I think we’ve all had an incident of one-sided jaw pain at some point, where it’s difficult to open and close the jaw without experiencing sharp pain. I’m not referring to chronic TMJ pain related to malocclusion (called TMD—temporomandibular joint dysfunction); I’m referring to those isolated incidents that happen to everyone on occasion. This condition can be caused by chewing hard/tough food requiring stronger than usual jaw muscle contraction; chewing a large piece of food on one side of your jaw; teeth grinding, and of course trauma to the jaw such as from boxing and other contact sports. The TMJ can also be misaligned from rear-end collision car accidents (acceleration-deceleration), as the force of impact is enough to violently hyper extend and flex the TMJ. Some cases of sudden onset TMJ pain self-resolve, but in other cases it can last for weeks, which can obviously be a nuisance as chewing food becomes uncomfortable.
The jaw, or temporomandibular joint is classified as a synovial, condylar joint. Joints are named after the two bones that comprise it, so the TMJ is formed by the articulation of the mandibular fossa (depression/pit) of the left and right temporal bones of the skull and the left and right condylar heads of the mandible (lower jaw), hence temporomandibular joint. It could have been named the “mandibulotemporal joint,” or MTJ, but someone long ago decided temporomandibular sounded better.
TMJ movement is very complex, involving flexion, extension, rotation, translation and oblique movements. These movements are accomplished by varying- magnitude, combined contractions of the temporalis, masseter, medial pterygoid and lateral ptergoid muscles controlled by the central nervous system, including nuclei in the brainstem. So, the simple act of chewing is neurologically complex; perhaps the most complex out of all the joints in the body.
Synovial means that the joint is encapsulated by ligaments and has an inner tissue lining called synovium that produces synovial fluid, a clear viscous fluid that reduces friction in the joint, very much like how motor oil reduces friction between a car engine’s cylinders and pistons. Not all joints are synovial, such as the acromioclavicular (AC) joint of the shoulder which is a fibrous joint; only the joints that are tasked to move frequently and have a comparatively larger range of motion i.e. knees, hips, shoulders, fingers, etc. The TMJ also has an articular disc, a thin slip of tissue that sits between the mandibular heads and temporal bone that provides cushioning/ shock absorption. Since the TMJ is a heavily used joint, nature added this extra protection. Just imagine the number of times the TMJ extends and flexes (opens and closes) in a typical day, from talking and eating!
So what is going on when you have one-sided jaw pain when you previously didn’t? The answer is that the jaw is slightly misaligned and the resultant, abnormal movement is pulling excessively on the soft tissues of the affected side and/or the condyle is pressing against the mandibular fossa excessively, firing surrounding nerve endings. Muscle spasm reflex of any of the aforementioned jaw movement muscles may also be contributing to the pain by maintaining the misalignment in place. TMJ misalignment is typically subtle and not usually visible, but sometimes you can see it if you open your mouth in front of a mirror. If you notice your mouth opening forms a tilted oval shape as opposed to an even oval shape, it means your mandible is deviating to one side due to TMJ misalignment. Usually, the mandible deviates to the same side of the misalignment/jaw pain, but not always.
To restore alignment and balance to your TMJ, try this:
Relax your jaw. This may sound easy, but for some people, especially those who subconsciously tend to clench their jaw, it is not. Just concentrate on your jaw and facial muscles, commanding them to let go. Your mandible should drop slightly so that your teeth are not touching at all.
Next, with your jaw still relaxed, using the palm of your hand on the side opposite to the painful side of your jaw, tap the opposite side of the jaw (the side of the jaw bone, not directly on the joint itself) firmly three times. Pause for ten seconds, then do it again. Wait for a couple more seconds, and see if you notice reduced pain. If pain is less, it means the TMJ settled back into alignment and the pain should start to go away and should be gone in about an hour or two. If not, tap obliquely at an upward angle towards the affected joint, then re-evaluate. If you notice the pain lessens, then that’s it—just wait a little longer, and the pain will disappear and your jaw will be back to normal.
If there is no change, try this: with your jaw still relaxed place your hand to the sides of your face with the tips of your index fingers directly on top of the protuberances of the condylar heads of the mandible and your thumbs cradling the back of the jaw bone (ramus). Alternately press gently inwards with your index fingers for a total of six times (three on each side). Then, using your thumbs gently pull the jaw forward three times. You can also gently push your jaw side to side alternating sides, three times per side. I need to emphasize that you must keep your jaw totally relaxed while you do this; otherwise it may not work.
Watch this video where I demonstrate these simple moves:
If you find that you get one-sided TMJ pain quite often, you may have malocclusion of your bite. Make sure to see your dentist/ orthodontist.
Sometimes TMJ can trigger headaches. If you have both, fixing the TMJ misalignment is likely to fix your headaches.
