3 types of TMJ pain with 6 causes. Which one is yours? - Be My Healer
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3 types of TMJ pain with 6 fascinating causes. Which one do you have?

TMJ pain types and causes

Temporomandibular joint pain, or TMJ pain affects roughly 20-30 percent of adults to various degrees. When this condition is being gentle, you only notice it when you attempt to attack a triple patty burger. However, fully manifested TMJ dysfunction can severely impact a person's life and functions, such as the ability to talk, to laugh, to eat, to sleep and more.

​Yet, TMJ pain does not always hurt the same way. In fact, there are three types of TMJ pain with a wide variety of causes. Isolating the most likely source of the problem will help you find relief sooner. 

TMJ pain type one: Arthrogenous TMD

"Arthrogenous" means joint-related. There are two common causes for TMJ pain, caused by the joint itself: TMJ disc displacement and TMJ arthritis.

Cause #1: TMJ disc ​displacement

TMJ joint arthrogenous pain

The articular disc is a cushion between the skull and the lower jaw bone. It is known to slide forward out of its normal place due to long-term imbalance in the TMJ. In some cases, this displacement causes no symptom at all.

Yet, if you are experiencing TMJ pain from anterior disc displacement, you are likely to hear clicking or popping from the joint when opening your mouth. You may also experience locked jaw, unable to open your mouth, especially immediately after waking up in the morning. The pain often develops on one side of jaw initially.

Who:  TMJ disc displacement can happen to almost anyone. It can happen due to chewing habits, facial muscle or expression imbalance, poor posture or chronic neck pain.

Treatment: For some people, the only symptom they have is clicking and popping jaw while chewing, and some of them choose no treatment at all. For others, your doctor may prescribe a TMJ splint or physical therapy for jaw exercises. 

A study was done with 52 individuals suffering from TMJ pain due to disc displacement. They were randomly assigned to receive either a TMJ splint or jaw exercises as treatment. After 8 weeks, both groups showed significant improvement in pain and symptoms. ​However, patients who perform jaw exercises had better jaw movement and function in addition to pain relief. [Read the abstract here: Good News...Exercise Improves Disc Displacement]

Cause #2: TMJ arthritis

Arthritis, or degenerative joint disease, refers to the wear and tear of the joints in our body. You may be more familiar with this condition in other body parts such as the back, hips or knees. Yet, did you know that the jaw is among the most used joints in the human body?

TMJ pain from arthritis is often more painful with use. Swelling in the TMJ joint in typical, making the area tender to touch. Jaw opening range is usually limited. Both sides of the jaw are affected together gradually, but one side is often worse.

​Who: Osteoarthritis in TMJ often affects people over 50 years old. And rheumatoid arthritis may also involve TMJ, as the jaws are normally the last to join the parade. 

Treatment: Doctors will often suggest treatment based on symptoms. Steroid injection ​can calm down flare-up pain. A mouthguard at night can slow the worsening of symptoms. For better ability to bite and chew, exercises are still the best bet.

TMJ pain type two: Myogenous TMD

"Myogenous" refers to muscle-related TMJ conditions. The mastication muscles, or "chewing muscles", consist of the

masseter muscle

Masseter muscle

temporalis muscle

Temporalis muscle

pterygoid muscles

Pterygoid muscles

  • Masseter muscle - shutting the jaw
  • Temporalis muscle - shutting and retracting the jaw
  • Lateral and medial pterygoid muscles - shifting the jaw around

The strongest muscle in the human body based on its weight is the masseter muscle. With all the muscles of the jaw working together it can close the teeth with a force as great as 55 pounds on the incisors or 200 pounds on the molars.

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These are the champions that allow us to devour beef jerkies, open beer bottles, crack open walnuts, and make teeth marks on number two pencils.

They can also be the villains that give you headaches, jaw pain​ and poor teeth when you are stressed, angry, or emotional.

TMJ cause #3: Bruxism or jaw clenching

"Bruxism" refers to excessive jaw clenching or teeth grinding. It is a nature body reaction to threat, part of the sympathetic reaction, controlled by brain. 

Constant and chronic jaw clenching and teeth grinding will result in tight and spastic masseter and temporalis muscles. This tightness may create excessive compression and pressure inside the TMJ joint, leading to inflammation and pain. These tight muscles will also limit jaw movement and prevent your mouth from opening fully. Both jaws are equally affected normally. Facial soreness may get worse during evening hours.

Who: You can find out if you are a teeth grinder from your dentist. You may also have other habits such as pen chewing, lip and cheek biting, jaw thrusting, excessive gum chewing, nail biting or even simply prefer very hard foods.

Treatment: TMJ massage therapy can help by releasing the tense mastication muscle and provide pain and stress relief. However, you will need to call around to find a massage therapist who is specialized in intraoral release to receive the most targeted treatment.

Other effective treatments include a nightly mouth guard and self jaw muscle stretching exercises. You can also work on breaking the jaw clenching habit by pushing your tongue against the roof of your mouth when you catch yourself clenching.

Based on your personal preference, ​you can also use aromatherapy, tapping or other meditation techniques to keep your stress level under control.

TMJ cause #4: facial or postural muscle imbalance

Here comes the most stubborn cause of TMJ pain. Muscle imbalance is commonly resulted from personal habits and lifestyle. For example, facial muscle imbalance.

facial expression muscle habit TMJ imbalance

Facial muscle imbalance can be caused by chewing habits or facial expression habits. If you prefer to chew most of your food on one side of your mouth, you will have more developed​ and tighter jaw muscles on one side. The tighter side tends to tug the jaw towards itself, causing one jaw to be too stiff and other jaw to be too weak and loose. You are more likely to feel the pain on the looser side first.

If you stand in front of a mirror and hold your TMJ and jaw bone with your hands and slowly open and close your mouth, you may even see or feel the deviation in your jaw movement.

Professions such as violin players may have an increased risk of developing TMJ pain due to muscle imbalance. They chronically use one side of their chin to secure the violin in position and hold the violin up with the same side arm. In the long run, a good chin rest, regular exercise and massage will be needed to maintain a pain-free body.

Severe head forward posture can alter the resting position of the mandible, or jaw bone. It also places neck and the jaw muscles in such a disadvantaged position that it impacts the closure of jaw and normal function ​of chewing muscles. Those who experience TMJ pain due to posture also have frequent neck pain, tension headaches, and clicking and popping in the TMJ with movement.

Who: Any human being because we are not perfect. Your TMJ pain may come and go triggered by stress, lifestyle or illness. 

Treatment: TMJ pain due to poor posture​ can be easily reversed with postural exercises and stretches. Habits such as chewing and facial expressions can be tough to manage. However, regular jaw exercises and stretches can help sustain jaw muscle balance and function. Professional or self massage can help existing soft tissue tightness, providing fast pain relief.

TMJ cause #5: Systemic influence

Earlier in the post, we already mentioned the association between TMJ and stress. In fact, 50-70% of people with TMJ pain report having stressful lifestyles. However, stress is not a simple emotional state, and it is not confined to our heads.

Stress is a systemic reaction based on our perceived danger, just like military actions based on intel. Regardless of the accuracy of the intel, the order and actions are real. Troops are mobilized, weapons are shipped and sometimes attacks are ordered and casualties are the result. A body under stress is like a war zone with imagined enemies. In the end, our body is the ultimate expense and casualty.

fibromyalgia symptoms

A well known association is between fibromyalgia pain and a prevalence of TMJ conditions. Fibromyalgia is a condition with global chronic myofascial pain closely tied to central nervous system dysfunction, impacting multiple body functions such as endocrine, digestive, immune and psychological systems. People who live with fibromyalgia fight long and tough battles day to day. And TMJ pain, as part of the "fight or flight" muscle reflex, is only a chapter from their pain book.

TMJ pain can also be a strange manifestation of PMS. Since women are more likely to experience TMJ pain, many scientists have theorized that the fluctuation of estrogen ​influence a woman's experience in TMJ pain. Some women report regular increases in TMJ pain during monthly ovulation when estrogen levels surge, while others report TMJ pain during monthly menstruation when the estrogen level are lowest. Research in this subject is still at its early stage, and results are primitive and contradicting each other.

In both cases, TMJ pain is likely to flare-up among other body symptoms. The joint itself and its mastication function may not be affected. 

Who: People with diagnosed fibromyalgia, chronic fatigue syndrome or chronic irritable bowel syndrome and psychological conditions such as depression, bipolar and severe anxiety dysfunction are at higher risks.

Treatment: If only there was a cure, the world will be a better place. There are a large number of medical and pharmaceutical options out there.​ Since I am a conservative treatment professional, I strongly recommend a combined approach, especially for those who have experienced little to no relief from medical or pharmaceutical treatment.

TMJ massage and exercises does not interfere with the progress of other treatments. ​Keep you pain relief tools, such as your TMJ heating or icing wraps, portable TENS unit, TMJ massage ball, mouth guard and favorite essential oil, close by for rainy days. And keep-up jaw and posture exercises on a good day.

TMJ pain type three: Idiopathic TMD

Idiopathic TMD refers to trauma directly impacting the TMJ and resulting in injury and pain. Such injury can happen during violent yawning, laughing, motor vehicle accidents, sports injuries, interpersonal violence or during dental treatments.

post trauma TMJ causes

TMJ cause #6: post-traumatic TMJ pain

A common cause of TMJ pain in low-risk populations is from a motor vehicle accident. Being rear-ended can result in severe neck and TMJ pain. TMJ pain may appear slightly later than neck pain with intense pain, tenderness and frequent jaw locking during joint inflammation. An x-ray is often done in a hospital to rule out fractures in the neck and jaw area.

Who: Those who have history of a fractured mandible, or jaw bone, are at high risk for developing chronic TMJ pain. People who went through multiple dental or facial surgeries are also susceptible to TMJ pain and chronic TMD.

Treatment: Post-traumatic TMJ pain is highly preventable. Early intervention such as physical therapy and massage therapy are excellent in preventing scar formation and muscle stiffness​. Gentle and progressive jaw stretching and exercises will build a strong muscle function to keep chronic and repetitive TMJ pain away.

Above are the three types of TMJ pain with 6 possible causes. Which one do you have and do you find my recommendations helpful? Please leave a comment for me below.

Thank you for reading, and I hope you find this post helpful.

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