TMD AND HEADACHES
Temporomandibular Joint Dysfunction (TMD) is a condition that occurs as a result of dysfunction in the jaw joint, the disc sitting within the joint, and/or the surrounding muscles that control jaw movement. Other contributing factors include poor posture, restriction of your neck, trauma/whiplash, clenching or grinding, poor stress management, and poor jaw habits such as nail biting and chewing on pencils. Dysfunction of the TMJ can result in limitations such as pain or difficulty with eating, yawning, talking, swallowing, and sleeping. It can also impact your ability to perform your normal daily, work or house activities due to pain or difficulty concentrating.
Common Symptoms
- Jaw or cheek pain
- Tooth pain or sensitivity
- Limited jaw movement
- Locking or popping of jaw
- Pain when chewing
- Neck pain or stiffness
- Ear ringing, pain or fullness
- Difficulty or pain with swallowing
Another common symptom related to TMD are headaches. Headaches can have many causes; however, common reasons are either muscle tightness, restricted movement of the neck, and/or poor posture. Although not all headaches are related to TMD, many individuals with TMD complain of headaches located along the forehead, behind eyes, temples, or back of head.
Physical therapy can address these issues through manual therapy, exercise prescription, lifestyle and activity modifications as well as modalities to manage pain. Expected outcomes include improved function (yawning, eating, talking), normalized range of motion, pain reduction, and increased awareness of behaviors that impact the jaw.
Below are some practical tips and at-home exercises to help relief you jaw symptoms and headaches. If your symptoms do not improve within 1-2 weeks, contact your local IPT physical therapist.
Do’s
- Do breathe through your nose if able, not your mouth
- Do rest your tongue against the roof of your mouth, behind your front teeth, to relax your jaw
- Do focus on maintaining good posture (keep your head in the midline over your shoulders)
- Do try to limit opening your mouth to a range of motion where it is not painful. Particularly when yawning, laughing, coughing, sneezing or singing
- Do cut your food into small bite-size pieces to prevent opening your mouth too wide
- When in a stressful situation, be mindful of unproductive tensing of your jaw, face and neck muscles, and use exercises or stress management techniques as appropriate
Don’ts
- Do not smoke or chew gum, even occasionally!
- Do not eat foods that require prolonged chewing (hard crusts, bagels, tough meats or popcorn)
- Do not eat hard crunchy foods (peanuts, raw vegetables) or chew on ice cubes
- Do not move your jaw in such a way that causes a click, pop or grinding sound
- Do not bite your fingernails, chew on pencils, or pens or bite your cheek or lips, etc
- Do not protrude your lower jaw forward when applying lipstick, eating or talking
- If you wear a dental splint, do not play with it with your tongue
- Do not clench or grind your teeth. Keep your lips together but your teeth apart!
- Avoid sleeping on your stomach, which forces the neck to rotate to one side, stressing the TMJ
TMD Exercises
These exercises should be performed 6x each and perform them all 6x/day.
Neck Stretches
Upper Trap Stretch
Tilt ear toward shoulder until a gentle stretch is felt along the top of the shoulder. No pain should be felt. To intensify the stretch, you can grab bottom of chair with opposite arm and/or apply overpressure to head. Hold stretch for 30 seconds and perform 3x on each side.
Levator Scapula Stretch
Tilt ear toward shoulder and then slowly rotate head down toward opposite armpit. No pain should be felt. To intensify stretch, can apply overpressure to head and/or hold bottom of chair with opposite arm. Hold stretch for 30 seconds and perform 3x on each side.
Scalene Stretch
Tilt ear toward shoulder and slowly rotate head up toward the ceiling. You can also apply pressure along the collar bone on the side you are stretching to intensify the stretch. No pain should be felt. Hold stretch for 30 seconds and perform 3x on each side.