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.