Temporomandibular Disorder (TMD): Causes, Symptoms, and How We Can Help
- staystrongtherapy
- Jun 30
- 5 min read
All information in this blog is supported by internationally recognised diagnostic criteria and peer-reviewed research. There is currently no dedicated NICE guideline for TMD, so current evidence is used throughout. Reference numbers appear throughout, with the full list at the bottom of the page. If you've read our blog comparing cervicogenic headache, migraine, and TMD, this blog goes into more depth on TMD specifically.
What Is Temporomandibular Disorder?
Temporomandibular disorder (TMD) refers to a group of conditions affecting the jaw joint (temporomandibular joint), the chewing muscles, and the surrounding structures. It's genuinely common, with an overall prevalence of around 30% reported in recent research. ¹
The Two Main Types of TMD
This is genuinely useful to understand, since TMD isn't one single condition. The internationally recognised Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) classifies TMD into two broad groups based on a person's signs and symptoms: ¹
Muscular TMD (Group I): involving the chewing (masticatory) muscles themselves, affecting around 45% of TMD presentations. ¹ This typically presents as muscle tenderness, tightness, and pain with jaw movement or chewing.
Arthrogenous TMD (Groups II and III): involving the jaw joint itself, including disc displacement and joint-related conditions, affecting around 70% of presentations, with meaningful overlap between the groups. ¹ This typically presents with clicking, locking, or restricted jaw movement, in addition to or instead of muscle-related symptoms.
It's genuinely common for people to have features of both, given the significant overlap between these groups. ¹
Common Signs and Symptoms
Jaw pain, often worse with chewing, yawning, or talking
Clicking, popping, or grinding sensations in the jaw joint
Restricted jaw opening, or occasionally locking
Pain referring into the temple, ear, cheek, or face (covered in detail in our headache comparison blog)
Muscle tenderness around the jaw, temple, and sometimes the neck
Risk Factors
The cause of TMD is genuinely multifactorial, and recent systematic review evidence has identified the following as having strong associations with TMD: ²
Female sex, one of the most consistently identified risk factors
Poor sleep quality
Depression and anxiety
Oral parafunction, habits such as nail-biting, pen-chewing, or chewing gum excessively
Somatisation, the tendency to experience and express psychological distress through physical symptoms
Anatomical features, individual variation in jaw and joint structure
Other recognised contributing factors include excessive muscle tension, teeth grinding (bruxism) and clenching as parafunctional activities, and repetitive trauma to the joint. ¹ Psychological and emotional distress is also genuinely important to consider, given that anxiety and depression can contribute to both the development and worsening of chronic pain conditions like TMD. ¹
It's worth noting that not every commonly assumed risk factor has held up under recent systematic review scrutiny, variables such as education level did not show a strong, consistent association with TMD in the most recent evidence. ²
TMD and Other Conditions: A Genuine, Bidirectional Link
This connects directly to what we've covered in our headache comparison blog. A 2025 systematic review and meta-analysis specifically investigating the relationship between migraine and TMD found a genuine association between the two conditions, and importantly, found evidence that this relationship runs in both directions, each condition appears to influence the other, rather than one simply causing the other in a single direction. ³
TMD has also been studied in relation to other neurological conditions, recent research investigating TMD in people with multiple sclerosis found a notable prevalence of TMD within this population, using the same internationally recognised diagnostic criteria, reflecting genuine interest in how TMD relates to broader neurological and systemic health. ⁴
What to Look Out For
Please seek medical or dental assessment if you experience:
Sudden, complete inability to open or close your jaw (true locking)
Significant swelling, fever, or signs of infection around the jaw
Jaw pain following significant trauma, with concern about fracture
Numbness in the face or jaw
Unexplained weight loss alongside jaw symptoms
How Is It Diagnosed?
Diagnosis relies on the internationally recognised Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a structured clinical examination protocol used across both clinical practice and research worldwide. ⁵ A simplified version, the brief DC/TMD, has recently been developed and validated against the full protocol, showing good reliability in identifying TMD diagnoses across primary and specialist clinic settings, making thorough, evidence-based assessment more accessible. ⁶
Myths vs Facts
"TMD is just one condition, and it's always about the joint itself." Not quite, TMD genuinely covers two distinct categories, muscular and joint-related, often overlapping, which is why a thorough assessment matters for identifying which structures are actually involved in your case.
"My anxiety has nothing to do with my jaw pain." The evidence genuinely disagrees. Psychological factors including anxiety, depression, and somatisation are consistently and strongly associated with TMD, not as the "cause" in a dismissive sense, but as genuine contributing factors worth addressing as part of a complete treatment plan.
"My migraines and my jaw problems are completely unrelated." Recent meta-analysis evidence suggests otherwise, finding a genuine, bidirectional association between migraine and TMD, reinforcing why we consider the whole picture rather than treating these as entirely separate issues.
How We Can Help
As covered in more detail in our headache comparison blog, treatment combining manual therapy with targeted exercise has good supporting evidence for TMD.
Jaw and craniomandibular manual therapy: hands-on mobilisation and soft tissue release of the jaw muscles and temporomandibular joint, addressing both the muscular and joint-related presentations of TMD.
Cervical and masticatory soft tissue release: given the close relationship between neck dysfunction and TMD, treatment addressing both the neck and the jaw muscles together has shown genuine benefit.
Medical acupuncture: used as part of a broader treatment plan to support pain management and reduce muscle tension.
Exercise: jaw range of motion and stabilisation exercises, alongside neck-focused exercise, given the strong evidence linking cervical spine function to TMD outcomes.
What to Expect at Your First Appointment
We will take a thorough history, including sleep quality, stress levels, any jaw clenching or grinding habits, and the pattern of your symptoms, alongside a structured clinical assessment in line with internationally recognised diagnostic criteria. We will explain clearly which type or types of TMD appear to be present, and build a treatment plan addressing the jaw, neck, and any relevant contributing factors together.
Frequently Asked Questions
Do I need a scan? Not usually for initial diagnosis. The internationally recognised diagnostic criteria for TMD rely on structured clinical examination rather than routine imaging.
Is TMD linked to my headaches? Genuinely, it can be. There's a recognised, bidirectional relationship between TMD and migraine specifically, alongside the close overlap with cervicogenic headache covered in our headache comparison blog.
Will addressing my stress and sleep actually help my jaw? Yes, genuinely. These are consistently identified, evidence-based contributing factors to TMD, not unrelated lifestyle issues, so addressing them forms a genuine part of comprehensive treatment.
How long will treatment take? This varies depending on which type of TMD is present and how long symptoms have been ongoing, but combining manual therapy with targeted exercise typically shows meaningful improvement over several weeks of consistent treatment.
Recognise these symptoms? Get in touch using the contact form and we will carry out a thorough assessment and build the right treatment plan for you.
References
Temporomandibular Disorders: Current and Future Concepts in Diagnosis and Management. PMC. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965485/
Warzocha J, Gadomska-Krasny J, Mrowiec J. Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) from 2018 to 2022. Healthcare. 2024;12(5):575. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10931313/
Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis. 2025. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902198/
Axis I of DC/TMD in Diagnosis of Temporomandibular Disorders in People with Multiple Sclerosis, Preliminary Reports. Journal of Clinical Medicine. 2025;14(12):4338. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194020/
Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Available at: https://www.researchgate.net/publication/259990067
Brief Diagnostic Criteria for Temporomandibular Disorders: Sensitivity and Specificity of Clinical Diagnoses (A Multi-Center Study). Journal of Oral Rehabilitation. 2025. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12290155/
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