Skip to Content

Can TMJ press on nerves?

Temporomandibular joint disorder (TMJD or TMD) is a condition that causes pain and dysfunction in the jaw joint and muscles controlling jaw movement. TMJD can lead to symptoms like pain or tenderness in the face, jaw locking, clicking sounds when opening the mouth, and difficulty chewing. One common question regarding TMJD is whether it can press on nerves and cause additional symptoms.

What causes TMJ disorder?

The temporomandibular joints (TMJs) are complex joints that connect the jawbone to the skull. There is one TMJ on each side of the head, just in front of the ears. These joints allow the lower jaw (mandible) to move up and down and side to side so that the mouth can open and close. The TMJs are surrounded by muscles that control jaw movement.

TMJD develops when there is a problem with the TMJs or surrounding muscles. Specific causes can include:

  • Injury or trauma to the jaw, TMJs, or muscles of the face and neck
  • Grinding or clenching of the teeth (bruxism)
  • Dislocation of the disc between the ball and socket of the TMJ
  • Arthritis or degenerative joint disease affecting the TMJs
  • Autoimmune disease, such as rheumatoid arthritis or lupus
  • Stress and tension of the jaw muscles
  • Developmental or structural problems with the TMJs

In many cases, TMJD arises due to a combination of factors. When the TMJs and surrounding muscles are impaired, it can disrupt proper jaw function and lead to pain.

Common symptoms of TMJD

TMJD causes a variety of symptoms involving the jaw joint and surrounding muscles. Common symptoms include:

  • Pain or tenderness in the face, jaw joints, temples, or neck muscles
  • Clicking, popping, or grating sounds when opening or closing the mouth
  • Locking or catching of the jaw when trying to open or close the mouth
  • Difficulty fully opening the mouth
  • Trouble chewing or discomfort when chewing
  • Earaches or ear pain
  • Ringing in the ears (tinnitus)
  • Headaches or migraines
  • Shoulder and neck pain
  • Dizziness

The symptoms may range from mild to severe. In many cases, the symptoms are intermittent and temporary, while some people experience chronic, persistent TMJD pain and dysfunction.

Can TMJD press on nerves?

Because the TMJs are so closely located to nerves in the face and head, it is possible for TMJD to put pressure on nerves and cause neuropathy symptoms. Some specific ways TMJD may press on nerves include:

Trigeminal nerve

The trigeminal nerve is responsible for providing sensation to the face as well as controlling chewing and biting. It splits into three main branches that transmit signals from the upper, middle, and lower portions of the face.

The trigeminal nerve runs very near the TMJs. One branch, called the mandibular nerve, actually passes through the temporomandibular joint on its path. TMJD-related inflammation or structural issues with the joint can press on the trigeminal nerve.

This can potentially cause pain, numbness or tingling in the face, jaw, teeth, gums, lips, or mouth. The pain may feel like a migraine concentrated around the jaw area. Temporomandibular neuropathy referring to trigeminal nerve pain is common in people with chronic TMJD.

Facial nerve

The facial nerve controls facial expressions and movement. It also provides taste sensation to the tongue and stimulates saliva and tear production. Facial nerve fibers pass near the TMJ on their pathway through the skull and face.

Compression of the facial nerve from TMJD may lead to symptoms like:

  • Muscle weakness on one side of the face (developing a crooked smile)
  • Twitching of the face
  • Decreased or loss of taste
  • Impaired tearing
  • Dryness of the eyes and mouth

However, facial palsy or paralysis due to TMJD pressing on the facial nerve is very rare.

Auriculotemporal nerve

The auriculotemporal nerve is a branch of the trigeminal nerve controlling sensation in parts of the ear and temple. It passes directly by the TMJ. TMJD putting pressure on this nerve can potentially cause:

  • Pain in the temple area
  • Pain behind or in the ear
  • Numbness or tingling around the ear and side of the face
  • Increased sensitivity to noise
  • Ringing, buzzing or hissing sounds in the ear (tinnitus)

Because the auriculotemporal nerve provides sensation to part of the auditory canal and middle ear, compression from TMJD is sometimes considered a potential cause of tinnitus and dizziness symptoms.

Can TMJD cause pinched nerves?

Doctors sometimes use the term “pinched nerve” to refer to a compressed, irritated, or inflamed nerve. In most cases, nerves are not actually pinched, but neuropathy symptoms occur due to some source of nerve irritation.

Given its close proximity to facial nerves, TMJD could potentially contribute to pinched nerve symptoms if it causes inflammation or structural issues that press on nerves. However, there are other potential sources of pinched nerves in the jaw and face area, such as:

  • Injury or trauma
  • Dental procedures
  • Abscesses or infections
  • Tumors or cysts
  • Arthritis

A pinched nerve feeling on one side of the face could stem from TMJD, but a doctor would need to evaluate the symptoms and probable cause. Pinpointing the source of a pinched nerve can help guide appropriate treatment.

Can TMJD affect the vagus nerve?

The vagus nerve is the longest cranial nerve, extending from the brainstem down to the abdomen. It controls a number of important functions:

  • Digestion
  • Heart rate
  • Respiration
  • Immune response
  • Various gland and organ functions

Since the vagus nerve does not run directly near the TMJ, TMJD is unlikely to directly pinch or compress the nerve. However, some researchers believe TMJD may trigger complex neurological signals that indirectly affect vagus nerve function and lead to problems like:

  • Dizziness
  • Nausea
  • Heart palpitations
  • Digestive issues

More research is still needed to understand the potential connection between TMJD and the vagus nerve.

Can TMJD cause optic nerve dysfunction?

The optic nerve transmits visual information from the eyes to the brain. There are two optic nerves, one coming from each eye. Compression, inflammation, or damage to an optic nerve can cause visual impairment or vision loss.

Since the optic nerves are located in the eyes and do not pass near the temporomandibular joints, it is highly unlikely that TMJD would directly press on or pinch the optic nerves. However, in rare cases, TMJD may potentially contribute to optic nerve dysfunction in indirect ways:

  • Compression from nearby inflammation: Severe TMJD causes significant inflammation around the TMJ. In some rare cases, this inflammation could potentially spread and put pressure on the optic nerves or surrounding blood vessels.
  • Reduced blood flow: Optic nerve damage is sometimes tied to reduced blood flow (ischemia). Theoretically, inflammation from TMJD could restrict blood supply to the optic nerves.
  • Medication side effects: Some medications used for TMJD pain, like steroids, may have optic nerve-related side effects in rare cases.

However, these scenarios are considered very rare. More commonly, optic nerve dysfunction is caused by direct factors like glaucoma, tumors, infections, or injuries. Overall, while TMJD may cause vision changes like blurred vision from pain or stress, it is unlikely to directly damage the optic nerves.

Can TMJD cause nerve damage or neuropathy?

Mild to moderate cases of TMJD are unlikely to cause permanent nerve damage or neuropathy. However, severe, long-standing TMJD could potentially contribute to certain neuropathies, such as:

  • Trigeminal neuralgia: Chronic compression/irritation of the trigeminal nerve may lead to persistent facial pain and trigeminal neuralgia.
  • Glossopharyngeal neuralgia: In rare cases, TMJD may irritate the glossopharyngeal nerve (controlling the throat, tongue, ears), possibly resulting in facial and throat pain.
  • Occipital neuralgia: Irritation where the trigeminal nerve attaches to the spinal cord (the occipital nerve) may rarely cause neck/scalp pain.

Many times, these neuropathies are reversible if the source of nerve irritation is treated. To help prevent permanent nerve damage, proper management of TMJD is important. This may include pain medication, anti-inflammatory drugs, mouth guards, physical therapy, massage, stress reduction, and surgery in some cases.

Can TMJD affect the hypoglossal nerve?

The hypoglossal nerve controls motor functions of the tongue. It allows tongue movements involved in speech, chewing, swallowing and other basic functions.

Since the hypoglossal nerve pathway does not pass directly near the TMJ, TMJD is unlikely to physically compress or pinch this nerve. However, moderate to severe TMJD could potentially affect the hypoglossal nerve indirectly by:

  • Causing tongue pain, which may inhibit tongue movement
  • Triggering spasms or tightness of the tongue muscles
  • Contributing to damage of the myelin sheath around nerve fibers

Rarely, hypoglossal nerve palsy caused by TMJD could result in impaired tongue mobility. But this is an extremely uncommon scenario.

Diagnosing nerve involvement

Distinguishing whether nerve compression or damage is involved in TMJD symptoms requires a medical evaluation by a doctor, dentist or orthopedic specialist. The evaluation may include:

  • Physical exam of the head and neck to check for areas of tenderness, limited mobility, or altered sensations
  • Neurological exam to assess nerve function
  • Imaging tests like MRI or CT scan to visualize the TMJ structure and surrounding tissues
  • Electromyography to measure electrical activity in muscles
  • Nerve conduction studies to evaluate how well nerves are transmitting signals

These tests can help pinpoint the underlying cause of symptoms and whether neuropathy is present. Even if nerves are affected, the goal is to identify whether any damage is permanent or reversible.

Treatment when nerves are involved

If physical exam and testing confirms that TMJD is contributing to nerve compression or damage, treatment aims to relieve pressure on the nerves and manage pain. This may include:

  • Pain medication – Over-the-counter pain relievers or prescription medications to reduce inflammation and discomfort.
  • Dental devices – Night guards, bite splints, or oral appliances to stabilize the jaw and prevent teeth grinding.
  • Physical therapy – Gentle stretching and exercises to improve jaw mobility and strengthen muscles.
  • Stress management – Relaxation techniques, biofeedback, cognitive behavioral therapy.
  • Alternative therapy – Massage, acupuncture, heat/ice therapy.
  • Surgery – Rarely needed, but might involve repairing joint structures or inserting implants.

With proper treatment, many patients find relief from TMJD-related pain and nerve symptoms. However, chronic nerve compression can sometimes lead to permanent neuropathy requiring long-term management.

Conclusion

Temporomandibular joint disorder involves complex structures near multiple nerves in the head and neck. In moderate to severe cases, it is possible for TMJD to press on or pinch nerves, leading to additional pain and neurological symptoms.

The trigeminal, facial, and auriculotemporal nerves are most likely to be affected due to their proximity to the temporomandibular joint. TMJD can potentially cause trigeminal neuralgia, facial weakness, tinnitus, and ear pain from nerve compression.

Optic, vagus, and hypoglossal nerve damage is possible but quite rare. The key is to get a proper diagnosis and appropriate treatment to address the TMJD and any resulting neuropathy symptoms. If treated early, nerve involvement often improves once pressure on the nerves is relieved.