By: Rob Stanborough, PT, DPT, MHSc, MTC, CMTPT, FAAOMPT

No, I’m not setting you up for a joke. In fact facial, jaw or neck pain is no laughing matter. Such pain can be debilitating and often is a result of a temporomandicular joint (TMJ) dysfunction.

Some estimates suggest over 10 million Americans are affected by TMJ dysfunction. It tends to affect women more than men and although its cause is often unknown it is considered a musculoskeletal disorder that responds to conservative treatments such as physical therapy.

The TMJ is a complex joint that connects the lower jaw (mandible) with the upper jaw (temporal bone). The joint surfaces of the mandible called condyles move within the temporal bone. The joint is filled with fluid, like many other joints and contains a disc that helps keep movement smooth.

The TMJ is a very active joint when you consider it moves with each spoken word, each bite of food, every yawn, laugh, or clenching of the teeth, day or night. Nightly teeth clenching, called bruxism, is thought to be a possible cause of TMJ pain. Signs and symptoms of TMJ dysfunction can include: radiating pain into the face, jaw or neck, jaw stiffness, limited jaw movement or opening, or painful clicking, popping or grating with jaw movements. Many times these symptoms resolve on their own but if reoccurring or constant, help may be needed.

Conservative treatment can include the use of a stabilizing splint or bite guard but may not be enough particularly if TMJ pain is due to myofascial tissues or internal derangment (a displaced disc, dislocated disc, jaw injury or faulty mechanics). When this is the case, treatment to the joint can help restore proper joint motion so forces are distributed in a more uniform manner. Treatment to the soft tissues such as massage can help resolve painful, taut bands.

Stretching and strengthening are helpful in restoring muscle so they can better control movement of the joints.

And in some cases, the neck is a contributing factor as it refers pain to the jaw and face. Treatment is necessary here to correct postural alignment. If you are experiencing pain as described above, perhaps you should consider talking to your doctor or dentist about receiving physical therapy, or simply call and speak with your physical therapist for additional information.

Rob Stanborough is a physical therapist serving St. Augustine for more than 20 years. He is president and coowner of First Coast Rehabilitation, as well as co-author of Myofascial Manipulation: Theory & Application, 3rd ed by Proed Inc. He is certified in manual therapy, a Fellow of the American Academy of Orthopaedic Manual Therapists and has presented on the topic of soft tissue dysfunction in a variety of venues. Read previous columns posted on