You may remember having ear infections as a child. The pain, lightheadedness, and nausea that often accompany ear pain are hard to forget. For adults, ear infections are much less common, yet adults go to their doctors with ear pain every day but it’s often not because of an infection. Even in children, ear pain may not necessarily be a result of an ear infection. More and more primary care physicians are finding a link between TMJ and ear pain. Understanding how these two conditions are linked can be the key to successful treatment for your ear pain.
What is TMJ?
TMJ is the common abbreviation for temporomandibular joint disorder. TMJ pain can be severe enough to interfere with daily life. The anatomy of the jaw is what makes it one of the strongest joints in the body. However, it also makes it the most vulnerable to stress and wear.
The temporal bone of your skull (located just below the temples on either side of your head) attaches to the mandible, the strong bone of the lower jaw, with a small disc of cartilage. This attachment allows you to eat, talk, laugh – any function that is necessary for the jaw to freely open and close.
TMJ occurs when there is damage, swelling, or abnormalities in the cartilage disc or any of the muscles or tendons in the area of the temporomandibular joint.
These days TMJ is now referred to medically as TMD (temporomandibular disorder), a disorder occurring in the area instead of just abbreviating the name of the joint. Many, however, still commonly refer to pain or problems in this area as TMJ.
What causes TMJ?
Common causes of TMJ include:
- Trauma to the jaw
- Teeth grinding
- Improper bite
- Excessive gum chewing
- Some types of arthritis
Risk factors for TMJ include:
- Gender: Women are more likely to suffer from TMJ and also less likely to find relief with pain medication
- Age: Women in childbearing year (18-44) have an increased risk, but men have the same level of risk regardless of age
- Genetics: Genetic stress response, psychological health, and propensity to inflammation play a part in risk level for TMJ
- Pain tolerance: People with a lower tolerance for pain have an increased risk of developing TMJ
- Previous pain conditions: TMJ may accompany other chronic pain conditions
What are common TMJ symptoms?
TMJ has a number of symptoms that are hallmarks of this disorder:
- Jaw pain: Many people will wake with jaw pain or sore muscles from clenching their jaws or grinding their teeth
- Jaw clicking and popping: Others might experience a popping or clicking noise in their jaw, or the jaw might lock (dislocate) open or closed
- Head and neck pain: Still others have frequent head and neck pain as a result, even leading to migraines
Can TMJ cause ear pain?
TMJ and ear pain is one of the most common symptoms that people may not recognize as part of the disorder, with 80% of TMJ patients reporting ear pain. Associated as it is with ear infection, TMJ and ear pain also go hand-in-hand. Why? As they say in real estate, the reason is simple: location, location, location.
The temporomandibular joint is located in close proximity to the middle ear and the ear canal. The muscles in this area support not only the temporomandibular joint and all of its actions but also the nerves of the ear. As the canary in the coal mine, ear pain may be a first sign that something is wrong with the temporomandibular joint, especially if the ear canal looks healthy and infection-free.
What does TMJ and ear pain feel like?
There are three types of TMJ, each of which can cause a different type of ear pain.
- Myofascial pain: This primarily affects the muscles of the face. Excessive strain, possibly due to jaw clenching or teeth grinding (also known as bruxism) can cause strain to the muscles surround the joint and in the face.
- Derangement of the temporomandibular joint: Derangement of the joint is when it is not functioning as it should due to dislocation. This can be caused by injury or excessive teeth grinding, gum chewing, or jaw clenching.
- Underlying degenerative disease: The most common degenerative disease that causes TMJ and ear pain is arthritis, but any other disease that causes system-wide inflammation may also contribute.
Common TMJ and ear pain symptoms
Each of these types of TMJ has some similarities when it comes to pain. Ear pain due to TMJ is often worse at night and in the morning. Sometimes it may be experienced as a dull, throbbing ache or as a sharp, searing pain.
Ear infection and ear pain from TMJ share overlapping symptoms that can make it hard to diagnose one from the other. Both cause ear pain and can produce a sensation of fullness in the ears. A decrease in hearing acuity and tinnitus (ringing in the ears) are also common with both conditions.
Do I have ear pain from TMJ?
There are certain signs to look for to determine if pain is an ear infection or TMJ.
Ear infections are a much more common diagnosis if the following factors are also in place:
- Recent cold or flu: Ear infections are often related to or caused by a previous illness
- Discharge coming from the ear: TMJ does not cause discharge from the eustachian tubes or any other part of your ear
- Fever, warmth, and even redness in the ear: Fever can be the body’s immune response to infection
If none of these factors are present, there are other signs to diagnose TMJ. The most important one is that your doctor will have completed an examination and cleared you from the possibility of ear infection. TMJ ear pain will be accompanied by other TMJ symptoms like head and neck pain. Your dentist may also notice excessive wear on your teeth due to grinding, and you may have other symptoms in your jaw and face.
While the pain of an ear infection does not go away and come back, TMJ ear pain may be episodic, occurring when the jaw is clenched throughout the night and then disappearing over a period of days, weeks, or months.
While TMJ ear pain and TMJ ear pressure are important signs that it is not an ear infection, because the symptoms are so similar, other symptoms should be present to rule out infection.
What helps with TMJ and ear pain relief?
When you wake up with an aching (or locked) jaw, your priority will be pain relief and restored mobility, but there is a difference between acute care, chronic care, and prevention.
For acute episodes of TMJ ear pain, warm compresses and over-the-counter non-steroidal anti-inflammatory (NSAID) medicines like ibuprofen can help ease your pain and restore jaw function. Patients might also be advised to eat only soft foods during the acute phase of TMJ to relieve your ear pain.
Long-term care of severe TMJ and ear pain requires a coordinated approach between your healthcare team, which may include your:
- Primary care physician
- Pain specialist
- ENT (ear, nose, and throat) doctor
They may suggest exercises or other preventative strategies for TMJ ear pain relief as well as pain relief for other affected areas. Long-term TMJ treatment may include:
- TMJ stretches and exercise
- Whole-body stretches and strengthening exercises
- A prescription bite plate from your dentist
- Stress management strategies
7 TMJ ear pain relief exercises
If recommended by your doctor, TMJ and ear pain relief exercises are an important part of treatment. They can help:
- Strengthen the muscles of the jaw
- Increase mobility
- Relax tension in the jaw
- Promote healing
Here are seven of our favorite TMJ ear pain relief exercises that also help with other pain symptoms of TMJ.
Exercises for overall TMJ pain
The “most famous physical therapists on the internet” suggest these three exercises for TMJ, pointing out that the exercises will take time to strengthen and reposition the joint.
With a tall spine, inhale deeply, and on the exhale, pull your chin straight back (this will give you a “double chin”). Repeat ten times.
Resisted closing the mouth
Open your mouth. Take your chin between the index finger and thumb (you can use one or both hands). As you close your mouth, provide gentle resistance with the fingers.
Side-to-side jaw movement
Place an object that is about ¼” thick between your teeth (you can use the handle of your toothbrush). Gently move the lower jaw side to side. At first this may be painful and the movement may be slight. As the range of motion increases, you can increase the thickness of the object between your teeth.
Forward and back jaw movement
Similar to the side-to-side movement, place an object of about ¼” thickness between your teeth. Gently move the lower jaw forward so that it juts out in front of the upper teeth. As the exercise becomes easier, increase the thickness of the object.
Other preventative and long-term treatments for TMJ ear pain
TMJ pain is a whole-body disorder, and it deserves to be addressed as such. Poor posture can even contribute to the pain, but go beyond the order to “stand up straight” with these three exercises.
Exercise 1: Standing at the wall (with towels)
Roll up two towels and keep them at hand. Place your heels against the wall, then place a rolled towel behind your neck and one behind your low back. Press into the wall for three minutes. For an extra challenge, open your arms out to the side (keep them below the height of your shoulders) and press the backs of your hands into the wall.
This simple exercise helps to “retrain” your spine into its natural curves.
Exercise 2: Seated pillow squeeze and shoulder opener
Sit on a chair with knees at a 90-degree angle (coming straight out from your hips while seated, not above or below). Place a firm pillow between your knees. Reach behind you to clasp your hands behind your back (with straight arms). Squeeze your shoulder blades towards each other as you squeeze the block between your knees 60 times. Allow your belly to relax and your breath to be even and full.
Your hands behind your back help to properly align your neck and shoulders. Squeezing the pillow helps to activate important muscles on the insides of your legs.
Exercise 3: Ankle squeezes
Come onto hands and knees with a foam block placed between your ankles. Make sure that your wrists are directly beneath your shoulders and your knees are under your hips. Relax your shoulder blades together and let your belly and head relax down. Squeeze and release the block between your ankles 60 times, remembering to breathe evenly and fully.
This exercise extends your spine and helps promote proper postural alignment.
Work closely with your dentist and doctor
A team-based approach to TMJ ear pain relief and prevention also includes working closely with a dentist as well as other healthcare professionals.
This video is a clear example of how addressing TMJ with your dentist can help solve stabbing ear pain. The dentist used dental treatment of broken teeth and non-surgical jaw realignment to help a patient who had been suffering for years.
Your dentist may also recommend a prescription bite plate for TMJ pain. These are different from the over-the-counter “boil and bite” mouth guards used for sports. A custom-fitted bite plate can prevent teeth grinding and mouth clenching while maintaining a properly aligned bite. Many people balk at the expense of these, which can be considerable and often not covered as a simple dental appliance. One of the benefits of working with a team of doctors is that a primary care physician can prescribe this and perhaps get the cost covered through a medical diagnosis.
Finally, for those people with TMJ pain that is caused by stress-relating jaw clenching and teeth grinding, it is important to carefully manage stress to prevent future pain and chronic damage to the joint. People who suffer from anxiety and depression are more likely to suffer from TMJ, and vice versa. Stress management strategies that include plenty of rest, mediation, and even behavioral therapy can go a long way to relieving acute pain and preventing future flare-ups.
If your TMJ and ear pain is so severe and unrelieved that it is impacting your daily life, getting immediate relief is crucial. A pain specialist can help you find a solution. Contact us today to make an appointment with one of our clinics across the country.