The temporomandibular (tem-puh-roe-man-DIB-u-lur) joint, also called TMJ, acts like a sliding hinge. It connects the jawbone to the skull. There is one joint on each side of the jaw. TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in the jaw joint and in the muscles that control jaw movement.

The exact cause of TMJ disorder is often hard to determine. The pain may be due to a mix of factors, including habits such as teeth clenching, gum chewing and nail biting; stress; and painful conditions that occur along with TMJ disorder such as fibromyalgia, osteoarthritis or jaw injury. The habit of teeth clenching or grinding also is known as bruxism.

Most of the time, the pain and discomfort related to TMJ disorders lasts for only a limited time. Self-managed home care, physical therapy for the jaw and the use of a mouth guard can be effective in treating symptoms of TMJ disorder. Surgery is usually a last resort after conservative measures have failed. But surgical treatments may help some people with TMJ disorders.

Symptoms of TMJ disorders may include:

• Pain or tenderness in the jaw.
• Pain in one or both temporomandibular joints.
• Aching pain in and around the ear.
• Having a hard time chewing or pain while chewing.
• Aching facial pain.
• Locking of the joint, making it hard to open or close your mouth.
• Headache.
• Neck pain.
• Eye pain.
• Tooth pain that occurs along with jaw tenderness.

TMJ disorders also can cause a clicking sound or grating sensation when you open your mouth or chew. But if there's no pain or limitation of movement related to your jaw clicking, it's likely that you won't need treatment.

When to see a doctor

Seek medical attention if you have constant pain or tenderness in your jaw that occurs suddenly or during jaw movements or if you can't open or close your jaw completely. Your dentist, TMJ specialist or other healthcare professional can discuss possible causes and treatments.

The temporomandibular joint combines a hinge action with sliding motions. The parts of the bones that work together in the joint are covered with cartilage and separated by a small shock-absorbing disk. This disk usually keeps the movement smooth.

Painful TMJ disorders can happen if:

• The disk erodes or moves out of its proper relationship between the ball and socket of the joint.
• Sprain or strain occurs in the ligaments or soft tissues associated with TMJ disorders.
• Arthritis damages the joint's cartilage.
• A blow or another impact damages the joint.
• Jaw muscles are associated with TMJ spasms.

Many times, the cause of TMJ disorder has a variety of causes and is hard to identify.

Factors that may raise the risk of getting TMJ disorders include:

• Different types of arthritis, such as rheumatoid arthritis or osteoarthritis.
• Jaw injury.
• Habits such as gum chewing, nail biting, and grinding or clenching of teeth.
• Certain connective tissue diseases.
• Stress, post-traumatic stress disorder, anxiety or depression.
• Conditions such as fibromyalgia, ankylosing spondylitis and sleep disturbances.
• Smoking.

Your healthcare professional will likely discuss your symptoms and study your jaw by:

• Listening to and feeling your jaw when you open and close your mouth.
• Watching the range of motion in your jaw.
• Pressing on areas around your jaw to find sites of pain or discomfort.

If your healthcare professional thinks there is an issue, you may need:

• Dental X-rays to look at your teeth and jaw.
• CT scan to show detailed images of the bones involved in the joint.
• MRI to show issues with the joint's disk or surrounding soft tissue.

TMJ arthroscopy is sometimes used to diagnose a TMJ disorder. During TMJ arthroscopy, your healthcare professional inserts a small thin tube called a cannula into the joint space. Then a small camera called an arthroscope is inserted to look at the area and help find a diagnosis.

TMJ arthroscopy also is sometimes used to treat TMJ disorder. The procedure can help with therapy, such as releasing scar tissue and removing inflammatory soft tissue and byproducts to improve TMJ symptoms and help the jaw move without pain.

Become more aware of habits linked with stress — clenching your jaw, grinding your teeth or chewing pencils — so you won't do them as often. These tips may help you reduce symptoms of TMJ disorders:

• Avoid overuse of jaw muscles. Eat soft foods. Cut food into small pieces. Steer clear of sticky or chewy food. Don't chew gum.
• Practice gentle stretching and massage. A physical therapist or other healthcare professional can show you how to do exercises that stretch and strengthen your jaw muscles and how to massage the muscles yourself.
• Apply heat or cold. Applying warm, moist heat or an ice pack to the side of your face may ease pain. Acute pain is best treated with an ice pack. Chronic dull pain is best treated with heat therapy. Apply heat or cold for 15 to 20 minutes several times a day. This approach, combined with stretching, has been found to be very effective.
• Adjust your diet. Eating soft foods or smaller pieces of food, not opening your mouth too wide, and eating foods using utensils such as a spoon or fork may ease symptoms. Chewing foods with both sides of the mouth and not just one side also may ease symptoms.

Complementary and alternative medicine techniques may help manage ongoing pain often related to TMJ disorders. Examples include:

• Acupuncture. A specialist trained in acupuncture treats ongoing pain by inserting hair-thin needles at specific locations on your body.
• Relaxation techniques. Consciously slowing your breathing and taking deep, regular breaths can relax tense muscles. In turn, this can lessen pain.
• Biofeedback. Electronic devices that track the tightness of specific muscles can help you practice effective relaxation techniques.

You'll probably first talk about your TMJ symptoms with your family healthcare professional or dentist. If suggested treatments don't give you enough relief, you may be referred to a healthcare professional who specializes in TMJ disorders.

What you can do

You may want to prepare a list that answers these questions:

• When did your symptoms begin?
• Have you ever had this occur in the past?
• Has your level of stress increased recently?
• Do you have headaches, neck aches or toothaches that occur often?
• What medicines and supplements do you take regularly?

What to expect from your doctor or dentist

Your healthcare professional may ask some of these questions:

• Is your pain constant or do your symptoms come and go?
• Does any activity seem to cause pain?
• Does your jaw click or pop when you move it? Is that clicking painful?
• Is it hard to open your mouth in the usual way?

Your healthcare professional will ask more questions based on your responses, symptoms and needs. Preparing and expecting questions will help you make the most of your time.