TMJ and Myofascial Pain

How can muscle tension cause TMJ pain?

If any muscle in your body tightens up and maintains that tension for a long period of time, it will eventually develop knots or nodule-like spots inside it. These knots are easy to find because in addition to having a distinct, nodule-like texture, they are tender when you apply pressure to them. These tender knots within a contracted muscle are called myofascial trigger points. (Myo means muscle, and fascia is the connective tissue that holds it together.)

Although trigger points are sensitive to pressure, they initially don’t cause any problems. Yet over time, myofascial trigger points start producing a sensation of pain in distant sites. That type of pain is called referred pain, because it originates from places outside of where you perceive it.

Pain referred from myofascial trigger points is called myofascial pain. If left untreated, myofascial pain may become chronic and develop into a condition known as myofascial pain syndrome (or myofascial pain disorder).

As we stated earlier, in most cases, TMJ pain is caused by chronically tight face muscles and is myofascial in nature.

Each muscle in the body tends to develop myofascial trigger points in specific locations. And each trigger point has a specific pattern of pain referral. Trigger points in the face muscles refer pain to various areas of the face, jaw, ear, eye, head, and teeth.

Here are some examples of referral patterns for some of the most common trigger points in the muscles of the face. The black x sign indicates a trigger point within a muscle and areas marked in red illustrate where that trigger point sends the referred pain:

TMJ Tension

Read about what myofascial pain in the face and jaw feels like

Read about what causes the muscles of the face to become tight

testimonialsTeresa’s approach to therapy is practical and effective. Her manual therapy for my chronic TMJ-related discomfort has been incredibly helpful in managing an otherwise painful and potentially debilitating condition.

– Female, 47

testimonialsFinding Teresa to treat my TMJ was a godsend. When I first started treatment, I could hardly open my mouth, and I was eating just mushy food. Sometimes even chewing oatmeal was painful! With treatment with Teresa, my muscles finally relaxed and my pain gradually decreased. Now I can eat normally, and I don’t have any more TMJ pain. There isn’t anyone else, anywhere that I’d recommend going to see if you have TMJ problems. (I drove to her 1.5 hours each way.) Thank you, Teresa!

– Female, 37

testimonialsTeresa Sienkiewicz of New Body – New Mind played a crucial role in my long journey back to health and well-being. I am so fortunate to have been referred to her – she is simply the best manual therapist, physical therapist and hypnotist I know.

I always looked forward to every visit with Teresa, not only because of her professional expertise, but also because I really like(d) her as a person. She is very intelligent, extremely hardworking and a joy to be with. She is cheerful and gregarious and gives patients her undivided attention. She really listens, truly cares and offers thoughtful advice and reassurance. Her office environment is beautiful and welcoming and made me feel very comfortable and at ease. During treatment, Teresa made me feel physically and mentally relaxed and well cared for. She exudes confidence and knows exactly what she is doing; you know you are literally in “good hands”.

Regarding my physical TMJ symptoms, I saw immediate improvements in pain, tightness, restrictions and trigger points in my face and neck fairly early on; I eventually saw marked improvements in these areas. Unfortunately, I had simultaneously developed chronic pelvic pain shortly after I began treatment with Teresa (a condition which must have begun years prior). While I continued with Teresa for treatment of TMJ symptoms, I needed to seek additional therapy elsewhere for this other complex and challenging disorder (Teresa referred me to an excellent practice for this). By this time, however, I was also suffering from serious anxiety and depression. All of these conditions proved to be overwhelming for me, and naturally, my progress slowed down.

The pain, anxiety and depression, the fear of not knowing when and if I my pelvic pain would get better (because my TMJ was by that time almost resolved), and the lack of my daily marathon training (so vital to my mental health), was crushing. Teresa was with me every step of the way, always listening to me through lots of my tears, and supporting me in the way nobody else had ever done. I decided to ask Teresa for hypnotherapy as a way to help alleviate my anxiety. She created personalized hypnosis sessions that I benefited greatly from. The messages from my hypnotherapy sessions are still with me in my mind and I continually derive strength and courage from them. Teresa invested the same level of expertise and caring into these sessions as she did with my manual therapy.

I am now back to my normal self. I had gotten my life back and I amazed myself by running my fastest Boston Marathon time with very minimal training.

I am so grateful for all Teresa has done for me. Throughout the nightmare of pain and suffering that I endured, a silver lining was coming to know Teresa Sienkiewicz.

– Female, 45

testimonialsHi my name is Robin, I am a 55-year-old woman from Rhode Island and this is my story. About 2.5 years ago I awoke with terrible jaw pain, which extended into my teeth. I spent the following 2 years going from doctor to doctor and was misdiagnosed with bi-lateral trigeminal neuralgia and a number of other conditions. I tried (unsuccessfully) many medications and finally, like most of you, I went on-line to research my symptoms. Eventually, I made my way to a pain clinic in Boston where I was referred to Teresa and my life had changed.

I started treatment with Teresa in her Newton office and I have to say that the ride from Rhode Island to see her is worth every minute. The office is calm, Teresa easy to talk to and work with and most importantly, when I didn’t have hope, she helped me to believe that I would get better. And I am better! With Teresa’s help I am off all medications, I am not in constant pain anymore and with each visit I am making further progress. By the way, after over 2 years of pain, I am still amazed at how quickly I responded to her treatment; not months of visits, just weeks. I knew I was better when riding home I began to sing and realized I could do so without pain (I had not been able to open my mouth like that and sing in years). If you are in pain, don’t wait, don’t hesitate, please see Teresa.

– Female, 55

testimonialsWhen I first went to Teresa, I was having terrible jaw pain. Even my teeth hurt me! I was desperate because despite seeing many doctors, dentists, and even an acupuncturist, my pain was just getting worse and worse. I was frightened that I would never get better. My doctor send me to Teresa. Teresa treated me with patience and respect (and I remember I was not an easy patient – when we started I was at the end of my rope). She impressed me with her knowledge and experience right away and I just knew I could trust her. And I was right – her treatment provided me with the relief I had long sought. Teresa is not only an excellent therapist, but a caring, thoughtful, engaging, and understanding clinician who truly cares for her patients.

– Female, 53

testimonialsI have suffered from TMJ dysfunction for many, many years. When I first met Teresa, my facial pain was off the charts. I was taking strong pain medications and even on medications I could not tolerate physical touch inside my mouth. I also had difficulties with chewing food and opening my mouth. Teresa was the only clinician who was able to alleviate my pain (I had tried working with many people before seeing Teresa). Teresa is a wonderful therapist. She is caring and gifted, and I recommend her highly! I traveled from New Hampshire to Massachusetts to have manual therapy treatments with her, and it was worth every mile!

Female, 61

testimonialsMy jaw felt very uncomfortable and a dental specialist determined that one of the muscles in my face was pulling my jaw out of line. She recommended manual therapy as a treatment option. She said that she usually refers her patients to Teresa Sienkiewicz. Because I lived an hour away, I was initially resistant to the idea of driving such a distance for each appointment, but since I trust my doctor wholeheartedly, I decided to at least try. So I set up an appointment with Teresa, and it was the best thing I have ever done! I can never repay Teresa for what she did for my jaw! I made many trips to Newton, and sometimes it took me over an hour and a half each way, but I would not go elsewhere. Teresa is simply the best!

– Female, 41

testimonialsI spent years with constant, severe jaw and neck pain that was intensified by the way my sleep apnea dental appliance affected the position of my jaw. I was truly in agony every minute of the day. I tried a daytime TMJ guard, chiropractic treatments, and acupuncture. Nothing worked. I was very discouraged. My orofacial pain specialist recommended manual therapy with Teresa. I honestly felt relief right after our first treatment session and was steadily improving with each subsequent session. I have worked with many physical therapists before for a host of conditions. I have never met a physical therapist like Teresa. She is one of a kind as she has a holistic approach and is willing to think outside the box. Teresa is a warm and caring professional. I recommend her to everyone!

– Female, 54

testimonialsI went to a TMD clinic because of jaw pain. I asked for medications to relieve the pain, and instead they gave me Teresa Sienkiewicz’s phone number. My discomfort has improved dramatically under her care, and now I only need to see her for an occasional tune-up. She is unique in her caring, wisdom, and manual therapy expertise. I call myself lucky in finding such a gem in a person as well as a professional.

– Female, 58

testimonialsI am a professional vocalist. I came to Teresa because I developed pain in my jaw, which made it impossible for me to sing. Thanks to Teresa I am now pain-free and I have resumed my vocal career. I cannot thank Teresa enough for her professionalism, competence and compassion. Her understanding of TMJ is unmatched.

– Female, 35

testimonialsAs a voice major in a college of music I was devastated when I started having problems with opening my mouth. I felt my muscles were in spasm and opening of my mouth became very painful. I could not eat, I could not sing. I became depressed and started thinking of changing my major. Hopefully my doctor referred me to Teresa. I felt a big difference in the muscle tension even after my first treatment. After 5 sessions my jaw pain was gone. Teresa not only knows how to treat TMJ, but who also completely understands how to work with vocalists, such as myself. After my pain was gone we worked on rehabilitation of my jaw. Now I am able not only to talk and eat without restrictions, but also sing for over 2-3 hours a day.

– Female, 19

testimonialsTwo years ago I was experiencing disturbing symptoms, including numbness in my tongue, face, and neck, pain in the jaw, headaches and tightness in my chest. Doctor after doctor could not diagnose the problem. It wasn’t until I began to receive treatments from Teresa in conjunction with dental appliance therapy that my symptoms became manageable and eventually completely disappeared.

– Male, 37

testimonialsI would strongly recommend Teresa to anyone who suffers from TMJ. She is an expert in treatment of TMJ – her knowledge and experience is far superior to what other physical therapists I had previously seen were able to offer. After seeing Teresa for just a few weeks, I was feeling better than I had in years.

– Male, 32

testimonialsTeresa Sienkiewicz treats me for trigeminal nerve facial pain. As a result of her hands-on and skilled approach, I’ve been able to reduce my medication by more than half, greatly improving my quality of life. Her techniques are the best of any therapist I’ve seen: her treatment is very personalized, targeted, and effective. I drive two hours to see Teresa, and it is well worth it!

– Female, 58

testimonialsI began treatment at New Body – New Mind for severe, chronic TMJ pain. I needed extensive dental work, but because of jaw pain I could not open my mouth wide enough or long enough to do it (even dental cleaning with frequent breaks was setting me off so badly I could not function for weeks). After my sessions with Teresa, I was able to open my mouth wide without pain and I was able to start the overdue dental work. I have learned to always schedule treatments with Teresa pre- and post- any dental procedure and this allows me to recover faster and reduces the need for post-procedure pain medications.

– Female, 57

testimonialsI saw my primary care doctor to complain about migraine-like headaches, jaw pain and cracking, and limited ability to open my mouth. My balance was off, and I was experiencing some dizziness. I was pretty miserable. This was especially debilitating for me since I work as an engineer, and I need to be clear-headed to concentrate and do well. My doctor referred me to Teresa for manual treatment. I was completely amazed that there was any kind of manual therapy for this at all, and even more amazed that it worked that well. Thanks to the work with Teresa my pain is now resolved. Teresa is very knowledgeable and well connected to the medical community. I could not recommend her more highly.

– Male, 55

testimonialsI suffered from chronic facial pain for years. I was seen by numerous doctors and therapists, none of whom were able to help me. I thought that it was a hopeless cause until I met Teresa, who has made a world of difference. She is an exceptional therapist, and she was the first person who was able to effectively treat my TMJ. If it was not for Teresa, I would still be living my life in pain. I would highly recommend Teresa to anyone who suffers from pain.

– Male, 47

testimonialsI was being treated by Teresa for TMJ issues. Teresa was the first physical therapist I had worked with who utilized manual therapy as part of her treatment. Her approach is very calm and gentle and with her techniques, she is able to release the pressure that causes pain. When I started manual therapy, for the first time since I developed TMJ I started believing that I may be free of pain one day. Well, I have been pain-free for almost two years now. I have recommended Teresa to everyone I know and prefer Teresa’s techniques to other forms of therapy. From my experience with her, I have learned that proper manual therapy is the key to resolving jaw pain and overcoming the condition I have lived with for much of my life.

– Female, 38

testimonialsI don’t know what I would have done had I not met Teresa. I was suffering from TMJ since my teenage years and I got to the point where I lost any hope. A co-worker told me about Teresa. At that time I was so discouraged that I was not even sure I wanted to see another specialist – I was afraid it would turn out to be a dead end again. Eventually I decided to give it one more try, and I was so glad I did. From the first meeting with Teresa I was confident that she was the person who might be able to help me. Teresa exudes confidence and professionalism. She is full of energy, positivity and compassion. And she knows more about TMJ than anyone I’d consulted before. Teresa not only helped me with physical pain by working on the muscles inside my mouth (nobody else I had seen before worked on the face muscles), but she also taught me how to relax. We had a few hypnosis sessions and I loved it! I believe that hypnosis made a big difference in my recovery process because it helped me stop clenching my teeth and also taught me how to relax my neck and shoulders (which made a huge difference for the jaw). Hypnosis also helped me feel calm at my work and during stressful situations in life, which, again, helped me relax my jaw, neck and shoulders (not to mention, it made my stomach feel much better – I used to feel my stomach was in knots all the time). I have completed my therapy with Teresa six months ago and I truly feel I am a whole new person – physically and emotionally.

– Female, 53

testimonialsTeresa made me feel like I was not just another patient, but her only patient. I found Teresa to be more helpful than any other doctor, PT, or chiropractor I had seen for chronic TMJ pain. Her practice is very unique and her treatment is totally individualized. Not only she provided therapy for my jaw, but she also taught me to love my body and helped me accept the idea of change (or believe that change is possible) through hypnosis. I would highly recommend her to anyone who has pain anywhere in their body. She will be definitely be the one appointment you will not want to miss.

– Female, 49

testimonialsTeresa is a talented professional with detailed knowledge about TMJ and how it impacts the entire body. She’s a skilled therapist who provides pain relief and positive encouragement in a calm, warm way. She takes a genuine interest in her patients and their lives, which helps her to understand them better and treat them better. She also does hypnosis, which I found to be very helpful. If you suffer from TMJ there is no better person for you to see. I’ve seen many therapists before meeting Teresa and nobody was able to help me the way she did.

– Female, 41

testimonialsI suffered from terrible pain in my face and jaw. Specialists at the pain center I was being treated at referred me to Teresa, saying that she was “the best manual therapist and physical therapist they knew.” They were right – she is the best. After starting treatment with Teresa, I saw almost immediate improvement, and with continued treatment my pain completely disappeared.

– Male, 39

testimonialsTeresa at New Body – New Mind helped me resolve the chronic headaches and TMJ pain. Teresa is professional and results-driven, but at the same time she is compassionate and caring. She is passionate about her work and her intellectual curiosity, problem-solving skills, and ability to think outside the box are unparalleled. In addition to providing a relief from headaches and TMJ pain, Teresa helped me understand my condition and taught me what to do in my daily life to remain pain-free. I highly recommend her to anyone in need of treatment of any physical pain.

Male, 45

testimonialsI started to see Teresa due to extreme pain in my jaw and neck from clenching and grinding my teeth. It was physical pain that had come from emotional trauma and severe stress. From very early on, Teresa seemed to understand what it was I needed, and even during our initial consultation, she suggested some techniques for me to try before I had my first formal manual therapy session with her. Teresa was very professional, but in a sensitive and warm way. Teresa worked gently, in a relaxing atmosphere. She always asked if what she was doing hurt, and if I had any residual pain from my last visit. She always told me what area of my neck, shoulders, and jaw she would be working on before she touched me. As she worked, she either spoke in a soothing voice to help me relax, or she would be peacefully silent. I hate to drive, and Teresa lived about forty-five minutes from my house. But I kept all my appointments with her because, out of all the treatments that had tried, my sessions with Teresa were the most beneficial. I always left her office completely relaxed and physically comfortable. Teresa taught me techniques that allowed me to relax my body when I felt it was tensing up and I have been using these techniques on my own ever since.

– Female, 46