TMJ disorders can cause jaw pain, clicking, locking, facial pain, headaches, neck pain, ear pressure, clenching, and pain with chewing.
This video explains how TMJ disorders may affect jaw movement, headaches, facial pain, clenching, neck symptoms, and treatment planning.
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Hi, I’m Dr. Jason Siefferman, headache specialist and medical director at Manhattan Pain Medicine. Temporomandibular joint dysfunction, or TMJ as most people call it, occurs for a number of reasons and our job is to understand what is driving it for each specific patient.
Common causes are generally not the joint itself. So, the joint itself can be the problem if there’s a primary autoimmune condition. We will see this with seronegative rheumatoid arthritis or Sjögren’s. There’s some other autoimmune conditions where this will pop up and we will see hypermobility. So, if someone has hypermobility spectrum disorder or Ehlers-Danlos syndrome and they have hypermobility of the jaw itself, that will cause primary TMJ dysfunction. We will also see this in trauma. Someone may have had a hyperextension jaw injury or some other trauma to the jaw which has led to primary joint dysfunction.
If there is not a primary joint dysfunction, then we want to look for what’s driving the problem. What’s causing pain to localize around the jaw? Commonly, migraine, because of the trigeminal nervous system involvement, will cause clenching of the jaw muscles. Sleep apnea will cause clenching. Bruxism, where people grind related to OCD or anxiety or just from stress. Malocclusion, meaning the teeth do not line up properly, will often lead to the body trying to align the teeth, which will lead to constant use and pressure across that joint, and a variety of other issues. Orofacial dystonia, which is a neurologic condition where the jaw-closing muscles are abnormally hyperactive.
I could keep going—dental issues, wisdom teeth, we’ve seen it with vasculitis. There can be other throat issues. We really want to understand what’s driving the TMJ dysfunction. Is there a primary joint issue or not? And then, how do we address it?
Oh, I forgot the neck. Of course, the neck can cause jaw issues. The articulation of the head-neck junction, as with craniocervical instability, affects the articulation of the jaw indirectly, right? There’s a compensation based on how your head and neck join that affects how the jaw moves.
We’ll take a deep look, we’ll understand all of the causes, and we’ll get you on a path to treatment.
TMJ disorders, also called TMDs, are a group of conditions that affect the jaw joint, chewing muscles, and related structures.
The TMJ is the temporomandibular joint itself, while TMD refers to the disorder group. Symptoms may include jaw pain, clicking, popping, locking, facial pain, ear pressure, headaches, neck pain, jaw fatigue, tooth-like pain, or pain with chewing.
TMJ symptoms can come from the joint, muscles, bite mechanics, clenching, arthritis, autoimmune disease, headache pathways, neck referral, trauma physiology, or chronic pain sensitization. Because the causes can overlap, diagnosis-first evaluation matters before treatment begins.
At Manhattan Pain Medicine (MPM), evaluation begins by identifying whether jaw pain is driven by the joint, muscles, headache pathways, neck referral, autoimmune inflammation, clenching, trauma physiology, or chronic orofacial pain.
For patients looking for TMJ disorder treatment in Manhattan, MPM evaluates jaw pain, facial pain, headaches, migraine overlap, tension headache, bruxism, chewing pain, jaw locking, clicking, neck symptoms, Sjogren’s, arthritis-related jaw pain, medical PTSD, and chronic pain sensitization.
Care may include conservative strategies, acupuncture, biofeedback, pain psychology, medication management when appropriate, botulinum toxin for selected muscle-driven TMJ dysfunction, and coordinated dental, oral surgery, neurology, or specialty referral when needed.
Many patients with TMJ symptoms are told the issue is their bite, their jaw joint, their stress, or their clenching. Any of those may contribute, but TMJ disorders are often more complex. Jaw pain can be muscular, joint-related, dental, neurologic, inflammatory, cervical, headache-related, trauma-related, or centrally sensitized.
MPM uses a diagnosis-first approach to understand the full pain pattern. The evaluation considers where pain occurs, whether chewing or clenching triggers symptoms, whether headaches or migraine are present, whether the neck contributes, whether autoimmune disease or Sjogren’s may affect the joint or surrounding tissues, and whether medical trauma or nervous system sensitivity is amplifying symptoms. This helps guide care toward the true pain driver rather than assuming every TMJ disorder is treated the same way.
TMJ disorders connect several MPM Zones of Expertise, with strongest relevance to Headache, Musculoskeletal issues, Psychology of Pain, Autoimmune and Inflammatory, and Complex Chronic Pain. This matters because jaw pain may overlap with migraine, tension headache, neck pain, facial pain, arthritis, Sjogren’s, stress-related clenching, medical PTSD, and chronic pain sensitization.
MPM uses the Zones of Expertise framework to evaluate whether symptoms are jaw joint-related, muscle-driven, headache-related, cervical, inflammatory, nervous-system mediated, trauma-informed, or mixed. This helps guide whether care should focus on conservative jaw strategies, dental coordination, headache care, pain psychology, biofeedback, acupuncture, botulinum toxin, or additional specialist referral.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
A TMJ disorder, or TMD, is a condition that affects the temporomandibular joint, chewing muscles, or related structures that help the jaw open, close, and move. The TMJ is the joint itself, while TMD refers to the broader group of disorders. TMJ disorders may cause jaw pain, clicking, popping, locking, facial pain, ear pressure, chewing pain, jaw fatigue, headaches, or neck pain. Symptoms may come from the joint, muscles, disc movement, clenching, arthritis, neck referral, headache pathways, or chronic pain sensitization.
TMJ pain may feel like aching, tightness, pressure, sharp pain, fatigue, or soreness in the jaw, face, temple, ear area, or neck. Some patients notice clicking, popping, locking, limited jaw opening, pain with chewing, tooth-like pain, ear pressure, headaches, or jaw fatigue. Symptoms may worsen with clenching, grinding, stress, chewing, yawning, dental work, prolonged talking, or poor sleep. Because TMJ pain can overlap with dental, ear, neck, nerve, headache, and inflammatory conditions, careful evaluation is important.
Yes. TMJ disorders can overlap with headaches and migraine patterns in some patients. Jaw muscle tension, clenching, trigeminal nerve pathways, neck mechanics, poor sleep, stress physiology, and pain sensitization may all contribute. Some patients feel temple pain, tension headache, facial pressure, or migraine worsening when jaw symptoms flare. TMJ disorders do not explain every headache, so MPM evaluates jaw pain alongside headache pattern, neck symptoms, neurologic symptoms, clenching, and prior migraine history to help clarify the relationship.
TMJ disorders may be caused by jaw injury, bruxism, clenching, arthritis, disc problems, bite or chewing mechanics, stress-related muscle tension, posture, cervical referral, autoimmune disease, or chronic pain sensitivity. Some patients develop symptoms after dental procedures, surgery, trauma, or prolonged jaw opening. Others have gradual jaw muscle overactivity or joint irritation. Sjogren’s, rheumatoid arthritis, and other inflammatory conditions may also affect joints and contribute to TMJ symptoms in selected patients. The cause should be evaluated before treatment is chosen.
TMJ disorders are evaluated through medical history, jaw examination, range-of-motion assessment, chewing muscle palpation, joint sound assessment, bite and chewing pattern review, headache history, neck assessment, and review of dental or medical history. Imaging may be considered when joint damage, disc displacement, arthritis, trauma, or structural concerns are suspected. MPM may also coordinate with dentists, oral surgeons, neurologists, ENTs, rheumatologists, or physical therapists when symptoms suggest dental, neurologic, inflammatory, or structural contributors.
Yes. Inflammatory and autoimmune conditions can involve joints and surrounding tissues, and in selected patients they may contribute to jaw pain, stiffness, inflammation, or dysfunction. Sjogren’s may also cause dry mouth and related oral symptoms that can complicate chewing comfort and dental health. Arthritis joint pain, rheumatoid arthritis, lupus, or other autoimmune conditions may overlap with TMJ symptoms. MPM evaluates TMJ pain in context and coordinates with rheumatology, dentistry, oral medicine, or other specialists when inflammatory or autoimmune drivers are suspected.
TMJ disorder treatment depends on the pain driver. Options may include jaw rest, avoiding overuse, soft foods during flares, gentle stretching, physical therapy, dental appliances through dental care, medication management when appropriate, acupuncture, biofeedback, pain psychology, headache-directed care, and selected injections. Treatment should be individualized because TMJ disorders can be joint-related, muscle-driven, inflammatory, headache-related, cervical, or centrally sensitized. MPM helps determine which contributors are most relevant and when dental, oral surgery, neurology, rheumatology, or behavioral health coordination is needed.
Botulinum toxin may be considered for selected patients with muscle-driven TMJ dysfunction, jaw muscle overactivity, bruxism-related pain, or overlapping migraine patterns. It is not a first-line treatment for every TMJ disorder and should not be described as a cure. Evidence varies depending on the type of TMD, the muscles involved, the dose, and the patient’s clinical pattern. MPM evaluates whether symptoms appear muscle-driven and whether botulinum toxin fits the patient’s risks, goals, and broader care plan.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
TMJ disorders, also called temporomandibular disorders or TMDs, are a group of conditions that affect the jaw joint, chewing muscles, and related structures. The TMJ is the temporomandibular joint itself. TMD refers to the disorder group. This distinction matters because many patients say they “have TMJ,” when the actual issue may involve the joint, muscles, nerves, headache pathways, cervical spine, inflammatory disease, or pain processing.
Symptoms may include jaw pain, clicking, popping, locking, limited opening, jaw fatigue, pain with chewing, facial pain, tooth-like pain, ear pressure, headaches, neck pain, and pain that worsens with clenching or grinding. Some patients have mostly joint symptoms. Others have muscle-driven pain or a headache pattern that overlaps with jaw tension.
TMJ disorders are not one diagnosis. Pain may come from inflammation inside the joint, disc displacement, arthritis, jaw muscle overactivity, bruxism, clenching, cervical referral, headache disorders, autoimmune disease, trauma physiology, or chronic pain sensitization. Some patients develop symptoms after a dental procedure, jaw injury, prolonged mouth opening, or a period of increased stress. Others experience gradual jaw tension, night clenching, or pain that spreads into the temples, neck, ears, or face.
This is why treatment should not begin with assumptions. A bite-focused solution may help one patient and miss the problem in another. Botulinum toxin may help selected muscle-driven cases, but it is not the right answer for every TMJ disorder. A patient with inflammatory arthritis of the jaw joint needs a different care pathway than someone with clenching-related muscle pain or migraine overlap.
Jaw pain and headaches often overlap because the jaw, face, head, and neck share important nerve pathways and muscle relationships. Patients may experience temple pain, tension-type headache, migraine worsening, facial pressure, neck pain, or pain that increases with chewing or clenching.
When TMJ symptoms and headaches occur together, MPM evaluates both patterns. The assessment considers migraine history, tension headache features, neck mobility, jaw muscle tenderness, sleep quality, stress physiology, bruxism, and neurologic symptoms. The goal is to determine whether the jaw is driving the headache, the headache disorder is amplifying jaw pain, or both are contributing.
Inflammatory and autoimmune conditions can affect joints and soft tissues, including the TMJ in selected patients. Sjogren’s may contribute to dry mouth, oral discomfort, dental complications, and overlapping joint or inflammatory symptoms. Rheumatoid arthritis, lupus, and other autoimmune conditions may also contribute to joint inflammation or chronic pain patterns.
MPM does not assume every jaw symptom is autoimmune. Instead, the evaluation considers whether there are signs of systemic inflammation, joint swelling, dryness, widespread pain, fatigue, or other symptoms that suggest the need for rheumatology, dental, oral medicine, or specialty coordination.
Some patients develop jaw pain in the context of medical PTSD, dental trauma, chronic illness, or repeated procedures. Fear, guarding, hypervigilance, and autonomic arousal can increase jaw tension and clenching. This does not mean the pain is imagined. It means the nervous system and jaw muscles may be reacting to threat, stress, or prior experience.
Pain psychology and biofeedback can be helpful in this setting. They may support clenching awareness, nervous system regulation, sleep, coping, and fear reduction. These tools are not substitutes for medical evaluation. They are part of coordinated pain care when jaw symptoms are influenced by stress physiology, trauma response, or chronic pain sensitization.
MPM begins with a detailed history and physical examination. The clinician reviews where pain occurs, whether chewing or clenching triggers symptoms, whether the jaw clicks or locks, whether headaches or neck pain are present, whether there are dental or ear symptoms, and whether prior dental, ENT, neurology, oral surgery, or physical therapy care has helped.
The exam may include jaw range of motion, chewing muscle tenderness, joint sounds, neck movement, headache pattern review, and assessment for referred pain. Imaging or dental evaluation may be recommended when structural joint disease, disc displacement, arthritis, dental pathology, or oral surgery concerns are suspected.
Treatment depends on the pain driver. Conservative strategies may include reducing jaw overuse, avoiding hard or chewy foods during flares, limiting prolonged mouth opening, gentle mobility work, heat or cold when appropriate, physical therapy, dental appliance coordination, and medication management when clinically appropriate.
Acupuncture may be considered as part of pain management for selected patients. Biofeedback may help patients identify jaw tension and clenching patterns. Pain psychology may support coping, stress physiology, sleep, fear of movement, and chronic pain regulation. Headache-directed care may be needed when TMJ symptoms overlap with migraine or tension headache.
Botulinum toxin may be considered for selected patients with muscle-driven TMJ dysfunction, jaw muscle overactivity, or bruxism-related pain. It may also be relevant when TMJ symptoms overlap with migraine and the patient meets appropriate criteria for headache-directed treatment. It should not be presented as a cure for TMJ disorders, a replacement for dental care, or a correction for bite mechanics. The decision depends on diagnosis, muscle involvement, symptom pattern, risks, and goals.
Jaw pain should be evaluated carefully because symptoms can overlap with dental infection, tooth pathology, ear disease, trigeminal neuralgia, cervical radiculopathy, headache disorders, inflammatory arthritis, infection, trauma, fracture, dislocation, cardiac symptoms, or other medical conditions. Patients should seek urgent care for chest pain, shortness of breath, fainting, severe jaw pain with cardiac symptoms, fever, facial swelling, trauma, inability to close or open the jaw, rapidly worsening neurologic symptoms, sudden severe headache, vision changes, or signs of infection.
MPM approaches TMJ disorders through a diagnosis-first, coordinated model. The evaluation considers jaw joint mechanics, chewing muscles, bruxism, clenching, cervical referral, headache and migraine overlap, autoimmune inflammation, Sjogren’s, arthritis, medical PTSD, pelvic pain overlap, and chronic pain sensitization.
For patients looking for TMJ disorder treatment in Manhattan, MPM offers a careful pain medicine perspective that can work alongside dentistry, oral surgery, neurology, rheumatology, ENT, physical therapy, and behavioral health when needed. The goal is to identify the true pain drivers and build a coordinated plan that supports jaw function, headache control, nervous system regulation, and daily quality of life.
