Physical Therapy as a Solution for Jaw Clenching and Grinding

Knees, hips, and shoulders are few joints that come to mind when we think about outpatient physical therapy. But did you know that physical therapy can be an effective treatment option for people with Temporomandibular Disorders, or TMD? TMD is sometimes called TMJ (a term that encompasses several diagnoses affecting the temporomandibular joint in the jaw). Physical Therapist Jason Gubler at Cope Family Medicine | Ogden Clinic talks more about this type of therapy.

What causes TMJ/TMD?

“Stress is usually a key factor in TMD,” says Jason Gubler. “We see patients who clench their jaw muscles or grind their teeth—usually at night. Often, you don’t realize that you do this until you wake up with pain or fatigue the next day.” TMJ/TMD could also happen because of postural issues during the day. “When we sit at a desk all day or spend hours on our phone, gravity pulls the jaw downward, eventually causing discomfort.” And occasionally, something as simple as excessive gum chewing can bring on TMD symptoms.

What does TMJ/TMD feel like?

TMD can present itself with one or more of these symptoms:

• Clicking or popping from the jaw
• Difficulty opening your mouth
• Painful chewing
• Feeling like your jaw catches or becomes stuck
• A ringing sensation in your ear(s)
• Fatigue while speaking

How does physical therapy help with TMJ/TMD?

Jaw pain is usually caused by prolonged tension and compression. “Physical therapy for the jaw includes both working on the soft tissue with massage and mobilization to lengthen it out and relieve tension, as well as prescribing postural changes and exercises that continue to take pressure off the joint.”

“Sometimes we see patients with so much tension in their jaw that their mouth doesn’t drop straight down when they close their mouth. If I put my thumb along the top of their mouth, I can feel deviations on their teeth where they clench on one side consistently.”

How quickly do people see improvements?

Interestingly, Jason Gubler says that many patients begin feeling improvements after one physical therapy visit. “When we start moving the joint around and correcting the imbalances, many patients start experiencing relief.” With adherence to the at-home exercises and postural changes, even patients with severe TMJ/TMD find relief in a few weeks.

Jason Gubler also works closely with dentists and other specialists to implement night guards for patients who could benefit from them. “In very severe cases, surgery is an option to restore the joint, but I’ve never had to prescribe this,” he adds.

What happens if you never get help with TMJ/TMD?

“Like other parts of the body, when something is not right, we will use other joints and muscles to compensate for the injury,” says Jason. While some people have short-lived jaw pain, most people with TMJ/TMD have it for months to years.

“Physical therapy is a conservative treatment that’s very effective. It’s best to be seen and start fixing that imbalance than to wait for symptoms to worsen or for compensatory problems to occur.”

Can you see a physical therapist for jaw pain without a referral?

Yes! In Utah, physical therapy is recognized as a “Direct Access” service meaning that most insurances do not require a referral from a primary care provider. This is great since it saves patients both time and money. However, some exclusions can apply, so you may want to check with your insurance before scheduling.

Jason Gubler is a Doctor of Physical Therapy at Cope Family Medicine | Ogden Clinic in Bountiful, Utah. Schedule a visit with him by calling 801-298-4112.