Pathophysiology: Understanding the Underlying Mechanisms of Jaw Pain

Jaw pain, often associated with temporomandibular joint (TMJ) disorders, can arise from a variety of factors, including muscle and joint problems, dental issues, and even referred pain from other areas. Understanding the underlying mechanisms of jaw pain requires considering the complex anatomy and function of the TMJ and surrounding structures. Check out our class listed directly below before continuing on to read this article.


Therapeutic Face, Neck, and Scalp Massage: Headache, Jaw Pain, and Sinus Pressure Relief (7CE)
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What Does Jaw Pain Feel Like?

According to this excerpt from the Cleveland Clinic, jaw pain may feel like:

  • “Stiffness in your temporomandibular joints (TMJ). Your TMJ are located on both sides of your face, just in front of your ears. They connect your lower jaw and your skull. Your TMJ are why you can move your lower jaw up and down and side to side.

  • Throbbing pain or ache in your jaw.

  • Intense pain in your jaw after an injury.

  • Pain that spreads from your chest or shoulders to your jaw. This may be a symptom of a heart attack. Heart attacks are medical emergencies. Call 911 if you have this symptom.

  • Pain when you try to open your mouth (trismus).”

Jaw Pain is No Fun

Jaw pain is definitely no fun to experience and can significantly affect your daily comfort and overall well-being. But what causes jaw pain?

Pathophysiological Mechanisms of Jaw Pain

Inflammation

Many conditions causing jaw pain involve inflammation, which can sensitize nerve endings and lead to pain signals. Inflammation of the joint lining (synovitis) or capsule (capsulitis) can contribute to pain and swelling. Conditions like rheumatoid arthritis or juvenile idiopathic arthritis can also affect the TMJ. Learn how to support your clients who are living with chronic illnesses here.

Muscle Hperactivity

Bruxism (chronic clenching and teeth grinding) and other factors can cause muscles to overwork, leading to spasms and pain. 

Joint Dysfunction

Structural problems within the TMJ can disrupt normal movement and cause pain. 

Nerve Irritation

Irritation of the trigeminal nerve or other nerves in the area can cause neuropathic pain. Learn more in our article about the pathophysiological mechanisms of headaches.

Dental Problems

Toothache caused by infections, cavities, or abscesses in the teeth can cause referred pain to the jaw. Infections in the gums can also lead to jaw pain. Impacted wisdom teeth can put pressure on the jawbone and surrounding tissues, causing pain. 

Psychological Factors

Stress, anxiety, and other emotional factors can exacerbate jaw pain. Bruxism (habitual teeth grinding and clenching), often linked to stress, can put extra strain on the TMJ and surrounding muscles, contributing to pain and dysfunction. Including a mindfulness practice into your massage therapy practice and into your daily routines can greatly reduce stress levels and help alleviate jaw pain. Read more here.

Trauma and Other Contributing Factors

Direct injury to the jaw, face, or head can can cause jaw pain, fractures, or dislocations. Other factors like poor posture, chewing habits (e.g., chewing gum excessively), and even sleeping position can contribute to jaw pain. Inflammation of the sinuses (sinusitis) can cause pain that radiates to the jaw. Trigeminal Neuralgia is a nerve disorder can cause severe, sharp, and shooting pain in the face, including the jaw. Pain from other areas (referred pain), such as the neck or even the chest, can be perceived in the jaw. 


Are you a trauma-informed practitioner? We firmly believe that all massage therapists and other medical and wellness practitioners should have, at minimum, a foundational level of understanding of trauma. Check out our class below if you would like to become a trauma-informed practitioner.

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Temporomandibular Joint (TMJ) Disorders

The pathophysiology of temporomandibular joint (TMJ) disorders is complex and often multifactorial, meaning it involves a combination of factors rather than a single cause. These factors can include abnormal dental occlusion, muscle spasms, joint capsule inflammation, disc displacement, psychological stress, and systemic conditions like arthritis. Essentially, TMJ disorders arise from disruptions in the normal functioning of the jaw joint and surrounding muscles, leading to pain, clicking, and limited jaw movement. 

Here's a more detailed breakdown of the key aspects of TMJ disorders: 

Masticatory Muscle Disorders

  • Pain in the jaw muscles (masticatory muscles) is a common symptom, particularly during chewing, speaking, or swallowing. 

    • These muscles can become strained or develop spasms, contributing to pain and restricted jaw movement. 

    • This can lead to pain that may radiate to the face, neck, and even the head. 

Derangement of the Condyle-Disc Complex

  • The temporomandibular joint relies on a disc (articular disc) that sits between the jawbone (mandibular condyle) and the temporal bone. This disc helps with smooth jaw movements. 

    • Disc displacement (when the disc moves out of place) can be a major cause of TMJ pain and dysfunction. This can be with or without reduction (meaning it either goes back into place or doesn't). 

    • Dislocation of the condyle (the jawbone part of the joint) can also occur, further disrupting joint mechanics. 

    • Problems within the TMJ itself, such as arthritis, disc displacement, or injury, can cause pain, clicking, popping, or locking of the jaw. 

Structural Incompatibility and Degeneration

  • Changes in the articular surfaces (the smooth parts of the joint) can occur, leading to friction and pain. 

    • Osteoarthritis (OA) can develop, characterized by cartilage breakdown and bone changes in the joint. 

    • These degenerative changes can result from mechanical overload, inflammation, or a combination of factors. 

    • Misalignment of the upper and lower teeth (malocclusion) can also place excessive stress on the TMJ, leading to pain. 

In summary, TMJ disorders are not a single disease but rather a group of conditions with diverse causes and mechanisms. Understanding the specific factors involved in each individual case is crucial for effective diagnosis and treatment.

Helping Our Clients Find Relief from Jaw Pain

Massage therapy is an effective non-invasive approach to alleviating jaw pain by targeting muscle tension and improving circulation. There are a variety of techniques that can reduce the intensity and frequency of jaw pain. Additionally, by promoting relaxation and decreasing stress, massage therapy helps to release endorphins, the body’s natural pain relievers, which can further ease jaw pain and related headaches. Regular sessions may provide immediate relief while addressing underlying muscular imbalances that contribute to chronic jaw pain.

In addition to using your hands, we also encourage you to learn and use specialized tools or products for helping your clients find relief from jaw pain. We encourage you to read these articles and learn more about using Heated Bamboo and CBD in your massage therapy practice. Further, we recommend integrating mindfulness or meditition into your massage therapy sessions to further facilitate relaxation and stress relief. Be sure to seek education and gain proper training before using tools and products in your massage therapy practice.


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Pathophysiology: Understanding the Classification and Underlying Mechanisms of Headaches