Blog Post

How Shoulder & Neck Pain Relates To Your TMJ

Aug 21, 2019

Temporomandibular joint disorders are a common cause of neck and shoulder pain. In fact, experts estimate that up to 70 percent of neck problems may be related to temporomandibular joint dysfunction.

The temporomandibular joints (TMJs) connect the skull to the jaw (mandible) on both sides of the head, just under the ears. They work in unison as sliding hinges, moving side to side, up and down, forward and backward. When TMJ problems occur, they may cause a painful condition called temporomandibular joint disorder (TMD). TMD pain is felt in the jaw joints and can spread to the associated system of facial muscles, tendons, and nerves, as well as to your neck, shoulders, and even your lower back.

Other TMD symptoms include, but are not limited to:

  • Jaw pain
  • Toothaches
  • Ear pain or ear fullness
  • Pain behind the eyes
  • Headaches or migraines
  • Popping or clicking sounds in the TMJ
  • Limited range of jaw motion and jaw lock
  • Dizziness
  • Facial pain

Fortunately, Dr. Katherine Phillips has years of experience treating complex TMJ disorders. To learn more about TMDs, click here.


Causes of TMJ Disorders 

Like any joint in the body, TMJ overuse and strain can result in pain, inflammation, and swelling. Habits and activities that create stress in your jaw joints and orofacial muscles include teeth clenching during the day, teeth grinding (bruxism) while asleep, chewing gum, eating chewy foods, and even fingernail-biting. Conditions known to cause TMD, such as bruxism and osteo, psoriatic, and rheumatoid arthritis, tend to run in families. Additionally, TMD is linked to obstructive sleep apnea (OSA), with studies confirming a significant association between OSA and TMD symptoms.  Evidence also indicates a relationship between TMD and mental health, physical trauma, and psychological trauma.

Can TMD Cause Pain in Your Shoulders and Neck?

A temporomandibular joint disorder can be debilitating. Jaw pain and lockjaw can make it difficult to chew or talk. Nagging headaches are also common. So too is neck and shoulder pain. Many of the muscles in the maxillofacial, neck, and shoulder regions are intricately connected. The complex TMJ system of muscles, joints, and bones allows you to talk, chew, turn your head, and more.


A problem in one muscle or joint can affect other muscles and joints. Thus, an injury, misalignment, or a host of other jaw issues could also result in pain in your neck and shoulders.

TMDs often fail to heal on their own and over time your condition could worsen. A sore jaw could be followed by headaches, or stiffness and soreness in your neck and shoulders. The resulting pain and discomfort could make it difficult to enjoy a good quality of life if left untreated.

Neck and Shoulder Related TMD Symptoms

So how can you tell if your neck and shoulder pain is the result of a TMD? These disorders can be difficult to diagnose and a diagnosis from an orofacial pain specialist is often required. TMDs share symptoms with many other conditions, and as a result, can be easily misdiagnosed.



At the very least, you can watch for troubling symptoms. TMDs normally start with a dysfunction in either the temporomandibular joint itself or the muscles directly connected to it.

Since our muscles are interconnected, the dysfunction can quickly spread, reaching as far as your lower back. Regardless, since TMDs start in or near the jaw, you should check to see if you are suffering from facial pain.


Even if you are suffering from a TMD, you may not notice any pain unless you move your jaw. Try stretching your jaw and moving it from side to side. If pain occurs, it may be due to a TMD. Also, watch for the common symptoms mentioned above.

You can see a more complete list of TMD symptoms here. If you’re suffering from neck and shoulder pain, as well as TMD symptoms, a TMJ disorder may be the cause.

How Can I Treat Neck and Shoulder Pain Caused by a TMD?

Typical neck and shoulder pain treatments may prove ineffective when TMD is involved because they do not address the underlying cause in the jaw joint. Due to the complex interactions of the TMJ and surrounding nerves, tendons, and muscles, it is vital to have a TMD expert like Dr. Katherine Phillips diagnose and treat the underlying cause. This will help ensure treatment success. Effective TMJ disorder treatments include:

  • Dental appliances custom-made to treat TMD
  • Physical therapy
  • Hot and cold compresses
  • Anti-inflammatory drugs and muscle relaxers
  • Low-dose antidepressants
  • Cognitive Behavioral Therapy/Biofeedback
  • Referrals to appropriate adjunctive health care professionals to address underlying contributing factors.


A TMD
specialist may be needed to successfully treat TMD-related shoulder and neck pain with related orofacial pain in the long run. Experts take a multifaceted approach that combines some of all the treatments above, depending on what’s causing the TMD and the severity of the case. The goal is to provide the most immediate pain relief and help you achieve long-term healing and relief.

Avoidance therapy may also provide short-term relief. For example, avoiding hard or chewy foods that strain your jaw joint and muscles may temporarily relieve TMD.

Medications for TMD

Sometimes drug-free treatment options such as physical therapy resolve TMD symptoms, especially if they are mild. Medications, however, are often recommended as part of a comprehensive treatment plan focused on delivering relief as quickly as possible. 


Anti-Inflammatory Medication


Over-the-counter (OTC) and prescription nonsteroidal anti-inflammatories (NSAIDs) help relieve pain, reduce swelling and inflammation, and restore function. OTC NSAIDs include Ibuprofen (Motrin), Naproxen (Aleve), and aspirin. However, OTC drugs’ effectiveness may decline over time, creating a need to progress to prescription medications until pain, swelling, and inflammation abate.

When stronger pain relief is needed, NSAIDs such as Mobic (meloxicam) may be prescribed. This can be especially helpful when degenerative conditions that result in chronic inflammation, such as osteo, psoriatic, and rheumatoid arthritis, are the underlying cause of TMD.


Muscle Relaxants


These medications relax the muscles in your jaw and face, helping decrease muscle tension and spasms associated with TMD. Addressing the cause of the pain also improves your sleep quality and supports better jaw function as TMD improves. However, be aware that muscle relaxants can cause drowsiness. As with any medication, follow the instructions carefully.


Antidepressants


Stress and anxiety can result in teeth clenching, often occurring throughout the day, and teeth grinding (bruxism) while you are asleep. Both of these habits exert excess pressure on the  TMJs, causing TMD. Low-dose antidepressants can be prescribed primarily to address pain and also help reduce stress and anxiety, so you are less likely to clench your jaw and gnash your teeth, which ultimately relieves stress and strain on the TMJs and thus relieves TMD. 


Physical Therapy

Physical therapy for TMD involves using various methods designed to help relieve pain, inflammation, and swelling in the TMJs. In addition, it helps restore normal jaw movement by improving joint motion, alleviating stress on the TMJ and its articular disc, and reducing muscle stiffness.


Massage - Kneading, stretching, and friction massage can be performed to relieve TMD symptoms. Additionally, TMD patients may be taught how to correctly perform self-massage at home to ease jaw muscle tension. 


Palpation - Palpation involves using the sense of touch to assess and heal. Working with their fingertips, therapists identify the location of muscular swelling and pain and evaluate the tissue’s health by feeling for its tone and texture.


Jaw exercises - Exercises for the TMJ are designed to stretch and relax the jaw and strengthen its muscles. TMD patients can do these exercises during a physical therapy session as well as at home.



Alternating heat/cool therapy - Known as contrast therapy, the application of heat and ice packs can decrease TMD pain and inflammation, and relax tight, tense jaw muscles. When subjected to cold, muscles contract, inflammation lowers, and pain signals are reduced. Conversely, heat therapy increases circulation and loosens tight muscles to ease the pain.


How Does an Occlusal Splint Work?

Custom-made occlusal splints, also known as bite guards, are worn in the mouth like a sports guard, although they are much different. They are specially designed to relax jaw muscles and ligaments and prevent teeth grinding, clenching, and other jaw actions and movements that could trigger TMD or cause it to worsen. Made from hard acrylic, they guide the jaw as it moves side-to-side and front-to-back, supporting the jaw muscles and preventing additional loading forces in the joint. Soft sports guards can worsen a TMJ problem due to their “chewy” nature. 


Dr. Katherine Phillips, who specializes in diagnosing and treating TMD, creates customized occlusal splints tailored to your bite using advanced 3D imaging. As treatment progresses, splints are modified or adjusted in the office to accommodate muscle changes and to maintain reduced force on the joints.


Once TMD is adequately treated, neck and shoulder pain directly related to the TMD may be relieved.  Additionally, combining splint therapy with physical therapy of the neck and shoulder region may increase the benefits.


Conclusion, Next Steps

TMD is a serious condition that can cause a surprisingly wide range of problems, including neck, shoulder, and even back pain. You may also suffer headaches, ear pain, have trouble sleeping, and struggle to chew or talk. It’s easy to underestimate just how debilitating a TMJ disorder can be.



Dr. Katherine Phillips specializes in diagnosing, treating, and relieving pain caused by TMD. She is double board-certified in orofacial pain and dental sleep medicine and has spent most of her career in these two fields instead of general dentistry. With extensive experience and education, she uses mainstream, evidence-based medical science to identify the contributing factors causing your pain and will offer a TMD treatment plan that best fits your needs. 


So, if you are suffering from neck and shoulder pain, along with other common TMD symptoms, contact Dr. Phillips today.

Contact Us Today For A Consultation!

Contact Us

Dr. Kathrine Phillips
About The Author
Dr. Katherine Phillips, DDS, MS received her undergraduate degree from the University of Michigan and her dental degree from the University of Detroit Mercy School of Dentistry. She currently serves as the Secretary/Treasurer on the American Board of Dental Sleep Medicine (ABDSM) Board of Directors and treats TMD and sleep disordered breathing at Restore TMJ & Sleep Therapy in the Houston, TX area. 
Woman standing outside smiling in the sun.
By manager 01 Mar, 2024
Explore non-surgical splint therapy for TMJ & orofacial pain with specialists Dr. Phillips & Dr. Joe. Achieve pain relief and improved jaw function.
Woman in yellow shirt with both hands on her head due to a headache.
By manager 13 Dec, 2023
Explore expert headache solutions for migraines, tension headaches, and more with Drs. Phillips and FischerHahm at Restore TMJ & Sleep Therapy.
Man smiling while sleeping in a bed with white sheets.
By manager 24 Oct, 2023
Discover the critical role of sleep in health with Drs. Phillips and FischerHahm. Achieve better sleep, enhance well-being, and address sleep disorders.
By manager 27 Jul, 2023
Explore treatments for sleep apnea: symptoms, remedies, and more. Improve your sleep with our expert guide from Restore TMJ.
By manager 05 Jul, 2023
Discover how oral appliances can enhance your sleep quality. Dr. Phillips, a dental sleep medicine specialist, offers custom-fit devices for sleep apnea, TMJ, snoring, and bruxism.
Man sleeping for an at home sleep study on a white couch.
By manager 20 Jun, 2023
Discover how sleep studies can diagnose TMJ disorders and sleep issues with Dr. Katherine S. Phillips. Enhance your sleep quality and overall health at Restore TMJ & Sleep Therapy.
ear pain caused by tmj disorder  - Restore TMJ & Sleep Therapy serving greater Houston, TX
By Dr. Katherine Phillips, DDS 21 May, 2023
Have you been experiencing ear pain lately and think it might be due to TMJD? Our article can help shed some light on the answer to that and what to do about it.
Women in a blue shirt is holding her jaw in pain.
By manager 09 Mar, 2023
Explore the differences between TMJ and TMD with REstore TMJ & Sleep Therapy. Get to know the causes, symptoms, and treatment options for jaw pain and disorders. Call 281-296-6797 for a consultation.
By manager 02 Mar, 2023
Teeth grinding is the most common cause of jaw pain. Grinding your teeth also results in fractured teeth and the destruction of dental work, which can even change how you look. People who grind their teeth during the day can make conscious changes to reduce their teeth grinding for those who grind their teeth at night . Fortunately, with a visit to Dr. Phillips, you can discover how to stop grinding your teeth. What is Teeth Grinding, and What Causes it? Grinding or clenching your teeth, or bruxism , is a common condition affecting millions of people and, if left untreated, can lead to broader health issues. According to the American Dental Association (ADA), a 2020 ADA Health Policy Institute report stated that half of the dentists saw a rise in clients with stress-related dental problems, primarily due to teeth grinding and jaw clenching. It can happen during the day or night and often goes unnoticed until the person is alerted by a partner or family member. Treating bruxism can prevent further damage to the teeth and relieve any symptoms associated with the condition, and there are several steps you can take to stop grinding your teeth and protect your oral health. People grind and clench their teeth for various reasons, including stress and anxiety, misalignment of the teeth and jaw, or an abnormal bite. In adults, teeth grinding is often caused by emotional tension and stress and can become a subconscious habit. In children, teeth grinding is usually due to an immature bite and can be triggered by new teeth erupting or the recent placement of braces. How Do You Know if You're Grinding or Clenching Your Teeth? Grinding or clenching your teeth can be challenging to identify since it usually happens when you are unconscious or sleeping. However, several signs could indicate you are grinding your teeth. Common symptoms of teeth grinding include: Waking up with a sore jaw Frequent headaches Increased sensitivity or pain in your teeth Tired or tight jaw muscles Pain that feels like an earache, but there is nothing wrong with your ear A locked jaw that is difficult to open or close completely Neck or face pain Noticing that your teeth feel different or worn down You or your sleep partner may also notice that you make clenching or grinding sounds during the night. At a dental appointment, your dentist may suspect teeth grinding if you have the following: Teeth that are chipped, loose, flattened, or fractured Worn enamel on your teeth Gum recession Possible Causes of Teeth Grinding Many people grind their teeth and tighten their jaws without realizing it, especially at night. Although stress and anxiety can lead to teeth grinding, other common causes are: Posture. Poor posture is not only horrible for your back; it's also bad for your teeth. When the body's joints aren't in proper alignment, it can result in jaw clenching and grinding. Misaligned teeth. If the upper and lower teeth don't fit together correctly, the misalignment may result in the tendency to grind teeth or clench jaw muscles. Sleep disorders. Sleep habits and sleep disorders can lead to teeth grinding at night. Chronic obstructive sleep disorder , also known as sleep apnea , is a known cause of sleep bruxism. Resolving sleep apnea can help stop teeth grinding. Sleep terrors and insomnia may also result in grinding teeth at night. Joint disorders. The temporomandibular region is around the jaw, mouth, and ears. This area contains the temporomandibular joints and jaw muscles, which allow the jaw to open and close. Disorders in this area can affect teeth grinding and a sore jaw. Stimulants. Stimulants like caffeine, nicotine, and alcohol can trigger teeth grinding. Avoiding these can help prevent teeth grinding. Stress. Stress is a common cause of teeth grinding and clenching. Finding ways to manage and reduce stress can help decrease teeth grinding. These can include relaxation techniques such as progressive muscle relaxation, yoga, deep breathing, meditation, and guided imagery can help relax the jaw muscles and stop teeth grinding. Chewing on Objects. Chewing on objects such as pencils or fingernails can trigger teeth grinding. You may also need to avoid chewing gum, which can exacerbate teeth grinding. Finding out how to stop grinding teeth at night takes getting to the root cause of grinding. Discovering the cause provides clues, pointing to the appropriate solutions. Prevent teeth grinding during the day. It is crucial to identify triggers that cause teeth grinding if you intend to stop grinding them during the day. Pay attention to your habits during the day and see if you notice when and if your grinding or clenching is worse. A TMJ specialist or dentist specializing in bruxism can provide you with exercises or relaxation techniques you can do throughout the day if you notice yourself clenching and, in some cases, offer medical treatment like muscle relaxants or Botox for bruxism. Prevent teeth grinding and clenching at night/in your sleep. You'll have to make changes during the day to stop grinding or clenching your teeth at night or in your sleep. Start by talking to your dentist or doctor to determine if you have underlying medical issues that could be causing the grinding. Additionally, your dentist may suggest you wear a mouthguard, splint, or other oral appliance. At the same time, you sleep to protect your teeth from further damage and keep your mouth in the proper alignment, helping your TMJ to relax. A custom-fitted mouthguard also helps lessen the impact of teeth grinding by covering the teeth to create a physical barrier that reduces damage. How To Stop Child/Baby Grinding Teeth Many children grind their teeth at night, but most grow out of it. If your child or baby grinds their teeth, the first thing to do is identify what might be causing the behavior. Stress, anxiety, or an underlying medical condition can cause your child to grind their teeth. If the grinding is stress-related, identifying and addressing the source of the stress, such as an overly demanding school schedule or peer pressure, may help. If a medical or dental condition causes the grinding, your child's dentist or doctor can help you determine the best action. If the grinding results from a habit, it can help redirect your child's attention when they start to grind and provide them with other activities that may help reduce their stress and anxiety. Side Effects of Teeth Grinding Grinding your teeth may seem like a harmless habit. After all, it's easier to notice this behavior if you're not on the lookout for it. And unless your significant other or family members complain about the noise from your nighttime teeth grinding, it's difficult to find proof of the act. However, long-term grinding of teeth at night can lead to significant side effects like: Pain in the jaw. The pressure and movement from teeth can lead to tenderness in the muscles, causing jaw pain . For some people, the pain may become chronic and severe. Headaches. The constant back-and-forth movement and clenching can impact the muscles around the neck and head, resulting in headaches due to muscle fatigue and tension. Wearing down teeth. Like sandpaper eventually smooths a surface, the repetitive motion from teeth grinding can flatten teeth and wear the enamel down over time. Teeth grinding can change the appearance of your teeth, causing them to look shorter and making chewing more difficult. Damage or fractured teeth. Grinding can destabilize teeth, making them shift and feel wobbly. The force from grinding may also crack teeth, causing pain and affecting oral health. Misalignment and cracked teeth can result in gum disease, cavities, and tooth loss — leading to poor overall health. Chronic ear pain. The temporomandibular area is closely connected. If the muscles around the ear become affected due to teeth grinding, chronic ear pain may occur. Facial muscle changes. Most people need to be aware that teeth grinding can change the shape of your face. Long-term bruxism can cause shorter teeth. Shorter teeth, in turn, change the structure of the face and jaw — leading to a sunken appearance. In addition, other muscles around the face can enlarge to compensate for dental changes. If you're concerned about your appearance, you may want to note that chronic teeth grinding can change the way you look. Remedies for Teeth Grinding The methods for how to stop teeth grinding at night versus teeth grinding when you are awake are typically the same. Although some treatments aren't quite possible when you're asleep, their benefits can last even after you've gone to bed. Reductive coronoplasty. Reductive coronoplasty directly involves changing or leveling the biting surface of teeth. This procedure reshapes crowded or crooked teeth, improving teeth alignment. Conversely, additive coronoplasty can add to the surface of teeth to help treat bruxism. Dental Appliances: Mouthguards, night guards, and splints. A mouthguard does just that — it guards teeth. Typically used for sports, a mouth guard keeps teeth from injuries sustained during activity. A night guard protects teeth from grinding at night. Lastly, a bit splint guides jaw movement, enabling the jaw to land in the appropriate position. These appliances protect teeth differently, and finding the right one for your situation is essential. Biofeedback. Biofeedback allows a person to train themselves by monitoring auditory and visual stimuli from the body. Although biofeedback needs a person to be alert, the technique can still help sleep bruxism by reducing overall stress. Stress reduction techniques. Though implementing stress reduction techniques such as yoga, exercise, and meditation requires a person to be awake, they can also help with nighttime teeth grinding. Allowing muscles to decompress and relieve tension alleviates stress-induced teeth grinding, even at night. Tongue and jaw muscle exercises. Most people don't stop to think about it, but their faces and mouth are a team of tissue, muscles, bones, and joints that closely affect each other. The tongue, for example, affects how the jaw moves. You reduce teeth grinding by exercising the right muscles — like the tongue and jaw. Behavior changes. Behavioral modifications like changing your posture and avoiding environments that cause stress can reduce instances of teeth grinding. Cognitive Behavioral Therapy (CBT) can help change behavior and thought patterns that lead to teeth grinding. Medications. A doctor can prescribe medication to help treat bruxism if all other treatments don't work. When used for short periods, muscle relaxants can relieve tension in the temporomandibular area. In severe cases of teeth grinding, botox injections can alleviate muscle tension. Antidepressants and anti-anxiety medications assist in decreasing anxiety, allowing jaw muscles to relax and reduce bruxism. How Can a TMJ Specialist Help with Teeth Grinding and Clenching? A TMJ specialist is a dentist board-certified in orofacial pain and conditions affecting the TMJ. TMJ specialists have extensive knowledge and experience regarding the structure, function, and pathology of TMJ. In addition to more thorough diagnostic evaluations, they can often provide more effective and long-term solutions for teeth grinding than your doctor or dentist alone. This is because TMJ specialists use a holistic approach to treatment, focusing on the underlying causes of the teeth grinding, such as stress, anxiety, or misaligned teeth, rather than just treating the symptoms. They often work with other medical experts like dentists or sleep physicians for more comprehensive care and treatment. Protecting Your Oral Health Protecting your teeth is critical to taking care of your overall health. Chronic teeth grinding can result in costly dental work, poor oral health, and chronic pain. If you're experiencing a sore jaw, headaches, or cracked teeth, seeking an expert diagnosis to find the cause is the first step to finding a solution. Get the answers you need on how to stop grinding your teeth at night or keep from grinding in the daytime to protect your oral health. As a TMJ and sleep apnea dentist, Dr. Katherine Phillips specializes in diagnosing and treating bruxism. With her Master of Science in Orofacial Pain From USC and extensive experience in TMJ therapy, Dr. Phillips utilizes proven and effective evidence-based medical interventions to identify bruxism and help find the right treatments to suit your needs. Get in touch today for more information.
By manager 16 Dec, 2022
The temporomandibular joint, or TMJ, is an anatomically complex joint, composed of muscles, joints, ligaments, bones, and discs. Proper jaw movement requires a high level of interaction and coordination among all these components, especially the articular disc (which absorbs stress), the adductors (jaw-closing muscles), the abductors (jaw-opening muscles), and jaw ligaments. This makes diagnosing problems or dysfunction with the TMJ extremely difficult. Properly diagnosing disorders of the TMJ—collectively referred to as TMD—requires both clinical examinations and medical imaging in order to develop an accurate assessment of the joint, its function, and its surrounding bone and tissue. If you are experiencing pain, discomfort, or dysfunction in your TMJ, you will first have a clinical evaluation. This is when your doctor or TMJ specialist will discuss your symptoms with you and examine your jaw, pressing on areas around it to identify any sensitivity. He or she will also observe the range of motion of your jaw and listen to and feel around your jaw while you open and close your mouth. In some cases, the doctor’s clinical findings are enough to diagnose a TMD and begin treatment. Other times, additional diagnostic imaging will be necessary to confirm the presence of a TMD.
Show More
Share by: