Your temporomandibular joints (TMJs) are small but powerful. They allow facial movements so that you can speak, chew, and express emotions. When these joints are not working well, daily activities can become unbearable. Pain associated with Temporomandibular Joint Disorder (TMD) can persist in your jaw, head, and even neck. Fortunately, a non-invasive solution (physical therapy) alleviates TMD symptoms and restores TMJ function.

TMD is a condition we at Suarez Physical Therapy in Las Vegas can treat through personalized physiotherapy plans to help you reclaim your life quality. We use a combination of education, therapeutic exercises, and personalized care to address your pain at its source.

What Are Temporomandibular Joints (TMJs)?

If you have seen a marionette's jaw, you will have an idea of how TMJs work. TMJ's work is the same, although in a more complicated way. Your mandible, or lower jaw, is connected to your skull's temporal bones just in front of each ear by these bilateral joints. The anatomical arrangement allows these basic tasks to be performed without interruption, including speaking, chewing, and yawning.

A TMJ is a complex structure consisting of many parts. The rounded protrusion at the end of your lower jaw, the mandibular condyle, fits into the mandibular fossa, a depression in the temporal bone. The space between these bony surfaces is filled with the articular disc, a biconcave, fibrocartilaginous cushion that serves as a shock absorber and helps with smooth movement.

This disc divides the joint into two distinct compartments:

  1. The upper compartment allows for translational movement (forward sliding of the jaw)

  2. The lower compartment allows for rotational movement (opening and closing of the mouth)

It is a fibrous capsule lined with a synovial membrane and secretes synovial fluid. This fluid lubricates the joint to reduce friction during movement. Additional support and limitation of excessive movements that could damage the joint are given by ligaments such as:

  • The lateral (temporomandibular) ligament

  • Sphenomandibular ligament

  • Stylomandibular ligament

The muscles of mastication, such as the masseter, temporalis, and pterygoid muscles, coordinate the movements of the TMJ. These muscles work together to do things like close your mouth or do complex things like grinding food.

What Temporomandibular Joint Disorder Means

Temporomandibular Joint Disorder includes a wide range of conditions affecting jaw joints, muscles, and ligaments. These disorders can affect the harmonious function of your jaw and cause you discomfort and impaired movement. The National Institute of Dental and Craniofacial Research estimates that TMD affects between 5 and 12 percent of the population, with women and younger people more likely to have it.

Myofascial Pain

Myofascial pain involves discomfort or pain in the fascia (the connective tissue covering the muscles) and the muscles that control the jaw, neck, and shoulder. Often the cause of this condition is oral parafunctional habits such as clenching or bruxism (teeth grinding), which may be related to psychological factors such as stress, anxiety, or depression.

Internal Derangement of the Joint

Internal derangement is the mechanical disruption of the TMJ. This disruption can include:

  • A dislocated jaw

  • A displaced disc—the cartilage cushion between the top of the jawbone and the skull

  • An injury to the condyle—the rounded end of the jawbone that articulates with the temporal skull bone

Derangements of such a kind can impede smooth jaw movement and produce pain and functional limitations.

Degenerative joint disease

In degenerative joint disease, also called osteoarthritis, cartilage breaks down within the TMJ. Wear and tear of this cartilage causes bone-on-bone contact and pain, inflammation, and restricted jaw movement. The factors that contribute to this degeneration are age, trauma to the jaw joint, or other joint disease.

How Does Temporomandibular Joint Disorder Feel?

Temporomandibular joint disorder symptoms can range from mild to severe with a wide range of duration. The disorder can make you feel uncomfortable, disrupting your normal routine and quality of life. The signs and symptoms of TMD go beyond the jaw and affect areas of your head, neck, and face, according to information from the National Center for Biotechnology Information.

You may have pain or tenderness near the temporomandibular joints, which might feel like a dull ache or sharp sting when you chew, speak, or yawn. These movements may be accompanied by clicking, popping, or grating sounds, although not everyone with TMD will have discomfort from these sounds. You may find in some cases that you cannot fully open your mouth because it feels like your jaw is stuck or misaligned. It is even a challenge to do simple things like eat or speak.

TMD can cause secondary symptoms that sometimes seem unrelated to localized pain. Common are persistent headaches, especially of a tension-type. You may also get earaches or feel like your ears are full, sometimes mistaken for an ear infection. The condition can also make some people dizzy and feel as if they are unbalanced. The discomfort doesn’t always stay in your face; it can spread to your neck and shoulders, making its way down your upper body in a chain of tension.

What Causes TMD?

The temporomandibular joint disorder is often caused by a combination of factors rather than a single identifiable cause. The National Institute of Dental and Craniofacial Research says some TMDs are caused by injury to the jaw or temporomandibular joint, but in most cases, the cause is unknown.

Excessive strain on the jaw joints and the muscle group controlling chewing, swallowing, and speech is one of the main reasons for TMD. Bruxism, the involuntary clenching or grinding of the teeth, may cause this strain, which is frequently due to stress. Repeated motions in the same way over time can wear down the muscles and ligaments, making them swollen and painful.

The development of TMD is also due to trauma to the jaw, head, or neck. Accidents or impacts can cause injury to the temporomandibular joint and disrupt the delicate balance, which can lead to misalignment or damage, pain, and restricted movement.

The temporomandibular joint can be affected by arthritis, including both osteoarthritis and rheumatoid arthritis, which can cause degeneration of the joint’s cartilage and contribute to TMD symptoms. Research shows recently that there are several genes, psychological problems, and life stressors, and how someone views pain may be involved in why a TMD starts and whether it will be chronic.

How Temporomandibular Joint Disorder Is Diagnosed

To diagnose TMD, your health history is evaluated, you are physically examined, and imaging tests are used as needed.

Health History

Your physician will ask about your symptoms. They will ask:

  • How long you have experienced pain

  • Whether you hear clicking or popping sounds when you move your jaw

  • If you have trouble chewing or talking

  • If the pain radiates to your ears, neck, or shoulders

These give you a timeline of your symptoms and help to identify patterns that could suggest underlying causes.

Prior jaw injuries, arthritis, or chronic pain conditions are often associated with TMD, and your provider may ask about them. Even seemingly unrelated factors, including frequent headaches, stress, or a history of teeth grinding (bruxism), have a big impact on narrowing down potential causes.

Another key area of focus is dental history. Past orthodontic treatments, misaligned teeth, or problems with previous dental work might give a clue as to what is triggering the pain.

Physical Exam

Your physiotherapist will review your health history and then do a thorough physical examination to determine the source of your discomfort. This step is hands-on and allows the clinician to assess your jaw’s movement, muscle, and function.

The physical therapist may ask you to open and close your mouth slowly to see how much range of motion is in your jaw. It may indicate a problem with the temporomandibular joint or its surrounding structures if the movement is restricted or uneven.

Your doctor will also gently palpate the area around your jaw, cheeks, and temples. The purpose of this examination is to find tenderness, swelling, or abnormal muscle tone. These maneuvers will help if you experience pain or discomfort while performing them.

The provider may also place their fingers on your jaw joints gently as you move your mouth, looking for clicking, popping, or grating sensations that may mean something is not working the way it should or even that the joint is inflamed.

Imaging Tests

Imaging tests are used in diagnosing TMDs by providing a detailed view of the TMJ and surrounding structures. These advanced tools reveal what a physical examination and health history cannot.

Imaging tests provide clarity about:

  • Possible joint abnormalities

  • Bone damage

  • Soft tissue problems

  • X-Rays

The first imaging test used to evaluate TMD is often an X-ray. They give you a basic view of the temporomandibular joint and jawbone. In this test, the machine takes images of the bones, showing fractures, misalignments, or signs of arthritis. The X-ray can help pinpoint concerns if the joint looks uneven or if the bones look degenerated.

  • CT Scan

Your physician may recommend a CT scan for a more detailed and 3D view of your TMJ. This test uses several X-ray images to create a cross-sectional view of the TMJ and surrounding bones. CT scans show fractures, bone degeneration, or structural deformities that might not be seen on standard X-rays. This test can help with a more precise diagnosis and design of treatment.

  • MRI

Magnetic resonance imaging (MRI) offers an unmatched view of your TMJ soft tissues, including the articular disc and ligaments. An MRI can confirm if your provider suspects a dislocated disc, inflammation, or damage to the soft tissues.

MRIs use powerful magnetic and radio waves rather than radiation, like X-rays and CT scans. Therefore, MRIs are useful for detecting soft tissue conditions. This test can tell if your articular disc is in the correct position or if your pain and restricted jaw movement are due to abnormalities.

How a Physical Therapist Helps

Physical therapy can help with relief and recovery if suffering from temporomandibular joint disorder (TMD). Your physical therapist will combine education, manual techniques, therapeutic exercises, and stress management to tailor your care to your particular condition.

Education

Your physical therapist will explain how the temporomandibular joint works and what causes your symptoms. They may discuss how the joint’s interplay with the muscles, ligaments, and bones that surround it can be out of whack and result in dysfunction when it is misaligned or overused.

Habits such as clenching your jaw, grinding your teeth, or poor posture at work or during sleep are all part of education. Your therapist identifies these behaviors so you can learn to recognize and change them, lessening the strain on your jaw. For example, you might find out that slouching can put pressure on the joint while standing up straight can take pressure off.

In addition, therapists recommend lifestyle changes, for example, dietary changes to avoid hard or chewy foods that can make the joint worse. Education teaches you what caused your condition and what you can do to fix it.

Modalities

Physical therapists use several modalities to alleviate the pain and inflammation of TMD. The techniques include immediate relief and the groundwork for long-term healing. Every modality is chosen carefully to address your particular symptoms and level of severity.

  1. Heat or Cold Therapy. Tight muscles relax from the heat, and the blood flow to the jaw increases, which can help heal inflamed tissues. However, cold therapy works on the contrary, in that it numbs the affected area and constricts the blood vessels to reduce acute pain and swelling. Your therapist will alternate between the two during treatment.

  1. Ultrasound Therapy. Physiotherapists use sound waves to penetrate deep into tissues to reduce inflammation and promote cellular repair. The vibrations are gentle enough to stimulate blood circulation and relax the muscles surrounding the TMJ, which can relieve the tension causing your discomfort.

  1. TENS, Electrical Stimulation. Mild electrical currents are delivered to the jaw area through transcutaneous electrical nerve stimulation (TENS) to disrupt pain signals moving to the brain and release endorphins, your body’s natural painkillers.

Soft-Tissue Release

In physical therapy, soft tissue release techniques work on the muscles, tendons, and ligaments that surround the temporomandibular joint, which are often tense or inflamed. Soft-tissue release fixes these underlying issues to restore mobility to your jaw.

Your therapist may start with manual techniques, which involve sustained pressure on specific areas of tight muscle or trigger points. Sometimes called myofascial release, this approach loosens muscles to encourage blood flow and reduce pain.

For example, the masseter muscle (the big muscle you use for chewing) can become hyperactive from stress or misalignment and cause a lot of pain. This area can be massaged, and you will see immediate relief.

Stretching and elongating tight muscles is another good way. Your therapist may help you through gentle stretches that stretch overworked tissues, relieve stiffness, and improve the range of motion in your jaw. Stretching helps ease discomfort and avoid the buildup of tension that can make your symptoms worse as time goes by.

Manual therapy may be complemented by instrument-assisted techniques. Your therapist can use specialized tools to reach deeper layers of tissue, where adhesions or scar tissue may be present. Precision is also possible with these tools, and they can speed up your recovery by breaking down fibrous restrictions in the muscles and fascia.

Joint Mobilization

Joint mobilization is a specific, hands-on technique to restore the normal movement of the TMJ. If this joint becomes restricted or misaligned, it can cause pain, stiffness, and trouble with even basic activities like speaking or chewing. These impairments can be directly addressed through joint mobilization—a skill performed by a skilled physical therapist.

Your therapist will gently move your TMJ to improve its alignment and increase mobility. These movements are slow, controlled, specific, and often aimed at the fine articulations of the joint itself. Joint mobilization is different from forceful adjustments because it uses subtle oscillations to help return proper function without causing discomfort.

One of the common techniques is to guide the mandible through some controlled motions to help improve the joint's ability to glide and rotate smoothly. The goal of these mobilizations is to release mechanical restrictions, such as joint adhesions or minor dislocations, that would otherwise allow dysfunction to persist. This therapy improves mobility, reducing pain, and also improving the coordination between the jaw and surrounding muscles.

Therapeutic Exercises

Unlike passive treatments, therapeutic exercises allow you to be an active participant in your recovery and to achieve sustainable long-term relief.

Your physical therapist will create a personalized exercise program designed to deal with your particular demands and symptoms. These exercises often involve stretching and strengthening techniques aimed at correcting jaw posture and improving muscle coordination. One example is controlled jaw movements to improve range of motion. This can be opening and closing your mouth gently or sliding your jaw side to side, but keeping the teeth in proper alignment.

Targeting the muscles around the TMJ are the masseter and temporalis muscles that are strengthened by exercises. Stabilizing the joint is what these exercises work to do, reducing excessive strain and preventing recurring issues. They help over time to build resilience against daily stressors, such as chewing, speaking, or grinding your teeth.

Relaxation-focused exercises are also often done to relax the jaw and surrounding areas in addition to the core activities. One of the root causes of TMJ discomfort is overactive muscles, and by learning to consciously relax overactive muscles, you can address one of the root causes of TMJ discomfort. Diaphragmatic breathing or gentle massage to relax the jaw and neck could be included in these relaxation techniques.

Find a Physiotherapist Near Me

The temporomandibular joint disorder can make your life miserable with chronic pain and discomfort. However, physical therapy can address the root causes of your symptoms through targeted interventions such as joint mobilization, therapeutic exercises, and stress management. These interventions restore balance to your jaw and improve your overall well-being.

With a skilled physiotherapist, you receive personalized care, helping you treat your condition and achieve long-lasting results. At Suarez Physical Therapy in Las Vegas, we work with evidence-based and personalized TMD treatments. Call us today at 702-368-6778 to schedule your consultation.