TMJ Pain, Physical Therapy, and the Pandemic

Dr. James DiGregorio Talks About TMJ Pain, Physical Therapy, and the Pandemic

With our most recent pandemic and being forced to wear masks out in public, I began to hear an increase in complaints of TMJ or pain, myself included. With this growing issue, I figured that I would highlight what TMJ is, how it is affected with the pandemic, and solutions for the pain.

First off, what is TMJ and how does it cause pain?

  • The temporal-mandibular joint is a saddle-hinge joint at the top of your jaw
  • The joint consists of two bones with a disc located between them and small muscles surrounding the joint
  • Pain is often caused by overuse of muscles around the area or impingement of the disc between the joints



Common reasons for TMJ pain?

  • Clenching of the jaw
  • Stomach sleeping
  • Post dental work/surgery requiring extended period of time with the mouth open
  • An increase in stress
  • Car accidents/whiplash
  • Shoulder pain or neck pain/headaches
  • Postural abnormalities and overactivity of sternocleidomastoid muscles
    • An increase in sitting
  • Wearing a mask?

How can wearing a mask aggravate this pain?

  • Reducing your jaw ROM during talking leads to over activity of muscles around the joint
  • People are dissuaded from talking with a mask covering their mouth which leads to an increase in stiffness
  • People needing to project their voice due to a barrier being over their mouth
  • Adjusting the position of the mask with facial muscles 

Symptoms of TMJ:

  • Face, ear, jaw, or mouth pain
  • Difficulty and painful chewing (only being able to take small bites)
  • Jaw locking
  • Headaches

Self care techniques for TMJ pain:

  • Icing of muscles around jaw
  • RACABADO exercises for TMJ pain (set of 6 exercises to retrain muscles around the joint)
  • Practicing relaxation of muscles around the joint
  • Stretching of neck muscles

Physical Therapy for TMJ pain:

  • Manual release of muscles around TMJ and upper neck areas
  • Manually improving joint mobility and disc placement between the joint
  • Modalities such as electrical stimulation to reduce pain
  • Re-educating muscles around TMJ to reduce pressure and stress on the joint
  • Postural re-education to reduce activation of sternocleidomastoid muscles


TMJ pain is an issue that will rarely go away without either self-treatment or professional treatments. Common treatments from your dentist or oral surgeon will be night guards or oral surgery which may solve the main problem. A combination of passive and active care techniques are necessary for full alleviation of jaw pain.

By Dr. James DiGregorio, PT, DTP of SHC Montvale


Condition of the Week- TMJ

[fancy_header3 variation=”blue”]The Pain of Temporomandibular Joint Disorders (TMJ) [/fancy_header3]

If you’re one of those unlucky people who have TMJ Symptoms in NJ, then this article is for you. Many people typically run to their Dentist or GP when faced with TMJ problems. While this is common and good practice, many are unaware that Chiropractors are leading the way in Treatments for TMJ.

First we need to understand what Temporomandibular Joint disorder is.

The TMJ or Jaw Joint is a hinge joint connecting the mandible (jaw) to the skull. The TMJ actually contains 2 joints allowing for rotating and sliding movement. Over time, these joints wear down and many people see pain at the TMJ which affects the way you chew, yawn, speak, and swallow. More severe cases or longer term cases may including locking, clicking and major pain in TMJ region.

Specific to the TMJ Disorder, people experience mild – extreme pain, headaches and overall discomfort. As these joints continue to displace the cartilage of the lower jaw connecting to the skull, more and more damage remains. It’s often overlooked that the TMJ or Temporomandibular Joint is one of the most commonly  and frequently used joints in the body. (It moves every time you chew, talk or use your mouth at all.) The displacement creates a painful pressure and stretching of the associated sensory nerves. Not all causes are known. Some possible causes or contributing factors are injuries to the jaw area, various forms of Arthritis, dental procedures, genetics, hormones, low-level infections, auto-immune diseases, stretching of the jaw as occurs with inserting a breathing tube before surgery, and clenching or grinding of the teeth.

TMJ Symptom List:

  • Tenderness of the Jaw.
  • Headaches or Neck Aches
  • Swelling on the Side of the Face
  • Pain at or in the Ear
  • Clicking, Popping or Grating Sounds When Opening the Mouth

How do Chiropractors help with TMJ?

Much of Chiropractic treatment focuses on relieving tension in the muscles around the joints themselves—working both outside and inside the mouth, using massage and trigger point therapy.