Temporomandibular disorders (TMDs) are a common condition characterized by pain and discomfort while chewing. Traditionally, when patients complain of jaw pain, the focus has been on structures like the temporomandibular joint or the masseter muscles. However, there’s a growing body of research suggesting the intimate relationship between the jaw and the neck may be a contributing factor or even the underling cause of a patient’s TMD.
In one study, which included 40 women between 19 and 49 years of age, half of whom had chronic TMD, researchers observed that participants with jaw pain and discomfort were more likely to have neck pain and stiffness that limited their daily activities. Additionally, among the TMD patients, the more jaw muscle tenderness they exhibited, the higher their scores for both TMD- and neck-related disability. The research team observed a similar relationship between tenderness in the upper trapezius (the muscles in the shoulder and neck regions) as well as the temporalis muscles that function to close the jaw, located on the side of the head above the ear extending to the temporomandibular joint. The authors concluded that a significant correlation between neck disability and jaw disability exists and that healthcare providers should consider the neck and its related structures during the evaluation and management of patients with TMD.
These findings are echoed in a July 2022 study that found TMD patients with restricted cervical range of motion experience more severe TMD-related pain and disability than TMD patients with normal cervical range of motion. Another study published the same month found that patients with chronic (lasting longer than three months) TMD were two times more likely to have neck pain than individuals with acute (less than three months) TMD. A study published later that year linked neck pain with increased sensitivity of the masticatory muscles in TMD patients, leading the author to conclude, “In TMD treatment, we should pay attention to and actively relieve neck pain.”
In a study published in October 2021, researchers found that patients with concurrent neck pain and TMD experienced improvements in jaw function following care targeting the cervical spine. A systematic review conducted in 2023 confirmed these findings. The authors cited five studies that supported the application of manual therapies to restore normal movement to the cervical joints can improve pain, pain sensitivity, and function in the jaw. Interestingly, a systematic review published in March 2024 concluded that cervical rehabilitation interventions—such as manual therapies combined with neck-specific exercises—are effective for reducing pain intensity associated with myogenic temporomandibular disorders, which is TMD specifically linked to pain originating in the jaw muscles.
The good news is that doctors of chiropractic are well-versed in managing patients with neck pain as well as TMD using manual therapies and specific exercises to address trigger points in the jaw and neck muscles, as well as to restore normal motion to the temporomandibular joint and cervical spine.
