Temporomandibular joint (TMJ) pain and acupuncture

What is TMJ?

The temporomandibular joints connect your lower jaw to your skull, just in front of each ear. You use them every time you talk, chew, yawn or swallow. Clinically the problem is called temporomandibular disorder (TMD), but most people call it TMJ. It covers pain and dysfunction in the jaw joint and the chewing muscles around it.

It can affect daily life more than people expect: meals out become uncomfortable, long meetings are tiring, and constant pain wears down mood.

What are the symptoms of TMJ?

Common symptoms include:

• Tenderness and pain around the jaw joint
• Pain in the jaw muscles, face or around the ears
• Difficulty opening or closing the mouth fully
• Clicking or popping sounds when opening or closing
• Difficulty or pain when chewing
• Headaches, especially around the temples
• Neck and shoulder tension

In our clinical practice we have found that TMJ is often connected to neck pain, particularly to tension and poor function in the levator scapulae muscle, which runs from the side of the neck to the top of the shoulder blade. If neck pain is part of your picture, see our page on acupuncture for neck pain.

What causes TMJ?

Often more than one of these is involved:

• Joint injury, such as a blow to the jaw or whiplash
• Clenching or grinding the teeth, often during sleep and often without knowing it
• Neck and shoulder muscle tension, especially in the levator scapulae
• Posture, such as long hours with the head pushed forward at a desk or phone
• Stress, which tends to show up as jaw clenching and muscle tension
• Arthritis in the jaw joint, in some cases

Can acupuncture help TMJ?

Acupuncture uses thin, sterile, single-use needles at specific points. For TMJ, the aim of treatment is to relax sore jaw muscles, improve blood flow to the head and neck, and calm the nervous system. Points are usually chosen around the jaw and face and in the neck, shoulders and hands.

Stress is a common contributing factor in TMJ, and acupuncture is widely used to help people feel calmer. Many clients tell us they feel relaxed after a session, which often goes together with the jaw muscles letting go. Research on acupuncture for TMJ pain is growing, and some studies suggest it may help reduce jaw pain, although results vary. If clenching seems tied to stress or worry, our page on acupuncture for anxiety and stress explains how we approach that side.

When you wake up already in pain

TMJ trouble sounds small: a sore jaw, some clicking, a bit of grinding at night. But if you grind in your sleep, you wake up with the pain already there. If you clench through the day, in meetings, in traffic, at your desk, by the afternoon it can climb into your temples as a headache.

It's rarely bad enough to force you to act, so people put up with it for years. Painkillers become routine, and a night guard protects the teeth but does nothing about why you're clenching. In our experience, clenching and grinding often go with a nervous system running hot, which is why they tend to get worse in stressful weeks and at night. So we don't only treat the jaw. We treat the jaw, temples, neck and shoulders together, and use Chinese herbal medicine where the pattern calls for it, particularly when sleep is disturbed.

How many acupuncture treatments will I need?

There's no fixed number. It depends on your condition and how your body responds. A recent strain may settle in a few visits, while longer-standing issues usually need more.

We start with an initial series of three treatments. This shows us how quickly your body responds to acupuncture and helps us set the right treatment frequency for you.

Acupuncture works cumulatively, with each session building on the last. For musculoskeletal concerns, most of our patients follow a one-month care plan:

• Weeks 1–2: 2–3 treatments per week
• Weeks 3–4: 2 treatments per week

That's typically 8–10 visits in the first month. After that, we reassess your progress and adjust your plan.

"Waking up and not being in pain is amazing"

Jenna had been grinding her teeth in her sleep for years and clenching through the day without thinking about it. The headaches came several times a day, and she was reaching for Tylenol often enough that it had stopped feeling like a decision.

The part she keeps coming back to isn't the jaw. It's the mornings: "Waking up and not being in pain is amazing. I feel like my day is already better, to wake up and be able to focus on my day and not be distracted by the pain anymore."

She tells us she no longer needs the painkillers for it. She started at three visits a week and is now on one a month, maintaining it herself with exercises in between. This is her experience; everyone responds differently.

"It's like a bug bite"

Most people hesitate over the needles, and near the face they hesitate more. Both patients we interviewed raised it without being asked. Jenna: "It's not that bad. The idea of having needles is scary, that's normal. It's uncomfortable at first when it first goes in, but then when you're lying there, it's just a nice nap."

The other described it as a bug bite, like a mosquito, maybe slightly more intense. What she mentioned more was feeling safe: "I felt very safe and comfortable. Even the way that you start the session, okay, we're gonna begin, kind of warning, and then take a deep breath and go through it."

The needles are about the thickness of a hair, and nobody goes near your face without telling you first.

What happens at a first visit for TMJ?

Before any treatment, we start with an initial exam with Dalibor Covic, R.TCMP. This includes a physical examination to decide on the most appropriate treatment for you. Along with specific tests for the jaw, we check the stability and movement of the neck and shoulders, and take your pulse as part of the TCM assessment. You then get a first treatment and a plan, including the suggested number of sessions and the cost. Your first visit is an initial examination ($110, about 60 minutes) followed by your first acupuncture treatment ($120).

What else helps between visits?

We also look at the habits that may feed jaw pain: posture, sleep, clenching, stress and diet. We place a strong emphasis on diet and can give you guidance on avoiding foods that seem to drive inflammation for you. During a flare, softer foods and smaller bites also give the jaw a rest.

Simple self-care steps that may help:

• Notice when you clench during the day and let the teeth rest apart, with the tongue resting on the roof of the mouth.
• Avoid chewing gum and very hard or chewy foods for a while.
• Use a warm compress on sore jaw muscles.
• Take regular breaks from screens and check that your head is not pushed forward.
• Ask your dentist about a night guard if you grind at night.

Because TMJ often comes with tension headaches, you may also find our page on acupuncture for headaches useful.

If jaw pain is affecting your eating, sleep or work, you can book a first visit at our clinic at 1550 Enterprise Rd, Mississauga, near Hwy 401 and Dixie Rd, about 20 minutes from Etobicoke.

Common questions

Should I see my dentist about TMJ pain?

Yes. A dentist can check your bite and teeth, look for signs of grinding and discuss a night guard. Acupuncture works alongside that care.

Where are the needles placed for TMJ?

Usually a few points around the jaw and face, plus points in the neck, shoulders and hands. Which points are used depends on your assessment.

How many acupuncture sessions do people have for TMJ?

It depends on your condition and how your body responds. We start with an initial series of three treatments, then most people with musculoskeletal concerns follow a one-month plan: 2 to 3 treatments a week in weeks 1 and 2, then 2 a week in weeks 3 and 4, typically 8 to 10 visits. After that we reassess and adjust your plan.

Should I keep wearing my night guard?

Yes. A night guard protects your teeth. Acupuncture works on the tension behind the clenching, alongside your dentist's care.

This page is general information, not medical advice. Acupuncture works alongside the care you get from your family doctor. If your symptoms are new, severe or getting worse, see your doctor first.