TMD — when your jaw hurts: what's behind it and how does physiotherapy help?

Does your jaw click when you chew? Does it hurt to open your mouth, do you have headaches or tinnitus without a clear cause? Then temporomandibular dysfunction (TMD) could be behind it.

Jaw-related complaints are nothing unusual. An estimated 20–30% of the population have TMD symptoms – many of them without a diagnosis. Women are affected somewhat more often than men.

Typical TMD symptoms

• Jaw clicking when opening or closing the mouth
• Jaw pain or stiffness, especially in the morning
• Limited mouth opening
• Headaches, often at the temples or the back of the head
• Neck pain and tension
• Tinnitus (ringing in the ears) or earache
• Teeth grinding (bruxism), often at night
• Facial pain
• In some cases also dizziness

What causes TMD?

TMD usually results from several factors working together:

• Stress and tension: many people unconsciously clench or grind their teeth when stressed.
• Misaligned bite: misaligned teeth, poorly fitting dentures or dental prostheses
• Trauma: after a fall, accident or blow to the chin
• Posture problems: a forward head posture (typical with office work and smartphone use) can contribute to the problem in some cases
• Overloading the chewing muscles: through clenching, grinding or chewing too hard
• Poorly conditioned chewing muscles

How we proceed

Our approach typically includes:

• Thorough assessment: we work holistically according to the bio-psycho-social model, analyse the jaw, cervical spine, muscles and posture together and also take further social and psychological factors into account
• Manual therapy: targeted mobilisation and soft-tissue techniques in the head and neck area
• Cervical spine treatment: because the jaw and cervical spine are closely connected
• Posture correction: small changes have a big effect
• Home exercises: strengthening or relaxation exercises for the chewing muscles
• Adjusting behaviour: unfavourable habits can lead to increased baseline tension and make jaw problems worse
• Interdisciplinary cooperation: we work closely with dentists and orthodontists. This is the only way to ensure the best treatment outcome.

Dentist or physiotherapist — who helps with TMD?

Ideally: both. The dentist can fit a bite splint that protects against grinding at night. The physiotherapist treats the muscular and joint causes. Physiotherapy treatment for TMD is covered by statutory health insurance when prescribed.

Conclusion: TMD is treatable

The combination of manual therapy, education and targeted exercises shows good results in relieving jaw and neck complaints.

We are happy to answer any questions.