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.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
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.
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...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
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.
