Monday, November 7, 2011

Jaw Pain? There is Help!

This week's guest post is by physiotherapist and yoga expert Shelly Prosko. Visit Shelly at 

Do you experience pain in your jaw? Perhaps radiating to your ear, face, neck, and even your shoulder?  Does this coincide with difficulty opening or closing your mouth while talking, chewing, laughing or yawning, or your jaw locking? You may be experiencing a dysfunction in your temporomandibular joint (TMJ). The TMJ joins the lower and upper jaws and is the joint responsible for opening and closing your mouth, as well as any side to side movement of the lower part of the jaw (which is important for chewing and articulation of speech). You have a right and left TMJ. You can actually feel the movement of the joint by palpating just in front of the ears as you open and close your mouth. There is a disc that is in between the joint that enables a smooth gliding motion. If this disc does not glide properly, you may experience clicking or popping sounds. 

Approximately 11 million people in the U.S. experience TMJ disorders at any given time, and an astonishing 90% of these people that seek treatment are women between the ages of 20-40 years old (National Institute of Dental and Craniofacial Research). There are several hypotheses as to why women suffer more from this potentially debilitating dysfunction, but overall, is widely unknown and more research is required.

There are a variety of factors that can cause TMJ disorders, and often times it is a combination of factors that need to be addressed in order for treatment to be effective.  Some of the common causes include the following:  1) Poor postural alignment. If you have habitually poor posture over time, this can greatly affect the position of your head and neck, creating chronic muscle imbalances, which in turn can affect the mobility of your TMJ.  2) Behavioural habits that create muscle tension around the jaw muscles such as grinding or clenching your teeth, excessive gum chewing or biting your nails.  A common underlying cause of poor habits can be stress related.  3) Trauma to the joint.  4) Arthritis in the joint. 5) Dental problems such as abnormal alignment of the teeth when the upper and lower jaws are brought together (malocclusion). 6) Hormonal changes.

Research suggests that estrogen levels show a link to increased TMJ disorders, particularly the intensity of the symptoms and the pain experienced (Ribeiro-Dasilva, 2009). Additionally, an important study showed that women that were on hormone replacement therapy (HRT) were 77% more likely to have jaw pain and treatment than women that were not on HRT (LeResche). That same study showed that women on oral contraceptives were 19% more likely to have treatment for jaw pain than women who were not on oral contraceptives. 

Treatment of your TMJ disorder may require more than one health care professional due to the nature of the potential causes.  Dentists, orthodontists, ear/eye/nose/throat specialists, physiotherapists, massage therapists, physicians, psychologists, and endocrinologists may be some of the professionals involved in your treatment.  It is essential to ensure your health care professional determines the cause(s) of the origin of your TMJ disorder before effective treatment can begin.  Treatment may include the following, depending on the cause: 
Addressing your postural dysfunctions by prescribing specific strengthening or stretching exercises specific to your deficits. This also includes education about your alignment and movement patterns at work, whether you sit at a desk or have a more physical job. A physiotherapist can assist you with this. 
Addressing any unhealthy behavioural habits (grinding, clenching, nail biting) can be challenging. It is helpful to look at the underlying cause, which frequently is related to stress.  Learning how to effectively manage your stress levels is important not only for your TMJ disorder and the muscle tension surrounding the joint, but is also important for many other systems of your body. Relaxation methods, breathing methods, appropriate exercise, regular yoga practise, a visit to your Yoga Therapist, or perhaps some small changes in lifestyle choices can all contribute to improving the way you handle your stress.
Physical therapy can address any TMJ instabilities, inflammation, or stiffness in the joint by manual therapy methods, electrotherapeutic modalities, and prescriptive exercises to address the specific dysfunction. A visit to your dentist is important to ensure you have a thorough assessment of your teeth/mouth alignment and to determine the need for night splints or guards or any other treatment option. Occasionally, there may be a more serious problem where you need to be referred to another specialist. Symptoms that include loss of hearing, nerve involvement, weight loss, or persisting pain and immobility despite ongoing treatment indicate a visit back to your physician for a referral to an appropriate specialist.

If you are suffering from TMJ pain, please know that there are many treatment options out there for you. Visiting the appropriate health care professional(s) will help determine the factors responsible for your TMJ disorder, therefore providing you with optimal treatment.  

About the Author

Shelly Prosko, RPT, PYT-C, CPI
Shelly is a Registered Physiotherapist, Yoga Therapist and a Certified Pilates Instructor. She received her Physiotherapy degree at the University of Saskatchewan, Canada in 1998, her Yoga Therapist training through Professional Yoga Therapy Studies in North Carolina ( and her Pilates certification through Professional Health and Fitness Institute in Maryland (

She has treated a wide variety of musculoskeletal, neurological and cardiorespiratory conditions while working in private orthopaedic clinics and long term care facilities across Canada and the United States. Shelly was the physiotherapist and clinic manager at The Morris Center For Sports Medicine in Watkinsville, Georgia for 7 years. In 2006, she relocated to Alberta and continued to work in the private orthopaedic clinic setting and was actively involved in the occupational rehabilitation programs at CBI Health.

In 2009, Shelly settled in the Okanagan and continues to follow her passions at Sun City Physiotherapy by offering private Physio-Yoga Therapy sessions and by incorporating Yoga Therapy and Pilates into her physiotherapy treatments ( She also teaches specialty Physio-Yoga Therapy classes in the community. She believes that bridging the gap between Western and Eastern healthcare philosophies is essential in order to achieve optimal health. Consequently, her treatments are individually based and are a unique blend of both approaches.

In addition to her many skills as a health care practitioner, Shelly is also an accomplished figure skater and has traveled the world with many professional ice shows. She is also passionate about music, dance, acting, trapeze, and spending quality time with her family and friends.


  1. Thanks for the great information Shelly. I think TMJ dysfunction is often not addressed as the thought is, treatment for this area is so complex. Your summary of the causes and treatment approaches smoothly puts forward how to go about addressing TMJ dysfunction. Really, it's like any other joint we would assess and treat in the body. I will be sure to pass this education on forward to my clients suffering from jaw pain.

    Terri Baldwin,

  2. Thanks for your informative comment Terri! Are you a PT or other health care provider? We would love to be able to write more articles that would help your client base. Thanks again for stopping into BITL and for referring your clients to my blog.
    Ginger Garner

  3. Thanks Terri. I'm glad you found this article on TMJ dysfunctions valuable and will share with your clients. BITL consistenly posts great articles on a wide variety of topics; hopefully you will continue to find them useful for yourself and your clients!
    Shelly Prosko

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