If you’re reading this blog I’m guessing you’ve experienced jaw pain before or are currently experiencing it right now and you want to know how to get rid of it! Well, you’ve come to the right place. As a chiropractor serving the Orange County area for over 2 decades, I see many patients who experience jaw pain and at times they don’t even think it is related to what they are at my office for. There is more to your jaw pain than the pain in the jaw!
In this blog I will go over:
- Why Jaw Pain Occurs and What Causes Jaw Pain
- Jaw Pain and Ergonomics
- Dental Procedures and Jaw Pain
- Can Jaw Pain Cause Headaches
- Jaw Pain Relief and TMJ Treatment
- Jaw Pain Exercises
Why Does Jaw Pain Occur?
What if your jaw pain is not caused by your jaw or is not actually a jaw issue? It’s important to always remember that the area of complaint is not always the main source of the pain. This is especially important in diagnosing and treating musculoskeletal issues.
So if your jaw is not causing your pain, then what is? As a chiropractor with a focus on postural neurology and functional movement, in the absence of ‘trauma’ and yes, dental work falls under that category, jaw pain and head tilt go hand in hand and are a sign of overstimulation of a specific portion of the brain! But this is not the only cause!
Jaw and Related area Anatomy
To fully understand why jaw pain occurs and how to treat it, it helps to know a little bit of the anatomy involved. I promise not to get too technical!
The first term that you’re probably already familiar with is Temporomandibular Joint or TMJ for short. This is the joint where your lower jaw bone (mandible) meets your skull (temporal bone) and is the moving joint every time you open and close your mouth.
This joint is surrounded by many muscles but the main ones involved in jaw pain include:
- Masseter
- Buccinator
Buccinator (Right)
Superficial Masseter (Right)
Moving past the jaw structure you have all the musculature of the neck! Imbalance of the neck musculature plays a huge role in jaw pain or TMJ dysfunction. The SCM or Sternocleidomastoid specifically is the main contributor given its role in laterally flexing the head and neck. If this muscle is too tight and becomes shortened on one side more than the other this creates an imbalance in the neck and how the head sits on top of the neck which will impact the balanced function of the jaw.
Sternocleidomastoid (SCM)
Living in a society that is so taken over by digital devices jaw pain is much more common because, with the increased use of computers, laptops, tablets, and phones come compromised posture! A simple overlook of the computer screen and your body, let’s say looking slightly to the right because that is where your laptop or one of your two monitors are, over time creates an imbalance and over contraction of your right SCM, that means that your head even in a neutral position will be slightly rotated to the right; the attachment of SCM in this example will be continuously pulled and this attachment happens to be your temporomandibular joint!
There are far too many imbalances that lead to many musculo-skeletal (meaning muscles, joints, and bones) issues that result from sitting behind a desk that I will spare you of the details. Your ergonomics, therefore, is a huge contributory factor that most people don’t think about when it comes to their jaw pain.
How Can Bad Ergonomics Cause Jaw Pain?
Ergonomics is optimizing the office work set-up in a way that minimizes postural decline and stimulates your brain in a positive way. With jaw issues stemming from postural deviations in the head and neck, and bad ergonomics directly resulting in these deviations, addressing this lifestyle factor is very important. If your work involves sitting behind a desk, working on a computer, phone, tablet, or laptop every day then check out this blog on Ergonomics and How It Can Be Contributing to Your Pain.
You can’t help that this is what your job requires, and making the Ergonomic changes is not going to make your jaw pain go away, but it is necessary to prevent further postural decline and works in conjunction with the treatment you receive rather than against it. Use this checklist to see how well you are doing ergonomically speaking.
Dental Procedures and Jaw Pain
The connection between lengthy dental procedures and jaw pain should be obvious. In the previous sections we talk about how proper alignment of the jaw, head, and neck are important and if misaligned can lead to jaw issues.
When going through dental procedures, clearly your mouth is open and many times, the procedure is more than a few minutes. When anesthetics are given to numb the area, the discomfort of your mouth being open too long, even shifting the jaw to clear room for the dentist and the dental tools, as an example is dampened.
It is hours later or even the next day that your jaw and face may be painful. At times it is not painful unless you touch it. Clearly, the shifted jaw, the lengthy opening of the mouth, all and all are the reasons for the surrounding muscles and ligaments to be impacted. When you go back to normal, this imbalanced activation (involuntary or voluntary) of the soft tissue becomes the reason for creating TMJ dysfunction.
This is not to say that dental procedures cause jaw issues but they are definitely contributors. I personally avoid numbing injections but that is not for everyone. I have noticed when it is not avoidable, I am sore for a week or more but I work the muscles of the area gently and cautiously go through opening and closing of the mouth, positioning my hands over the TMJ, close to the ear, and cautiously resume the normal function of the area. I always make sure I am well adjusted in the neck before and after all dental procedures.
Can Jaw Pain Cause Headaches?
By the time a patient comes to see me, it’s because the headaches have gotten so bad that they finally decided to do something about it. For every patient I treat for headaches, I will always evaluate for jaw issues, and what I have found is that almost everyone with headaches also has jaw dysfunction if not pain!
Most headaches are cervicogenic or stem from neck issues and as you know, our lifestyle and ergonomics play a huge role there. As previously mentioned, your posture plays a role in the muscle tension balance (or lack of) and with certain muscles directly connected to the TMJ, opening and closing of the jaw in talking and eating for instance, play its role in pain creation.
The jaw pain may not necessarily be the cause of the headaches but the two go hand in hand and both are directly related to postural deficiencies. If you are looking for some headache specific content check out this blog on Why Headaches Occur and When to Seek Treatment.
Jaw Selfcare Treatment
While there may be injections, dental devices, and pain medicines to ‘treat’ jaw pain, none of them address the cause of this pain. To address any pain, we first need to understand what caused it (hopefully this can be pinpointed) so we can stop doing the wrong thing, then address the damage that is done and going forward, be alert and aware of the recuperation time which is more than getting out of pain and what caused the issue so we don’t do it again by habit!
The self-care treatment should include:
- Ergonomics as discussed above
- Limit digital device use and modify how you use them
- Self massage the area over the cheekbones regularly and on both sides as well as below the lower jaw close to the ear
- Get neck manipulation and/or mobilization before and after dental visits (cleaning or not)
What Doctor Treats Jaw Pain?
“Playing’ with the jaw to treat it should not be handled by anyone!! This is a small joint with not much room for error- in other words, if the person does not know what she is doing, it can get ‘dirty’ real fast!
Dentists and Chiropractors have always worked close to deal with TMJ issues and the doctor to see when there is a dysfunction at this intricate joint is in fact, your chiropractor. Chiropractors don’t adjust the TM joint. The adjustment or spinal manipulation is done to the neck (you should understand now why neck alignment and its muscles and ligaments are so important in the health of the TMJ) and mobilize the jaw joint instead.
There is a misunderstanding of what adjustments do! Adjustments don’t set your bones!! They stimulate the nervous system, the very system that controls EVERY function of your body. They work because the ‘master coordinator’ becomes alerted and what happens after that matters greatly.
Adjustments help but the ‘message’ that is focused on after the nervous system stimulation better be profound and on target. This message always, regardless of the problem being jaw pain or anything else, has to be in terms of postural neurology and functional movement when it comes to musculoskeletal and postural issues. I will get into it a little bit later but make sure you pause and read on those two very important topics now because chances are if you have jaw pain and TMJ dysfunction you have other issues that should be addressed now and before it is too late.
Mobilization of the jaw joint is done through the principles of Active Release Technique or ART. You can read more about ART and watch a video of this treatment done on a patient below:
Chiropractic Adjustment is an important contributor to the treatment of every musculoskeletal issue; not because it pops all your joints into place, but because it stimulates the nervous system.
This is valuable because stimulating the nervous system is like a teacher walking into a classroom and saying, “ Okay everyone, listen up!”. The students get quiet, sit up straight, anxiously listening, but if what comes next is not stimulating, the attention goes elsewhere. This is why what comes after the adjustment is crucial.
Let’s digress a little bit but I promise you understanding what I am about to share is so important in the long-term solution of not only your jaw issue but all of your movement, posture, and musculoskeletal problems.
There is a map of your movement and sensation in your brain that you are born with; this is called Homunculus. This map gets fine-tuned with details as we go through the developmental stages from birth to about 2 years of age. As we get older, the map gets modified based on our habits, lifestyles, and injuries for example.
During this time, the neurological tracks related to movement get established and finely tuned as well. Thankfully we have tests that identify what YOUR map looks like and when compared to what the actual map is supposed to look like (and frankly the first 2-4 years of age was at its ideal stage), we can see what areas need some attention.
For instance, when you sit behind the computer, the part of the brain that says upright against gravity, called PMRF (Ponto-medullary-reticular-formation) does not get to do its part because this lifestyle encourages slouching rather than sitting upright. Exercises like, praise the Sun, seen in the video below, will positively stimulate the PMRF to get that part of the brain back in the ‘picture’.
Enabling the neurology is one of the two main steps toward correction after the adjustment and/or mobilization. Functional Movement such as Dynamic Neuromuscular Stabilization or DNS assures not only the body part moves as per its design but it also moves in harmony with the rest of the body.
If babies all over the world move the same way from birth to 2 years of age, then we must be born with that as our blueprint for movement. If we have issues related to movement and posture, the answer lies in the discrepancy that is developed for whatever reason between that blueprint and how we move now.
As a chiropractor specializing in Postural Neurology and Functional Movement, all that needs to happen is to see what the neurology behind your movement is and where the dysfunction happens. Then we just go in and fix what is not right. It is as simple as that. Here is a video of a patient’s take on his treatment. You can jump to 3:35 if you don’t want to watch the beginning (though I would).
…and here is an example of exercises we did on the same patient who had a history of neck pain. You will notice the exercise seems to be that of the shoulder joint but all shoulder joint issues have a neck component and while the ‘spotlight’ is on the shoulder joint, in this exercise, similar to a concert, all the other body parts have to perform their role properly just as in a concert, there are other musicians that still play their part while the spotlight is on the let’s say the pianist!
Exercises for Jaw Pain
Now that you understand the principles of Postural Neurology and Functional Movement, I can tell you that for jaw issues, the immediate areas that require attention are not just the jaw and face muscles but the neighboring areas. They are neck, shoulder, upper back, arm, and shoulder blades. I suggest you visit my youtube channel and under the playlist with each of these areas labeled, start your own exercise series. The channel has over 400 videos with the hopes that the general public start effective exercises instead of wasting time getting injured!
Here’s another example of one of these exercises that stretch the tight muscles and strengthen the weak while addressing the body functions in movement as a whole:
The exercise above specifically addresses the posture of the head and neck which is important in treating jaw pain. As you can see, no bands and no weights yet it’s challenging for most of my patients, even those that would consider themselves relatively fit. This is because we are requiring the right muscles to do the job and not allow any helpers to assist. This happens to be what we all did when we were 3 months old btw!!
TMJ pain and joint dysfunction is a result of dysfunctional movement, which results from lifestyle and injuries for instance. The dysfunction manifests itself as tight, short, weak muscles, and over/under firing of muscles with movement. The sequence of muscle firing (which we innately do vs think about) changes based on what is available to perform the job.
In order to correct the ‘malfunction’ is to ‘speak’ the language that the body understands and is programmed with which is what Functional Movement, Dynamic Neuromuscular Stabilization is. If the correct patterns of movement are missing, putting the weak muscle through resistive exercise or isolating it to stretch does NOT fix the problem. This is why so many treatments fail.
Muscles can become weak under multiple conditions:
- When a muscle is overactive it becomes shortened and tight which results not only in tension but also in weakness. The muscle is exhausted from working overtime.
- When a muscle becomes overly stretched it loses its elasticity, kind of like a rubber band, and becomes weak.
- When a muscle is ‘bypassed’ or does not get to use its ability partly because of the modification in how a movement occurs; its lack of work makes it deconditioned and weak.
Most people see muscle weakness as a strength issue rather than a functional issue and they add bands and weights not realizing they are doing more harm than good.
Don’t Live With Jaw Pain
The biggest obstacle is going to be to find someone that can help you do the right thing instead of the generic solution. If those solutions worked, people would not continue having problems. The solution is never short and easy but what are your other options?
I hope this blog has given you some insight into your own jaw issues and hope for the effective treatment you are looking for. If you have any questions make sure to contact me