Understanding TMJ Pain – Causes and Solutions

By Dr. Amod Manocha, International Pain Centre

Temporomandibular Joint (TMJ) pain is a common yet often misunderstood condition that can significantly affect one’s quality of life. It can cause jaw discomfort, headaches, facial pain, and difficulty eating or speaking. At International Pain Centre, we aim to raise awareness about TMJ pain and provide comprehensive solutions tailored to each individual’s needs.

In this blog, we’ll explore what TMJ pain is, what causes it, common symptoms, how it is diagnosed, and the range of treatment options available.

What Is TMJ Pain?

The temporomandibular joints (TMJs) are the two joints that connect your lower jaw (mandible) to your skull. These joints are located just in front of your ears and help you chew, speak, yawn, and perform various jaw movements.

When these joints or the surrounding muscles become dysfunctional, it can lead to a condition known as Temporomandibular Disorder (TMD) – commonly referred to as TMJ pain.

Common Symptoms of TMJ Disorders

Symptoms can vary from person to person and may affect one or both sides of the face. Common complaints include:

• Jaw pain or tenderness
• Clicking, popping, or grinding sounds in the jaw
• Difficulty opening or closing the mouth
• Locking of the jaw
• Headaches or migraines
• Ear pain or pain around the ears with ringing sounds or fullness sensation in ears
• Facial pain or pressure
• Neck and shoulder stiffness or discomfort
• Eye or dental pain

These symptoms may worsen with jaw movements such as chewing, talking, or stress.

What Causes TMJ Pain?

TMJ disorders are often multifactorial, meaning several contributing factors may be at play:

• Bruxism (Teeth Grinding or Clenching) –Unconscious clenching or grinding, especially during sleep, puts excessive pressure on the jaw muscles and joints.
• Jaw Injury or Trauma –Accidents, dental procedures, intubation during a general anaesthetic or even excessive yawning can strain or injure the TMJ.
• Arthritis- Both osteoarthritis and inflammatory arthritis (like rheumatoid arthritis) can affect the TMJ.
• Stress and Emotional Tension – Stress often leads to muscle tightening and jaw clenching, which can exacerbate TMJ issues.
• Poor Posture- Prolonged poor neck or jaw posture, while working or sleeping, can strain jaw muscles.
• Structural Abnormalitiessuch asmisalignment of the jaw or teeth, or displacement of the disc within the joint.
• Associated Conditions- People with fibromyalgia, irritable bowel syndrome (IBS), or chronic headaches often experience TMJ symptoms.

How Is TMJ Pain Diagnosed?

Diagnosis is primarily clinical, based on a thorough history and physical examination by a pain specialist. Key aspects include:

• Palpation of the jaw and facial muscles to identify tender points
• Assessment of jaw movement, joint sounds (clicking, popping) and tenderness
• Evaluation of posture and bite alignment

In some cases, imaging may be recommended including:

• MRI – to assess disc position and joint inflammation
• CBCT or CT scan – to evaluate bone structure and joint alignment
• Ultrasound – for dynamic assessment of joint and soft tissues
• Scintigraphy – in suspected inflammatory cases

Treatment Options for TMJ Pain

At International Pain Centre, we follow a stepwise, evidence-based approach tailored to each patient’s needs.

1. Self-Care and Lifestyle Changes

• Avoid hard or chewy foods
• Use warm or cold compresses
• Practice good posture
• Manage stress with relaxation techniques

2. Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants
• Low-dose antidepressants (especially for chronic pain)

3. Mouthguards / Occlusal Splints

Custom-fitted appliances that reduce teeth grinding and jaw pressure during sleep.

4. Physiotherapy

Jaw exercises, massage, and posture correction by a trained therapist can significantly improve symptoms.

5. Minimally Invasive Injections

These are offered when conservative treatments do not provide sufficient relief. These may not only provide relief but also help identify the precise pain source and may include:

Steroid Injections – reduce joint inflammation and in many cases are the fastest route to manage these persistent problems followed by supportive therapies inclusive of physical therapy.However, the effectiveness of these injections can vary from person to person. These injections can be helpful in

• Confirming diagnosis
• Reducing inflammation and Pain
• Quick recovery, and rapid relief from chronic jaw pain, headaches, and discomfort.

Botulinum Toxin (Botox) – relax overactive jaw muscles

Platelet-Rich Plasma (PRP) – promotes healing in chronic joint or muscle inflammation

Trigger point injections– Trigger points are painful “knots” in muscles that can be sensitive to touch / pressure. These can form after acute trauma or by repetitive micro-trauma, leading to muscle fibersstress and causing them to be stuck in a state of sustained contraction. Quite often these knots when you rub your muscles. A trigger point injection is used to relax the muscle tension.

Nerve Blocks e.g. auriculotemporal nerve. These blocks can be performed by trained specialists using ultrasound guidance.

All injections are best performed using image-guidance (ultrasound or fluoroscopy) to ensure accuracy and safety.

6. Surgery

Reserved only for very severe, resistant cases with structural damage. Most people do not require surgery.

Tips to Prevent and Manage TMJ Pain

• Avoid excessive jaw movements like chewing gum or wide yawns
• Use ergonomic pillows and avoid sleeping on your stomach
• Perform regular jaw relaxation and stretching exercises
• Identify and address stress triggers
• Seek specialist opinion

Final Thoughts

TMJ pain can be debilitating, but with a correct diagnosis and personalised treatment plan, relief is absolutely possible. At International Pain Centre, we specialise in managing TMJ disorders using a combination of modern diagnostics and minimally invasive techniques.

If you’re struggling with persistent jaw pain of any of the above symptoms, don’t ignore it. Reach out to us for a consultation and let us help you get back to a pain-free life.

Book an appointment at International Pain Centre today.
www.internationalpaincentre.com
Delhi, India