TMJ Referred Pain: Tinnitus, Headaches, Ear and Neck Symptoms, and Finding the Cause

My ears feel blocked and I have tinnitus, but the ENT says they’re normal. Could it be my jaw?

Problems with the jaw joint and surrounding muscles can cause symptoms such as ear fullness or tinnitus [2]. The jaw joint is very close to the ear canal and the chewing muscles are spread around the ear, so even if the ear itself checks out normal, referred pain from the temporalis and neck muscles can cause ear symptoms [2]. Referred pain is a phenomenon in which the area with the actual problem differs from where you feel the pain, and problems in the jaw joint and muscles are sometimes felt as symptoms in the ear or head [1]. In such cases, if an ENT exam comes back normal, an Oral Medicine assessment that also looks at the jaw joint may be appropriate [2].

When DentStat analyzed about 1,800 patient comments on referred pain and accompanying symptoms in YouTube dental content, frustration such as “I’ve been to several departments and no one can find the cause” came up repeatedly [3]. The following situations were mentioned as calling for this kind of assessment [2].

• Ear fullness and tinnitus continue even though ear tests are normal
• Symptoms in front of the ear or at the temples change when chewing or yawning
• The jaw and temples feel stiff when you wake up, with signs of clenching

Are headaches at the temples related to the jaw?

The temporalis muscle at the temples is involved in clenching and chewing, and tension in this muscle can be linked to headaches [2]. If you unconsciously clench your teeth under stress, the temporalis stays tense and temple pain can keep coming back [2]. These headaches may ease temporarily with painkillers but recur if the clenching habit remains, so one approach is to look at muscle tension and habits as the cause as well [1]. The comment analysis also found cases of people complaining of pain at the temples and top of the head together with jaw symptoms [3].

Is neck and shoulder pain also caused by the jaw?

Posture and neck muscle tension sometimes appear together with TMJ symptoms [2]. Referred pain in the neck and shoulders and TMJ disorders can overlap, so a multidisciplinary approach that looks broadly for the cause, rather than at one area, is sometimes needed [2]. A forward head posture or chewing on only one side can increase strain on both the jaw and neck muscles, so it helps to look at lifestyle habits as well [1]. The comment analysis also found cases of people complaining of pain at the back of the neck and trapezius together with jaw symptoms [3].

Why do I get noise or pain in my ear when I chew?

The jaw joint sits right in front of the ear canal, so noise or pain may be felt around the ear when chewing or opening [1]. Because the joint and the ear canal are adjacent, ear symptoms are explained as appearing together when chewing, and some people feel pain in front of the ear when opening wide, as when yawning [1]. Some also report that the loudness or pitch of their tinnitus changes when they chew, which is explained by the movement of the chewing muscles and joint affecting the area around the ear [2]. If ear tests are normal but symptoms keep recurring when chewing or opening, a TMJ assessment may be appropriate [2].

Common myths and facts

Myth	Fact
Ear, head, and shoulder symptoms have nothing to do with the jaw	They can appear as referred pain from the temporalis and neck muscles, so the cause needs to be identified [2]
Tinnitus is only seen by ENT	TMJ-related tinnitus and ear fullness may call for an Oral Medicine assessment [2]
Referred pain is only due to stress	Besides muscle tension, joint and disc factors can also play a role [2]

These related symptoms can have several possible causes, so it is hard to judge them yourself. For an overview of TMJ symptoms, which department to see, and health insurance, see the TMJ disorder guide. For dental clinics by region, see Find a Dentist.