Most of us are required to wear a mask in public these days. Since COVID-19, my TMJ specialists at Freedom Physical Therapy see an increase in TMJ/Headache patients. Some of these are patients whose previous symptoms are getting worse, patients who had responded well to our care but now have had their symptoms return, and many patients who never had TMJ problems in their lives. Wearing a mask can make your jaw tight, especially if you protrude your chin forward or tense your jaw and jaw muscles to try to hold your mask on. Stress also plays a large role in increasing muscle tension with TMJ/Headaches and the whole body. We all know how stressful 2020 has been, so make sure you’re also managing your stress appropriately.

Here are a few tips we give our patients to help reduce their TMJ/Headache pain or minimize the potential for the pain to emerge:

1. Be aware of your jaw when wearing a mask

It should be relaxed at rest, teeth not touching, lips lightly together, tongue lightly resting on the roof of the mouth (say the word “No” or “Never and hold the “N”). When wearing a mask, try not to tense your jaw or push your jaw forward to hold your mask on – those elastics are designed to keep it on, so let them do their job!

Without even realizing it, you may be pressing your lips together in a pursed position or clenching your teeth under your mask. These are normal human reactions to fear, anxiety, and worry. Also, many of us are unconsciously and repeatedly pushing down on our chin in the attempt to move the mask away, adjust its position, or release the tension of the mask. When the jaw and facial muscles are in this contracted or tense position for an extended length of time, they become overworked and fatigued. And, like any other muscle in your body, when the jaw and facial muscles become overworked, they can start to scream out in pain.


2. Ear-loops that pull and tug on your ears are another reason why wearing a mask can cause TMJ/Headache symptoms.

They can cause pain that can be felt from your ears, across your jaw joints, and into your face – all within a short time. Some people even get headaches that extend from their ears into their temples. This can be caused by the auriculotemporal nerve (which is a branch of the trigeminal nerve), which runs just in front and above the ear into the scalp. Compression through this area from too tight of ear straps, goggles, or the stems from glasses that do not fit well and are too tight, can cause facial pain and headaches. A great solution to this problem is ear savers or extenders. Ear savers/extenders allow you to eliminate ear loops and eliminate the pulling or compression they can cause.

3. Finally, masks might prompt us to breathe through our mouths instead of our nose.

When we breathe through our mouth, the jaw is held slightly open, and this can cause tension to develop in the muscles around the jaw. At rest, we should mainly be breathing through our nose. Breathing through the nose can also mean the air you take in is filtered for dust, pollen, and pollution. Nasal breathing does a better job of adding moisture and warming the air we breathe in and allows our jaw to stay in a better resting position.

In addition, the sinus passages connected to the nose make nitric oxide, a gas that helps your body get more oxygen. It also encourages your blood vessels to expand and your smooth muscle tissue to relax. Nitric oxide also has powerful antiparasitic, antifungal, antiviral, and antibacterial properties, which reduce the chances of you getting sick. To achieve good nasal breathing, review item 1 above for the jaw’s relaxed position with the tongue up and breathe through your nose.

I hope this provides some helpful insight into managing TMJ/Headache pain related to mask-wearing. Try to keep a smile on your face when your mask is on. The loss of facial expression and seeing someone’s emotions with the mask on is a topic for another day.

Please stay healthy and well!

Michael Karegeannes