The jaw joint the temporomandibular joint is something I find myself
examining again and again when patients come in with headaches, especially pain at the top of the neck. It's often involved. And quite often, the person has no idea.
Some people do know their jaw is a problem. Maybe they can't open their mouth fully, or there's a clicking and crunching sound every time they chew. Those clicks feel particularly intrusive because the jaw joint sits right next to the ear canal the sound goes straight in. That's hard to ignore.
But plenty of people have jaw problems that show up only as a vague, persistent headache. Nothing obviously wrong with the jaw, just that dull ache that never quite goes away. That's why I always include a jaw examination when
I'm assessing someone for headache it has to be part of the picture.
What the examination actually involves
What the examination actually involves
I start by simply looking is there any asymmetry, any sign that the muscles on one side are working differently from the other? Then I test the movements: opening and closing (the most important), side-to-side movement, and protrusion and retrusion of the jaw. All of this should be smooth, symmetrical, and pain-free.
Then I feel the main chewing muscles. The temporalis fans up the side of the skull, the masseter sits along the jaw you can feel it bulge when you clench and the digastric runs along the floor of the mouth and helps open the jaw. I check each of these for tenderness and uneven tension.
Going deeper, I examine the pterygoid muscles. These lie far back inside the jaw and can only be reached with a gloved finger. In patients with real jaw problems, pressing on these muscles often reveals marked tenderness on one side but not the other and that's a very useful finding.
If the bite itself is uneven if the teeth don't line up correctly that sets the jaw off-centre before anything else can be done. No manual treatment will fix that. It needs a dentist.
If the bite itself is uneven if the teeth don't line up correctly that sets the jaw off-centre before anything else can be done. No manual treatment will fix that. It needs a dentist.
Which pattern do you notice most in your own body?
What treatment looks like
What treatment looks like
One of the more common findings is a jaw that tracks sideways on opening there's a click, and the whole jaw shifts to one side. This usually means one of the intra-articular discs is sitting slightly out of position. With careful, gentle joint guiding as the person opens and closes, repeated over several sessions, it's often possible to encourage the disc back into a better position. The clicking and restriction can reduce significantly.
Trigger point treatment is another important part pressing and working on the tender spots in the masseter, temporalis, pterygoids, and digastric. This is the same principle as treating trigger points anywhere else in the body, and it can make a real difference to jaw pain and associated headache.
The jaw exercises I give every patient
These are not strength exercises. You're not trying to build muscle you're restoring normal movement. Light resistance, done consistently, every day.
Start by pressing your tongue gently up against the roof of your mouth and keep it there throughout this is the starting position for everything. From there, place one hand lightly under your chin for gentle resistance and open and close your mouth slowly, about ten times. Then move to side-to-side: same light hand resistance, pushing gently against the side of your chin, ten times each way. Finally, push your lower jaw forward into a slight underbite and draw it back again easy and controlled. You're jogging the joint, not training it.
The key word is daily. This won't fix anything in one session but done consistently it gradually normalises how the jaw moves.
"There is a certain peace that comes with knowing less and choosing better."
The jaw, the neck, and headache they're all connected
The jaw doesn't work in isolation. The top three segments of the cervical spine the occiput, atlas, and axis are neurologically closely linked to the jaw joint. Problems in one area almost always affect the other. So whenever I'm treating someone for jaw-related headache, I always examine and treat the upper neck as well.
And there's something else worth knowing. In both tension headache and migraine, the muscles of the face and skull are almost always involved the chewing muscles we've talked about, but also the muscles around the eyes, the forehead, and the back of the head. Trigger point treatment and gentle massage across all of these muscle groups can give real relief to people who've been living with chronic headache.
This is actually the same mechanism behind Botox treatment for chronic migraine those injections target exactly these muscle groups, reducing tension at the source. It's highly effective for people who have migraine attacks multiple times a week. The manual therapy approach works on the same principle, just without the needles.
Until the next signal,
Dr Erik Rudberg
Chiropractor
Most people wait for pain. The attentive ones notice the signal.
