Painful Jaw and Clicking Sounds? Your Body May Be Sending a Warning Signal (With Self-Help Guide)

Have you ever experienced waking up in the morning and wanting to yawn, only to find your jaw stiff and painful, or while eating an apple, you open your mouth a bit wider and suddenly hear a crackling sound from your bones?

In our lives, many people first hear the term(TMJ) when they are troubled by lower jaw pain or stiffness. Under normal circumstances, these joints are very strong, but once inflammation occurs, it can lead to intractable, severe pain and functional impairment.

What you may not know is that long-term looking down at mobile phones, resting your chin on your hand while thinking, long-term side sleeping/stomach sleeping, etc.
can all be triggers, and studies have shown that about 72% of TMD patients also have cervical spine dysfunction.

The temporomandibular joint is located at the junction of the jawbone and the temporal bone, one on each side, just in front of the ears. This joint is not only composed of bones but also connected by muscles responsible for chewing and opening the mouth, and there is a small disc (called the “articular disc”) between the bones, which acts like the discs between the vertebrae, providing cushioning for the joint. Uniquely, the TMJ disc is the only joint disc in our body that can regenerate, thanks to its good blood supply.

Although the TMJ has a strong ability to recover, like other joints in the body, it can also be troubled by inflammation and functional disorders.

Temporomandibular joint dysfunction(TMD) refers to pain in the jaw joint and surrounding muscles, which can significantly limit or cause pain during functions such as eating, opening the mouth, and yawning.

Symptoms of TMD include:

Many patients find that the pain and stiffness are most pronounced upon waking in the morning or during eating.

It is worth noting that the temporomandibular joint and the cervical spine, especially the upper cervical segment(C1-C3), have a close anatomical and functional connection. Dysfunction of the occipitoatlantal joint(the connection between the head and the first cervical vertebra) often interacts with TMD. This is because the nerves and muscles that control jaw movement have a complex interaction with the structures of the neck. Studies have shown that about 72% of TMD patients also have cervical spine dysfunction, especially problems in the upper cervical segment.

Causes of Temporomandibular Joint Dysfunction

In addition to cervical spine dysfunction-related factors, there are some common habits and behaviors that cause temporomandibular joint dysfunction:

⚠️Improper sleeping posture:

For example, sleeping on your side or stomach, excessive head rotation, or nighttime teeth grinding.

⚠️Prolonged dental contact:

For example, unconsciously clenching your teeth or maintaining dental contact for extended periods.

⚠️Long-term jaw tension:

For example, tensing the jaw muscles without clenching the teeth, or persistently pressing the tongue against the teeth.

⚠️Improper posture:

For example, resting your chin on your hand, or holding the phone between your head and shoulder while talking. It is particularly important to note that a forward head posture can change the position of the occipitoatlantal joint, thereby affecting the resting position of the jaw.

When the head is tilted forward, the jaw is forced backward, increasing the pressure on the temporomandibular joint. Long-term poor cervical posture can affect the tension of the masticatory muscles through myofascial chains.

⚠️Excessive chewing:

For example, chewing only on one side, chewing gum, or frequently eating foods that require a lot of chewing.

⚠️Lifestyle habits:

For example, playing musical instruments that involve the mouth and jaw(e.g., woodwind, brass, string instruments), continuous singing, or talking for extended periods.

⚠️Wide yawns.

Being aware of and improving these bad habits is crucial for alleviating TMD.

TMD Treatment Options

Many patients experiencing jaw pain or clicking sounds are referred by dentists or doctors to oral surgeons. However, some patients find that they are not suitable for surgery while waiting for their appointment, delaying treatment only exacerbates the condition.

The good news is that physical therapy has shown significant effects in treating temporomandibular joint pain and dysfunction.

Studies have shown that manual therapy combined with a home exercise program can significantly improve pain and jaw function. Finding an experienced TMD specialist physical therapist can help change the course of the condition and alleviate common pain.

Physical therapy typically includes the following:

✅ Manual therapy:
Restoring painless range of motion of the joint, reducing pressure on the articular disc, and improving joint gliding.

✅ Soft tissue massage and stretching:
Relieving tension in the jaw and neck muscles.

✅ Cervical spine manual therapy:
Particularly targeting the upper cervical segment(C1-C3) and occipitoatlantal joint function assessment and treatment. By improving cervical spine mobility, especially the flexion, extension, and rotation of the occipitoatlantal joint, significant improvements in mandibular movement patterns can be achieved.

✅ Cervico-mandibular coordination training:
Training the coordinated movement of the cervical spine and jaw, such as jaw movement exercises while maintaining a neutral cervical spine position, and cervical stability training with jaw relaxation.

✅ Jaw relaxation training:
Relieving tension in the masticatory muscles.

✅ Strength training:
Improving muscle imbalances in the jaw and correcting movement patterns during opening and closing of the mouth.

✅ Lifestyle advice:
Adjustments to sleeping posture, eating habits, etc., to reduce pressure on the jaw.

✅ Posture correction:
Reducing additional pressure on the jaw due to poor posture(e.g., forward head posture).

Key focus:

✅ Ergonomic adjustments to the work environment to reduce the cervical spine pressure caused by prolonged looking down.

In Conclusion

Understanding the interrelationship between the temporomandibular joint and the cervical spine is crucial for effective treatment of TMD.

Physical therapists, when assessing TMD, will also examine cervical spine function, especially the mobility of the upper cervical segment and the occipitoatlantal joint. By integrating treatment plans to address both jaw and cervical spine issues, better treatment outcomes are often achieved. Patients should also recognize that improving cervical posture and function is significant in preventing TMD recurrence.

TMD can be a painful and frustrating condition, and it can also present challenges in social and professional life. However, in most cases, surgery is not necessary or recommended. Our experience has shown that addressing TMJ pain and dysfunction through physical therapy is highly effective. Physical therapists not only provide manual therapy and exercise programs but also help patients better understand their jaw joint conditions, reducing the risk of symptom recurrence and truly solving the problem at its root.