in as far as it will go. Hold for 5-10 seconds in each position.

How do I get rid of TMJ fullness in my ears? ›

What Are the Treatment Options?
  1. Eat soft-foods.
  2. Try relaxation techniques.
  3. Do TMJ stretches and exercises.
  4. Avoid chewing gum.
  5. Avoid clenching or tensing your jaw.
  6. Apply moist heat to the area.

How can I realign my jaw at home? ›

Simple Fix for One-Sided TMJ (Jaw)Pain - YouTube

Does magnesium help with TMJ? ›

Calcium and magnesium.

May help the jaw muscle relax, although there are no scientific studies using them for TMJ problems. Magnesium and calcium interact with several medications, herbs, and supplements. They can also affect your heart and blood pressure, so be sure to tell your doctor before you take them.

How can I relax my jaw at night? ›

Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax. Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

Can a chiropractor fix TMJ? ›

Licensed chiropractors adjust bones, joints, and muscles to improve function and reduce pain in their patients. One option a TMJ chiropractor can provide is to make these adjustments to help ease TMD/TMJ symptoms, including pain: Manipulate the jaw joint so it can move more easily.

How do you release TMJ trigger points? ›

TMJ Jaw Pain Massage and Trigger Point Release - YouTube

How do you massage TMJ from the inside of your mouth? ›

Intra-Oral NeuroMuscular Therapy for TMJ demonstrated by Stew Wild

What is normal range of motion for TMJ? ›

A normal opening for an adult is 53 mm to 57 mm.

Along with opening movement, an individual should be able to slide their jaw to the left and to the right at least 25 percent of their total mouth opening in a symmetrical fashion.

How is TMJ range of motion measured? ›

Measure the distance traveled. Repeat this for the right side by tapping the right side of the jaw. Fold the range of motion scale in half at the black triangle on the lateral scale. Measure the overjet, then ask the patient to move their jaw forward “like a bulldog” and measure that number.

What is the three finger test TMJ? ›

The 3 Finger Test

A quick and easy way to identify a possible case of Trismus is to place three of your fingers, stacked, between your upper and lower teeth, or dentures. If the mouth can open wide enough to accommodate them comfortably, then Trismus is unlikely to be a problem.

Can your jaw realign itself? ›

Trauma can result in your jaw being broken, fractured, or dislocated. A slight fracture will usually heal on its own. A major break in the jaw could require surgery to help the jaw heal properly. A dislocated jaw may need to be surgically stabilized.

Are you born with TMJ? ›

Even though TMJ is hereditary it's important to understand that physical irregularities that you happen to be born with can be corrected with dental treatments.

What TMJ sounds like? ›

Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it.

How is TMJ syndrome diagnosed? ›

How are TMJ disorders diagnosed?
  1. X-rays. X-rays of the jaw and teeth usually involve you biting down on a small mouthpiece as your dentist moves an imaging machine around your head. ...
  2. CT scan. A CT scan of the jaw allows your doctor to see the bones and joint tissues in a more advanced way than a regular X-ray.
  3. MRI.

What is the normal ROM of the jaw? ›

A normal opening for an adult is 53 mm to 57 mm.

Along with opening movement, an individual should be able to slide their jaw to the left and to the right at least 25 percent of their total mouth opening in a symmetrical fashion.

What is the normal range of mouth opening? ›

In studies, MMO for adults has generally been around 50 mm, with a range from 32mm to 77mm. Men can open to about 50-60, and women to 45-55mm.

Videos

1. How We Treat TMJ/TMD | Physical Therapist | Hands-On Techniques
(Rehab and Revive)
2. TMJ Physical Therapy - In Motion O.C. Physical Therapy and Fitness
(In Motion O.C. Physical Therapy and Fitness)
3. Treatment for TMJ Online Webinar
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4. Examining for TMJ Articular Dysfunction w/ NAIOMT's PT, MS, OCS, COMT, FAAOMPT
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6. APTEI: How to Assess TMJ Patients With Dr. Bahram Jam
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