Best TMJ Exercises for Jaw Pain Relief

Teeth grinding, clenching and having constant contact between the upper and lower teeth — all these put stress on the…

Teeth grinding, clenching and having constant contact between the upper and lower teeth — all these put stress on the temporomandibular joints, often referred to as TMJ. These are the two joints that connect your jaw to your skull. Excessive chewing, continual gum-chomping, even hours of sitting slumped over a screen can also contribute to TMJ pain.

Jaw discomfort and tightness, facial pain, headaches, earaches and neck stiffness are all possible symptoms. Stress itself plays into TMJ problems, and these days, stress is hard to avoid.

“People are stressed out emotionally, mentally and physically,” says Dr. Nitinkumar Patel, an otolaryngologist and surgeon who specializes in head and neck surgery, practicing in Mid Atlantic Permanente Medical Group’s Falls Church, Virginia, office. “That stress translates to a lot of tension when we’re sleeping or when we’re trying to sleep. That’s where I find most of the TMJ pain comes from that clenching or grinding of the teeth at night, which can be related to those external stressors.”

Not surprisingly, he’s seeing more of these patients with the ongoing COVID-19 pandemic.

Temporomandibular joint and muscle disorders are the most common cause of facial pain, affecting 5% to 12% of the population, according to the National Institute of Dental and Craniofacial Research. About one-half to two-thirds of those with TMJ disorders seek treatment, and of those, about 15% will develop chronic conditions.

Your ENT or otolaryngology doctor, dentist, physical therapist or other specialist may recommend jaw and other exercises as part of your TMJ pain management plan. Here’s how it works.

[SEE: How to Describe Medical Symptoms to Your Doctor.]

Joint anatomy

The TMJ is a busy, complex joint. You have two TMJs, each located in front of the ear at the point where your lower jaw, or mandible, connects to the temporal bone at the side of your head. The TMJ is both a hinge and sliding joint, and it includes a small disk that acts as a shock absorber.

The following key muscles connect to the TMJ:

masseter The most powerful jaw muscle in mastication, or chewing, the masseter lifts your jaw and closes your mouth.

Pterygoid muscles. The lateral and medial pterygoids are involved in jaw-lifting, mouth-closing and sliding your jaw forward or from side to side.

temporalis muscle. The temporalis, which runs from the temporal bone at each side of the head to the bony part of the lower jaw, is a chewing muscle involved in crushing and grinding.

Your TMJs are involved in many repetitive daily functions. Every time you open or close your mouth, chew, talk or yawn, the TMJ is active.

TMJ Pain: A Joint Disruption

When the TMJ disk erodes, or joint cartilage is damaged by arthritis or trauma, pain can arise. Dental problems like an incorrect bite can play into TMJ pain, as well. And because the TMJ muscles, nerves and bones have connections with other parts of the face and body, TMJ problems may have wide-ranging causes and effects.

When your TMJs aren’t working properly, a temporomandibular disorder can result Although sometimes used interchangeably, TMJ and TMD have different meanings, explains Dr. Karyn Kahn, a general dentist whose primary focus is conservative management of temporomandibular disorders with the Cleveland Clinic.

TMD refers to a variety of disorders involving the jaw muscles, temporomandibular joints and nerves that are related to chronic facial pain. For example, a dislocated jaw, displaced disc or degenerative rheumatoid arthritis in the jaw joint would all be classified as types of TMD, whereas TMJ refers to the specific joint.

TMJ-related symptoms can take several forms:

Pain while chewing. When your jaw is rigid and tight, you feel discomfort with every bite you take.

Tell tale sounds. Clicking, grating or popping sounds (possibly caused by injury) may emanate from your jaw as it moves.

Facial ache or pain. With the central facial location of the joint, pain can easily spread across your face.

Ear pain. Ear pain is a pretty common symptom, says Patel, who explains how nerves around the TMJ affect the nerves in and around the ear, and down the neck, so they can manifest pain anywhere in those general regions.

Headaches. Morning headaches can result from clenching or grinding your teeth at night, or from having misaligned teeth and an uneven bite, which places stress on the jaw. Tension headaches occur in as much as 70% of people with TMJ disorders, according to a December 2020 study.

Neck and shoulder pain. When your jaw bone isn’t closing properly, the surrounding tissue can suffer from pain, swelling and chronic stress. The jaw muscles play a role in maintaining proper head posture and also connect to muscles in your neck that are involved in spinal alignment. Unexplained neck, shoulder pain or even back pain may be related to a TMJ disorder.

Tinnitus ringing in the ears. This can be associated with TMJ issues.

[See: On a Scale From 1 to 10: Most Painful Medical Conditions.]

Early Remedies for TMJ

Patel recommends several initial techniques to rest and relieve the overworked joint. Following a soft diet for about two weeks helps. Pain management with Tylenol or ibuprofen is an option.

“Warm compresses over the joint area help a lot,” he says. “If there’s a history of grinding the teeth or clenching at night, what a spouse or partner says they do, we typically refer them to our dental colleagues, and sometimes we can have them get a mouth guard.”

Targeted exercises and physical therapy can have a big impact. “It’s unclear exactly how it helps relieve the pain, but we do know that exercises help strengthen the jaw muscles,” Patel explains. “They stretch the jaw to relax it, they increase mobility and they can reduce the clicking sounds (patients) may have.”

Gentle jaw-opening exercises help stretch the masseter and medial pterygoid muscles, Kahn says. “That’s particularly helpful in patients who grind and clench their teeth, because those are the elevator muscles, the closing muscles,” she explains. “They get hypercontracted and have to be stretched. That’s the goal of physical therapy and jaw exercises. It’s to help get the tight jaw muscles back to their resting length.”

Exercises for TMJ Pain

Experts often recommend these jaw and facial exercises:

Relaxed jaw exercise. Rest your tongue on the roof of your mouth, behind your upper teeth. “Then, let your teeth come apart and relax your lower jaw,” Patel says. As your lower jaw pulls downward, your upper and lower teeth will fall apart.

Goldfish (partial). Put your tongue on the roof of your mouth.Put one finger on the TMJ (area) where your pain is located and the other finger underneath where your lower lip and chin meet,” Patel says. “Then, lower your jaw halfway, and close it.”

Goldfish (full). Again, with your tongue on the roof of your mouth, place one finger on your TMJ and the other on your chin. Drop the lower jaw so your mouth fully opens, and then close it.

Chin tucks. First, stand with your shoulders back and your chest up. “Then you pull your chin straight back, sort of creating a double chin,” Patel says. “Hold that for three seconds or so and repeat it a few times.”

Side to side jaw movement. Put a pen or similar object between your front top and bottom teeth. “Some people use a tongue blade or tongue depressor,” Patel says. “You just hold the object there and roll it from your teeth from side to side” in a left to right motion.

Forward jaw movement. Again, hold an object in your mouth between your teeth. Move your lower jaw forward and back, instead of left to right.

Resisted mouth opening. Place your thumb under your chin. “Open your mouth slowly, pushing against your chin,” Patel says. “Hold it there for three to five seconds, and then close your mouth slowly.

Resisted mouth closing. Squeeze your chin with your thumb or index finger. “Try to close your mouth while applying downward pressure on your chin, and resist upward closing of your mouth,” Patel says.

Lateral pterygoid exercises. To target this chewing muscle, which can be affected by grinding teeth, open your jaw an inch or so. Slowly move your jaw from the left to the right, side to side, keeping it only slightly open.

Like resistance workouts at the gym, these exercises are done with repetitions. “We typically recommend sets of these exercises,” Patel says. “Everyone varies in how they do it.” Some people experience relief within a few weeks, although they don’t work for everyone.

Body wide exercises

Posture affects how the TMJ functions, making neck-stretching exercises useful for patients. “That’s because cervical muscles have quite a bit of influence on the masticatory muscles — the jaw muscles,” Kahn says. “So, if we can correct their posture — everything from sleep posture to their computer posture — it helps relieve some of the tensive (stretching or straining) forces on the jaw muscle.”

Postural and body-wide exercises include:

Neck muscle stretch. Standing straight, cross your arms on your chest. Gently stretch your neck from side to side, and then stretch it front to back.

Postural straightening. While walking, pretend you have a book on your head. This reduces slouching and pushes back your shoulders and to put your neck and spine in line.

Sitting straight up. Press your back against the back of your chair while sitting. This supports your back and helps you maintain a correct posture as you avoid sitting hunched forward, for instance when focusing on your computer screen.

Relaxation, stretching and mindfulness practices. Yoga, tai chi or meditation may help alleviate overall stress and muscle tension. Anything to relax the face can be helpful, Patel says.

[SEE: Mindfulness Exercises to Reduce Stress or Anxiety.]

Evaluating TMJ Pain

Exercises, meditation, over-the-counter medicine and self-care measures like warm joint compresses can do a lot to ease TMJ pain, but these aren’t always enough. You may need a clinical evaluation to get to the root of the problem and develop a treatment plan.

“We look beyond just the temporomandibular joints,” Kahn says. “I evaluate the jaw and neck muscles. I also look to see the occlusion, the bite and to see if there is grinding or clenching contributing to the disorders. So, in one appointment we come up with what I would call a working diagnosis and (initiate) the use of conservative treatment.”

Physical therapy is an important treatment component. In addition, Kahn says, an occlusal guard or splint — otherwise known as a night guard — is oftentimes part of therapy. Dentists custom-mold these appliances to meet patients’ individual needs, using different designs.

“I call mine a stabilization splint,” she says. “It helps stabilize the position of the temporomandibular joints, the muscles of the jaw and how the teeth occlude on the splint, so we can put everything in harmony.”

Awareness is essential, Kahn emphasizes. “It’s very important to educate the patient to attempt to recognize all the aggravating factors — whether it be computer posture, clenching during the day, gum-chewing, cheek-biting — all these little things that are using their jaw muscles as they’re not designed to be used. So, education is a very important part of conservative management.”

Patel urges patience. “Having facial pain in the ear, the face, the neck — it’s debilitating,” he says. “It can be quite frustrating. See an experienced medical doctor or surgical provider. And just be patient with the treatment course. It’s not a one-size-fits-all. There will be many medical, nonmedical, surgical techniques to help with TMJ pain and it’s just finding the right ones that work.”

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Best TMJ Exercises for Jaw Pain Relief originally appeared on usnews.com

Update 06/16/22: This story was previously published at an earlier date and has been updated with new information.

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