The temporomandibular joint is the hinge connecting your jaw to your skull, just in front of the ear. TMJ dysfunction covers pain and restricted movement in that joint and in the muscles that work it. The neck is almost always involved, which is one reason physiotherapy helps.

What it feels like

• Pain in the jaw, in front of the ear, or across the cheek and temple
• Clicking, popping or grating when you open and close your mouth
• Difficulty opening wide enough to eat an apple or yawn comfortably
• The jaw catching, locking, or deviating to one side as it opens
• Headaches, earache, or a feeling of fullness in the ear with no infection
• Tenderness in the jaw muscles, often worse first thing in the morning

Common causes

• Clenching or grinding the teeth, frequently during sleep and often stress-related
• Sustained postures that load the neck and jaw, including long periods at a screen
• Direct trauma to the jaw or face, including whiplash from a motor vehicle accident
• Arthritic change in the joint
• Displacement of the disc that sits inside the joint
• Habits such as nail biting, gum chewing, or resting the chin on a hand

How physiotherapy helps

TMJ problems are usually driven by muscle and movement rather than by the joint surfaces alone, which is why a hands-on and exercise-based approach works for most people. Treatment commonly includes:

• Manual therapy to the jaw muscles and joint, and to the upper neck
• Controlled exercises to restore a straight, symmetrical opening pattern
• Treatment of the neck and upper back, which commonly refer pain into the jaw and head
• Identifying and retraining the clenching, posture and daily habits that keep it going
• Dry needling to the jaw and temple muscles where appropriate
• Advice on diet consistency, sleep position and jaw rest during a flare-up

What to expect at your first visit

Your physiotherapist takes a history, measures how far and how symmetrically your jaw opens, examines the joint and the jaw muscles, and assesses your neck. Dental causes and jaw joint problems are easy to confuse, so part of the assessment is working out which you are dealing with. They will explain what they have found and agree a plan with you. Most people begin treatment in the same appointment.

When to see a doctor instead

See your dentist if the pain is clearly coming from a tooth, or if you may need a night guard for grinding — these often work best alongside physiotherapy rather than instead of it. See a physician if your jaw locks closed and will not open, or if the joint is swollen with fever. Jaw pain that comes on with exertion and is accompanied by chest pain, breathlessness or pain in the arm needs emergency assessment.

Booking an appointment

You do not need a doctor’s referral to see a physiotherapist in Ontario. Some extended health plans ask for one before they will reimburse you, so it is worth checking your policy.

We are at 2600 Skymark Avenue, Building 3, Unit 102, Mississauga, open Monday to Friday 9:00 AM – 10:00 PM and Saturday and Sunday 9:00 AM – 7:00 PM, with free parking. See our fees or call 647-998-4727.

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This page is general information, not medical advice. An assessment with a registered physiotherapist is the way to find out what is causing your symptoms and what will help.