TMJ Neck Pain
TMJ Neck Pain
By Dr. Thiago Nascimento
TMJ Neck Pain: Causes, Treatment, and Prevention
Pain and tender points in the neck are common in individuals suffering from temporomandibular disorders (TMD)
Treatment of jaw, neck, and orofacial pain remains a significant challenge for many healthcare providers. Clinicians must distinguish the type of pain and the probable cause of the pain to offer patients a comprehensive pain treatment plan. This article will look at how TMJ can be associated with neck pain and how to treat it.
Table of Contents
- TMJ Neck Pain: Causes, Treatment, and Prevention
- Why are my Jaw and Neck Both Tender?
- How are Neck Pain, Jaw Pain, and Migraine Headaches Related?
- TMD-Related Pain Directly Correlates to Pain in Neck Muscles
- How Jaw Pain May Affect a Person’s Head and Neck Region
- SUMMARY: Next Step if Experiencing Persistent Neck Pain
Can shoulder and spine issues cause jaw pain?
Shoulder and spine issues can contribute to jaw pain. The human body is interconnected, and dysfunction in one area can affect other regions.
As shown in many studies, there is a very close relationship between the upper cervical spine and a person’s jaw posture. People may experience neck discomfort, or they may experience headaches, jaw pain, ear ringing, or even vertigo. When C6/C7 spine damage occurs along with neck and shoulder pain, the patient will likely need a group of medical experts, including an orofacial pain specialist.
How do you “fix” TMJ neck pain?
The key is being consistent with gentle stretching, having a balanced, relaxed posture, and reducing repetitive strain. In other words, being regular with self-care strategies.
Self-Care Strategies: Most people can relieve TMJ-related neck tension and discomfort with specific exercises. Our physical therapists may recommend resisted opening and closing, side-to-side jaw movement, and forward jaw movement. The goal is to relieve tension in your jaw joint and ease stresses to the neck area.
Professional interventions, medications, lifestyle modifications, and stress management are also often necessary for solutions for pain and dysfunction in the jaw joint and muscles that control jaw movement.
Additional ways to resolve TMJ neck pain include:
- Applying cold or heat compresses to the affected area.
- Being consistent with gentle stretching.
- Having a balanced, relaxed posture.
- Reducing repetitive strain.
- Professional interventions.
- Medications.
- Lifestyle modifications.
- Stress management.
Your pain care provider can help establish which pain treatment strategies are either necessary or best for you. Your TMJ pain severity level will be a determinant factor.
Can TMJ cause constant neck pain?
TMD primarily affects the jaw joint and surrounding muscles, but it can sometimes lead to neck pain. The temporomandibular joint (TMJ) connects the mandible (jawbone) to the base of the skull, and dysfunction in this joint can lead to a variety of common symptoms, including jaw pain (pain in your jaw muscles and/or joint), headaches, earaches or ringing in the ears, and neck pain.
The relationship between TMJ disorders and neck pain can be complex and may involve several factors, such as increased muscle tension and discomfort in the neck, poor posture, referred pain (where the source of pain is in one location, but the pain is felt in another), and cervical spine involvement.
What does TMJ neck pain feel like?
TMJ neck pain can be manifested in a variety of ways and may be experienced differently by different individuals. The symptoms can range from mild discomfort to more severe pain.
Understanding the TMJ and Neck Connection: The temporomandibular joint and the muscles in your neck are closely interconnected. Muscle tension, nerves, or issues in the TMJ can easily radiate to the neck and vice versa.
Types of pain associated with TMJ dysfunction can manifest as:
- Dull Ache: A way that patients often describe TMJ-related neck pain.
- Sharp Pain: When this occurs, it suggests a more severe inflammation or issues within the joint.
- One-Sided or Bilateral: Pain may be felt on one side of the neck or both, depending on where the muscle tension originates.
What part of the neck hurts with TMJ?
TMJ-related neck pain doesn’t stick to one pinpointed area. Here’s where it often manifests:
- Base of the Skull: Pain often radiates to where your skull and neck meet, sometimes just underneath the ears where the TMJ is located.
- Sides of the Neck: Tension and pain can extend down the sides of the neck, affecting the muscles running along either side of your spine.
- Back of the Neck: TMJ issues can cause tension in the muscles at the back of the neck, leading to stiffness and pain,
Alana Biggers, MD states that “Up to 70% of people diagnosed with a TMD report neck pain as a symptom,” in the 09.06.2023 Neck pain and TMJ disorders: Are they related? article. She talks about how people can experience muscle tenderness and muscle pain in the cervical spine area, the neck region of the spine. Our TMJ pain specialist also sees that overusing your neck muscles during repetitive or strenuous activities can lead to stiffness and TMJ pain.
“High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.” – Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders
Why are my Jaw and Neck Both Tender?
Conditions like teeth grinding, jaw injuries and a sports injury to the head can strain the jaw joints and the muscles used for chewing, swallowing, and speaking. This strain may lead to symptoms such as jaw pain, tender neck muscles, limited mouth movement, and jaw clicking, popping, or locking.
Dental issues can also cause strain on your jaw joints. This may be caused by having your mouth wide open for a long period during a dental procedure. With your neck tipped back for hours and this added pressure on your jaw, even a misaligned bite can be triggered.
How prolonged dental work can put a strain on your jaw and neck:
- Prolonged dental procedures often require you to keep your mouth wide open.
- If this continues for hours, it strains your jaw joints (TMJ) and the surrounding muscles.
- The awkward neck position adds to this strain.
- During that time, an uneven pressure on your jaw joints may occur. The stress can worsen during dental procedures if you have a pre-existing baseline misaligned bite (Malocclusion).
Extended strain on your jaw and/or neck could exacerbate a pre-existing, but perhaps unnoticed, misalignment. A temporary shifting of the jaw could also impact the proper alignment and cause pain. Seek help if it persists and feels like TMJ pain.
How are Neck Pain, Jaw Pain, and Migraine Headaches Related?
Neck pain, jaw pain, and migraines can be interrelated, and their connection is frequently multifaceted.
A person’s sternocleidomastoid (SCM) muscle is a powerful neck muscle that helps people bend their neck and turn or tilt their head. Your neck SCM muscle moves in conjunction with your jaw and head. Your trapezius muscle connects at the base of your skull. This means that if a person clenches their jaw, nerves and ligaments can also be impacted by the compression of these jaw joints.
Factors that contribute to the association between neck and jaw pain symptoms:
- Muscle Tension: Increased stress, poor posture, or habits like teeth clenching or grinding can lead to increased muscle tension in these areas.
- Cervicogenic Headaches: Neck pain and migraines may be linked through cervicogenic headaches, which are headaches originating from issues in the cervical spine or the neck. The pain is typically referred to the head from structures in the neck, such as the joints, muscles, or nerves. Cervicogenic headaches can cause pain on one side of the head or face and are often associated with neck pain.
- Nerve Irritation: Irritation of nerves in the neck region, such as the occipital nerves, can contribute to both neck pain and migraines.
- Posture: Poor posture, especially involving the neck and shoulders, can contribute to both neck pain and tension-type headaches, and in some cases, migraines. The SCM muscle in the neck works in conjunction with your jaw and head. Your trapezius connects the base of your skull. If you clench your jaw, nerves, veins, arteries, and ligaments may be impacted by the compression of your jaw joints.
- Shared Triggers: Certain triggers, such as stress, anxiety, and hormonal fluctuations, can contribute to both jaw tension and migraines.
- Central Sensitization: Chronic pain conditions, including migraines, may involve central sensitization, where the nervous system becomes more responsive to stimuli. This heightened sensitivity can lead to an increased perception of pain in various regions, including the neck and jaw.
It’s important to note that while there is a connection between these symptoms, the relationship varies among individuals. Managing one factor, such as improving posture, managing stress, or treating TMD, can help alleviate symptoms in multiple areas.
How long does TMJ neck pain last?
The duration of TMJ neck pain can vary extensively among individuals, and it depends on several factors, including the underlying cause, triggers, severity of the condition, and the effectiveness of treatment. TMJ neck pain may be acute (short-lived), or it can become a chronic issue.
How long pain flare-ups last can vary from one individual to another, depending on the root cause or trigger. Whether your TMJ disorder is actively being managed by an orofacial pain specialist can also impact how long a flare-up lasts. TMJ neck pain flare-ups commonly last between two days to a few weeks.
Could my whiplash head and neck injury cause TMJ?
Following a whiplash injury to the head, neck, and jaw area, The National Institute of Health (NIH) is studying changes in the coordination, ability to open one’s jaw, severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, myofascial pain levels, muscle tenderness, and a patient’s quality of life. [1]
There is mounting evidence of a strong association between whiplash and TMJ disorders, with some studies showing that close to 25% of people with whiplash injuries have coincident TMJ pain. NIH deems that an association most likely exists between chronic whiplash-associated disorders (WAD) and TMJ issues.
Whiplash-associated pain disorders are the most common non-hospitalized injuries after a road traffic crash or blow to the head when playing sports. One traumatic injury to the head, neck, and temporomandibular joint can trigger sudden neck hyperextension and hyperflexion. A pain specialist certified in pain management can help with reducing symptoms and signs of temporomandibular disorders in patients with chronic whiplash-associated disorders.
Can neck misalignment cause TMJ?
Specifically, both forward head posture and cervical spine alignment are found to be implicated in TMJD. It is hypothesized that any head deviation, including a lateral translation posture, may affect the biomechanical integrity of the TMJ and cause TMJD.
TMD could potentially affect the cervical spine and contribute to neck pain, especially if there are issues with the alignment or movement of the spine. Individuals with TMD may alter their posture to minimize jaw pain, leading to poor neck posture. This altered posture can result in strain on the neck muscles, causing pain. Poor posture over time causes an even more head-forward position, as the ligaments can no longer keep the cervical vertebrae in their proper posterior alignment. The paracervical muscles (the neck muscles) tighten to stabilize the joints and head. As the muscles tighten, they create more pain.
TMD-Related Pain Directly Correlates to Pain in Neck Muscles
A National Institute of Health study discovers that the severity of neck pain increased as the severity of TMD increased.
Studies signal that both jaw injury and psychosocial factors are significantly associated with both jaw pain and neck pain. Our Minnesota Head & Neck Pain Clinics see patients who increasingly report neck pain symptoms when observed with increasing TMD severity.
This aligns with author Abhishek D. Sanchla’s comments that people experiencing pain in the neck muscles may be a co-existing symptom in patients with TMJ dysfunction. Early diagnosis and insights into a person’s TMJ-related neck pain may help prevent severe TMD.
“Based on the results, it was observed that the severity of TMD directly correlated with pain in various groups of neck muscles. 59.09% of patients with TMD reported varying degrees of pain in the neck musculature. The severity and distribution of pain in the neck muscles increased with the increasing severity of TMD.” – Comparative Evaluation and Correlation of Pain Pattern in Neck Musculature Observed in Mild, Moderate, and Severe Temporomandibular Joint Disorder Cases as Compared to Non-temporomandibular Joint Disorder Cases [2]
Additionally, the above NIH study reports that “… on palpation, 23-67% of the patients with TMD had neck muscle tenderness in the sternocleidomastoid and upper trapezius as well as other cervical and shoulder muscles, which was only rarely present in the control group. It is observed that neck muscle pain may be present in patients with TMD, so there was a need to precisely correlate the severity of neck muscle pain with the severity of TMD.”
Table: Correlation between muscle tenderness and neck disability and jaw dysfunction
| Spearman’s rho | |||
|---|---|---|---|
| Side | Muscle | Jaw dysfunction | Neck disability |
| Right | Temporalis | −0.585 | −0.517 |
| Masseter | −0.512 | −0.443 | |
| Sternocleidomastoid | −0.387 | −0.319 | |
| Upper trapezius | −0.408 | −0.352 | |
|
|
|||
| Left | Temporalis | −0.646 | −0.554 |
| Masseter | −0.595 | −0.48 | |
| Sternocleidomastoid | −0.426 | −0.374 | |
| Upper trapezius | −0.647 | −0.518 | |
Source NIH: Correlation between muscle tenderness (PPTs) and neck disability and jaw dysfunction
How Jaw Pain May Affect a Person’s Head and Neck Region
Understanding the connection between jaw issues and neck pain cannot be overstated. Our clinics have practiced treating neck and jaw pain for decades. An office visit is best, where we can go into more detail about the connection between jaw problems and neck pain and provide specific solutions to help you find relief. We understand why neck pain is often present with TMJ issues.
“Temporomandibular disorders (TMD) are a musculoskeletal disorder affecting the masticatory muscles, the temporomandibular joint (TMJ), and associated structures. Evidence suggests that TMD are commonly associated with other conditions of the head and neck region, including cervical spine disorders and headache. Presence of neck pain was shown to be associated with TMD 70% of the time. Neuroanatomical and functional connections between masticatory and cervical regions are discussed as explanations for concomitant jaw and neck symptoms. The presence of pain in the masticatory system, especially related to myogenic TMD, could be caused by dysfunctions in the cervical column, or vice versa, showing the intrinsic relationship between the different structures.” – Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders [3]
SUMMARY: Next Step if Experiencing Persistent Neck Pain
It’s important to note that not everyone with TMD will experience neck pain, and the relationship between TMD and neck pain varies from person to person. If you are experiencing persistent neck pain, it is recommended to consult with a healthcare professional, such as an orofacial pain specialist, to assess the TMJ and rule out other potential causes of neck pain. Additionally, we have a team of experts, including neurologists, clinical health psychologists, physical therapists, and health coaches who are involved in addressing specific factors, such as muscle tension and posture-related issues contributing to your discomfort.
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About the Author
Thiago Nascimento, DDS, MMedSc, MS is a leading orofacial pain certified specialist at the Minnesota Head and Neck Pain Clinic. Additionally, he has a master’s degree in Neuroscience and a postdoctoral fellowship in pain neuroimaging. Nascimento is fully dedicated to helping patients suffering from pain gain relief.
Resources:
[1] Nicola Montemurro, et al.,”Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review,” August 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456620/
[2] Abhishek D Sanchla, et al., “Comparative Evaluation and Correlation of Pain Pattern in Neck Musculature Observed in Mild, Moderate, and Severe Temporomandibular Joint Disorder Cases as Compared to Non-temporomandibular Joint Disorder Cases,” October 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9642967/
[3] I. C. Gadotti, et al., “Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders,” March 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391655/
