Condition Guide · Brighton & Hove
Temporomandibular joint dysfunction is more common than most people realise, and more treatable than most expect. Soft tissue therapy produces excellent results.
Understanding TMJ
The temporomandibular joint (TMJ) connects the lower jaw to the skull on each side of the face, just in front of the ear. It is one of the most frequently used joints in the body, involved in chewing, speaking, yawning and swallowing. TMJ dysfunction (TMD) is a term covering a range of conditions affecting the joint, the surrounding muscles and the articular disc within the joint.
TMD is significantly more common than most people expect, affecting up to 30% of adults at some point in their lives. It is more prevalent in women and in people with high levels of psychological stress, bruxism (tooth grinding) or a history of jaw trauma. It is also frequently associated with neck pain and cervicogenic headache, reflecting the close anatomical and functional relationship between the jaw and the cervical spine.
The muscles of mastication and the upper cervical muscles share nerve supply, fascial connections and functional relationships. TMJ dysfunction and cervical spine problems frequently co-exist and mutually maintain each other. Treating the jaw in isolation while ignoring the neck, or vice versa, often produces incomplete and temporary results. A full assessment includes both.
Bruxism (teeth grinding, typically during sleep) is the most common driver of myofascial TMD. Jaw trauma, including dental procedures requiring prolonged mouth opening, direct impacts, and whiplash, can precipitate disc displacement and joint inflammation. Postural factors, particularly forward head posture and upper cervical tension, alter jaw mechanics significantly. Psychological stress increases masticatory muscle tension and bruxism frequency.
TMJ dysfunction with significant disc displacement, occlusal problems (bite misalignment) or symptoms suggesting joint degeneration warrants dental or oral surgery assessment alongside soft tissue therapy. A well-fitted night splint from a dentist significantly reduces bruxism-related loading. Soft tissue therapy and dental management work well together and are not mutually exclusive.
Recognising TMD
Pain in the jaw joint area, cheek or temple, often worse with chewing, yawning or talking. May be one or both sides.
Audible or palpable clicking, popping or grinding sounds with jaw movement. Not always painful but clinically significant.
Restricted jaw opening, sometimes with deviation to one side. Normal mouth opening is approximately 40-50mm. Restriction below 35mm is clinically significant.
Temporal headaches and pain behind the eyes are common with masticatory muscle tension. Often misdiagnosed as tension headache or migraine.
Earache, fullness in the ear, tinnitus and sometimes dizziness from the close anatomical proximity of the TMJ to the ear canal.
Upper cervical tension and suboccipital pain frequently accompany TMD, either as a contributing cause or as a consequence of altered jaw mechanics.
Treatment Approach
Soft tissue therapy produces excellent results for the myofascial component of TMD, which is the most common presentation in clinical practice.
Jaw range of motion, muscle palpation, cervical screen and history of bruxism, trauma or dental work to identify the primary drivers.
Targeted soft tissue work to the masseter, temporalis, medial and lateral pterygoid muscles, which are almost universally involved in TMD.
Highly effective for masseter and temporalis trigger points, producing rapid reduction in jaw pain, headache and muscle tension.
Assessment and treatment of the upper cervical spine and suboccipital musculature, which frequently contribute to or maintain TMD.
Gentle intra-oral and extra-oral mobilisation techniques to restore normal joint mechanics and reduce disc displacement symptoms.
Jaw awareness exercises, advice on reducing parafunctional habits and guidance on when dental referral for a night splint is appropriate.
TMJ dysfunction responds very well to soft tissue therapy. Most patients notice significant improvement within 2-4 sessions.