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Jaw clicking and popping are symptoms of a TMJ disorder. TMJ is the acronym for ‘temporomandibular joint.’ There is a joint on each side of the jaw with muscles connecting the jawbone to the skull and enabling chewing, moving the jaw, and talking. Like any joint, one or both temporomandibular joints can develop problems that cause pain in the jaw and the surrounding areas. TMD stands for ‘temporomandibular joint disorder’, which involves the jaw bones, joint, and surrounding tissues controlling jaw movement. It affects millions of people in the U.S., and there is still much more to learn about this condition through additional research. Currently, a TMD is primarily treatable by taking self-care steps that a pain specialist recommends.
What is TMJ Pain?
TMJ pain is experienced in the jaw joint, the jaw muscles, or both. The joint is designed to move like a sliding hinge. When the jaw is damaged or misaligned for any reason, the hinge movement becomes dysfunctional. The same is true when the muscles connecting the jawbones to the skull are stretched or damaged.
Jaw pain is a symptom of TMJ that may manifest in various ways and can be accompanied by other symptoms.
- Pain in the jaw may be sharp, dull, or stabbing
- The jaw joint area is tender or sore
- Jaw clicking and popping are heard when using the jaw
- Ear pain develops because the jaw joint is close to the ear
- Headaches develop from jawbone stress
- Locked jaw pain when the jaw hinge is stuck open or closed
- Jaw muscle tension causes pain
- Opening or closing the mouth is painful
What Causes TMJ Pain?
Pain is the most common symptom of a TMJ disorder. The pain develops due to various reasons.
- The joint disc erodes and loses some or all of its ability to rotate
- The joint disc is displaced or dislocated
- Arthritis erodes the jaw joint’s cartilage and bone
- Joint inflammation causes deep, continuous pain
- Jawbone or surrounding soft tissues are injured
- Jaw muscles are strained due to tearing or stretching
- Jaw ligaments are sprained due to tearing or stretching
- Muscle dysfunction is experienced when chewing, swallowing and speaking
- Joint’s smooth sliding surfaces become rough and cause friction, limiting the ability of the joint to function
- Pain is experienced when opening the mouth beyond a painless mandible restriction caused by something like muscle contracture or ankylosis
Approximately 85% of the people with a TMJ disorder have one or more chronic health conditions, like fibromyalgia and rheumatoid arthritis. Some of the comorbid conditions are painful, but not all of them, i.e., hypertension or sleep disorders. However, researchers are studying why TMJ disorders seem to be related to other health disorders. Various studies have identified 30 health conditions that may be present with TMJ disorders. A few were just mentioned. Some others include ankylosis spondylitis in other joints, back and neck pain, heart disease, osteoarthritis, and stress, to name a few.
Though it is not clear yet what causes TMD in many people, some researchers believe that, in many cases, it is not only a localized jaw disorder. It develops and becomes painful due to many contributing physical and psychological factors.
What Groups are at Risk for TMJ?
Two population groups have the highest risk of developing TMJ.
- Adults between 20 and 40 years
- Women are more likely than men
It is not understood yet why women are more susceptible to experiencing TMJ. Based on research to date, it may be due to hormone fluctuations.
Also being investigated is a potential genetic factor. The risk of developing TMJ may be higher for individuals with a family history of TMJ disorders.
Treatment
TMD treatment options are limited. A medical professional will first evaluate a patient to determine if TMJ really is causing the pain or if other disorders may be causing headaches, ear pain, or facial pain. For example, trigeminal nerve inflammation, sinusitis, headaches, dental abscesses, cluster headaches and middle ear infections might be the source of pain.
If a temporomandibular disorder is diagnosed, the most conservative treatment and management plan is developed first. It may involve the following.
- Do gentle TMJ exercises that improve the joint’s range of motion
- Press a warm or cold compress on the painful area
- Rest the jaw
- Develop a plan to reduce stress if stress causes teeth clenching or tense muscles
- Wear a nightguard for TMJ because it can prevent teeth clenching and grinding
- Avoid activities like gum chewing that stress the joint
- Take NSAIDs (nonsteroidal anti-inflammatory drugs) for pain
- Take muscle relaxants if the muscles are experiencing spasms
- Avoid consuming anti-inflammatory foods and eat a healthy, balanced diet
Given the numerous factors involved in TMD, consulting a pain specialist is crucial for developing an effective TMJ self-care plan. The pain doctor can create a targeted treatment plan to address everything from unlocking a jaw to TMJ headache relief. In combination with the treatment plan, patients are encouraged to end behaviors that contribute to TMJ pain, like gum chewing and nail biting.
TMJ Pain FAQ
What happens if TMJ is left untreated?
There can be consequences if TMJ is left untreated.
- Joint damage can worsen over time, leading to inflammation in the face, neck and shoulders.
- Jaw functioning could continue to decrease, eventually leading to a locked jaw.
- If arthritis is present, the joint will continue to deteriorate.
- An injured joint could lead to permanent jaw damage or misalignment, requiring surgery.
- Excessive teeth clenching and grinding (bruxism) will erode and damage the teeth, which can make TMJ progress faster and cause more pain.
- TMJ can lead to jaw stiffness, which can trigger tension headaches and migraines.
- Chronic, untreated TMJ can make it difficult to do everyday activities, like eating and sleeping.
If TMJ pain becomes recurring or lasts for more than a couple of weeks, it is important to see a pain specialist. TMJ can significantly impact the quality of life in various ways.
Is TMJ from stress?
Stress leads people to clench their teeth and tense facial and neck muscles, triggering TMJ pain. There is research evidence that stress, anxiety, and depression may trigger TMJ and accelerate its progress. The exact reason this happens is still not fully understood.
Can TMJ cause ear pain, headaches, or facial pain?
TMJ or TMD expresses itself in many ways, but there is likely jaw pain involved. Other symptoms include face swelling, aching teeth, and eye, neck, or shoulder pain. Experiencing headache pain is common. In fact, TMJ is frequently comorbid with primary headache disorders and can contribute to sinus headaches. Pain can radiate from the jaw area to many other areas.
What makes TMJ flare up?
There are several reasons why the TMJ can flare up. A ‘flare-up’ refers to a sudden and often intense episode of pain or other symptoms. They include teeth clenching, teeth grinding, inflammation in the jaw joint, and other health conditions that produce their own painful flare-ups. Overworking the muscles around the joint is another common reason. Chewing on hard foods like carrots or caramels can stress the jaw joint and trigger a TMJ flare-up. Even poor posture can lead to jaw misalignment and tense muscles.
How long does TMJ pain usually last?
TMJ pain can last days, weeks, or months. Some people develop chronic TMJ pain. The amount of time TMJ symptoms endure is driven by factors like the cause of the TMJ. A jawbone or jaw joint injury may be painful for weeks. If someone develops chronic jaw pain due to jaw clenching or teeth grinding and wears a nightguard, the pain will likely improve. In many cases, TMJ pain is acute, and the pain of a flare-up is relieved by taking NSAIDs and reducing stress through rest.
Each person has a unique experience.