Headache / TMJ / Facial Pain

Your head is the most complex area of your body. This is due to the hundreds of anatomical parts that are packed into the relatively small area of your head.

Most patients with headache, TMJ, or facial pain have been treated by many physicians, dentists, chiropractors, massage therapists, and Physical Therapists before they are seen in our clinic. Most of these practitioners, despite their best intent, focus treatment on one area to get you pain relief. Dentists focus on your teeth and bite. Chiropractors, massage therapists, and most Physical Therapists focus on your neck. Physicians focus on medications.

The truth is that it is so much more complex. Most often, headache, TMJ and facial pain have their root in the combination of 3 areas of the body that need to work well, and together, for you to be pain free. If one area doesn’t work well, it will cause the others to have problems too.

These 3 areas are:


  • Jaw-bite: Jaw function affects your bite and your bite affects your jaw function. Normal jaw function requires normal mobility of the jaw joints (located in front of the ears), muscles, and ligaments. Limited mobility of one or both joints will create jaw and facial pain, headaches, neck pain, and sometimes popping of the disc in your jaw. The muscles of the jaw and TMJ attach to the sides of your head. When these muscles are tight and under strain, they can cause pain to radiate to your head and result in headache and facial pain. You can push on the fleshy part of these muscles on the sides of your jaw and head in the temple area when you have a headache and see if these spots are tender. Treatment entails specific Manual Therapy to normalize jaw muscle, ligament and joint mobility. Referral to a dentist that specializes in the treatment of jaw-bite issues is sometimes necessary to assist you in getting pain free. We can provide you with several dentists that we work with routinely.

  • Upper neck: The muscles of the upper neck attach to the back of the head. When these muscles are tight and under strain, they can cause pain to radiate to the head and result in headache and facial pain. You can push on the fleshy part under your skull when you have a headache and see if these spots are tender. Doctors call this “Cervicogenic Headache or Tension Headache.” It can be easily treated by normalizing mobility of the vertebrae (bones) and muscles of the neck with specific Manual Therapy. In longstanding headache however, treating this area alone is usually not enough to get you pain free.

  • Craniofacial system (bones of the head and face): Often blows to our head, that may have occurred long ago, are the root cause for headache, TMJ, and facial pain that just won’t go away (you will need to carefully think about your past to see if you remember any of these blows….most of us have had several). Since our head and face are formed from many bones that are joined together at structures called “sutures”, these blows are very important. These sutures are actual joints that have motion like other joints in the body, but their movement is small. Like other joints they can become injured and “stuck”, like your shoulder or your neck as an example. When that happens the nerves and other tissues that run through the sutures get irritated and cause headaches and facial pain. Unfortunately, the stuck sutures don’t show up on X-rays or MRI. These stuck sutures can be gently and effectively treated by an experienced Manual Therapist that practices Cranial Mobilization to restore mobility and decrease your pain.

Successful treatment of these 3 areas together are often required to eliminate longstanding pain. At Manual Edge Physiotherapy, we are skilled in treating these areas to give you lasting results.