TMJ Disorders: A Physiotherapist’s Guide to Conservative Management

Brett Weiss
Nov 30, 2025
3 min read

🧠 What Are TMJ Disorders and Why Should You Care?

Temporomandibular joint (TMJ) disorders affect millions — causing jaw pain, clicking, headaches, and difficulty chewing or speaking. But here’s what many don’t know: TMJ disorders are not just a jaw problem. They're deeply interconnected with the neck, nervous system, stress, posture, and even mental health.

Physiotherapists trained in TMJ and orofacial pain are uniquely positioned to help — using hands-on therapy, education, and neuro-based rehab to improve function and reduce pain without surgery.

🔍 Why the Education Gap Matters

Most dental and physiotherapy programs offer minimal training in TMJ or orofacial pain, leaving new grads underprepared. Certified Cervical & Temporomandibular Therapists (CCTTs) fill this gap with years of post-grad education and cross-disciplinary skills.

If you're a dentist or surgeon referring a patient post-op, it matters who you refer to.

⚙️ How We Assess TMJ Disorders Without Imaging

Physiotherapists don't always need an MRI. A comprehensive TMJ/Cervical spine exam includes:

History & Habits: Bruxism, posture, sleep, stress, locking/clicking, and function.
Jaw ROM + Palpation: Mapping myofascial pain, intraoral checks, auscultation for joint sounds.
Neck Involvement: Cervical ROM, provocation testing, and posture analysis.

These findings guide us to subgroup diagnoses — like hypermobility, myofascial pain, or intra-articular derangements — each with distinct treatment paths.

💥 Conservative Treatment That Works

1. Manual Therapy & Dry Needling

Effective for releasing trigger points and restoring mobility. Dry needling (not to be confused with acupuncture) can “reboot” the system, especially for chronic pain.

2. Pain Neuroscience Education (PNE)

PNE helps patients reframe pain, reduce fear, and improve outcomes. We explain complex nerve pathways in simple, relatable language that shifts the focus from “damage” to “sensitivity” — backed by strong evidence in chronic pain populations.

3. Neuromuscular Re-education

We rebuild function with:

Tongue-jaw dissociation drills
Mandibular gait training
Strengthening for chewing and speech

This is especially critical for hypermobility-dominant patients, who often “feel tight” but are actually unstable.

🏥 Post-Surgical Rehab: Beyond Stretching

For OMFS teams, post-op PT is more than just mouth opening exercises.

We provide:

Scar tissue mobilization
TMJ and cervical spine joint mobilization
Class IV laser (where indicated)
Function-focused training for eating, speaking, and quality of life

Clear communication between the surgeon and therapist ensures optimal recovery. Sending over imaging reports and post-op notes helps your PT educate and support your patient better — and can even reduce callbacks to your office.

❗ Final Thoughts: Pathology ≠ Pain

MRIs may show disc displacement or degeneration, but these are often seen in pain-free people. We must treat the person, not just the picture.

🦷 For Dentists & Surgeons: How to Vet Your PT

Before you refer, ask:

Are they CCTT certified or trained in TMD/OFP?
Do they understand orthognathic surgery?
Can they co-manage with your office and explain imaging to patients?

These patients spend months with their therapist — let’s make sure they’re in the right hands.

🔑 Takeaway

TMJ disorders are complex but manageable. With the right interdisciplinary approach — blending physical therapy, pain education, and careful assessment — patients can regain control of their lives and often self manage this area of their body.