Conditions · Carrollwood · Tampa Bay
Jaw and Facial Muscle Pain (TMJ) in Tampa
An aching jaw when you wake up. A click or a catch when you open wide. Soreness that spreads up into your temple or down into your neck by the end of the day. People usually call this "TMJ," short for the jaw joint itself, but a lot of what actually hurts is the muscle around that joint: the muscles that move it and the neck muscles that work with it every time you chew, talk, or clench.
Dr. Bobby Koser, DC, chiropractic physician, examines the jaw muscles, the neck, and how they work together, and treats what he finds within that scope.
Jaw and TMJ Pain Overview
What Jaw and Facial Muscle Pain Feels Like
Most people describe a dull, tired ache along the jaw and up near the temple, worse in the morning or after a long day of talking, chewing, or gritting their teeth without noticing. Some feel jaw clicking or popping when they open wide, a catch, or a jaw that seems to want to drift to one side. Jaw pain near the ear shows up often as well, since the joint sits just in front of the ear. Headaches that sit right at the hinge of the jaw are common too, and so is soreness in the muscles at the side of the neck. The two areas tend to travel together.
What people usually notice:
- Jaw ache, especially on waking
- Clicking or catching when you open
- Soreness that spreads to the temple
- Tight jaw after a stressful day
- Grinding or clenching at night
- Neck tightness alongside jaw pain
- Headaches near the jaw hinge
Two muscle groups do most of the work here: the masseter, which runs along your cheek from your cheekbone to your jaw, and the temporalis, the fan-shaped muscle at your temple. When either one is overworked, it can feel tight, tender to press on, and sore when you chew something firm. Neck muscles often join in, because the jaw and the upper neck share nerve pathways and postural habits.
What Contributes to It
Jaw and facial muscle pain rarely has one single cause. It usually builds from a combination of habits and mechanics, some of which a patient hasn't connected to their jaw at all.
- Clenching and grinding. Daytime clenching under stress, or grinding at night, loads the masseter and temporalis far past what normal chewing asks of them.
- Posture. A forward head position puts tension on the muscles that run from the jaw down the front of the neck, which can change where the jaw sits at rest and how hard the jaw muscles work.
- Neck muscle involvement. Tight muscles at the base of the skull and side of the neck refer pain up into the jaw and temple, and can be part of the problem even when the jaw itself feels like the whole story.
- Repetitive strain. Gum chewing, nail biting, and resting your chin in your hand all add small, repeated loads that add up.
- Old injury or whiplash. A prior neck injury can leave muscle patterns that keep feeding tension into the jaw long after the original injury has settled.
Teeth Grinding and Jaw Clenching
Grinding or clenching your teeth, which dentists call bruxism, is one of the most common ways the jaw muscles get overworked. Chewing loads the masseter and temporalis in short bursts. Clenching holds them tight for minutes at a stretch, and night grinding works them in short, repeated bursts through the night while you sleep. Mornings are often the worst.
The hands-on exam looks at what that load leaves behind: tender points in the masseter and temporalis, how far the jaw opens, whether it tracks straight, and whether the neck muscles have joined in. Care here does not stop the grinding itself. It addresses the overworked muscle the grinding produces. Worn teeth and night guards are dental territory. Whether you need a guard is a question for your dentist, and if your exam points that way we'll say so.
How the Exam Works
- History and pattern. When it started, what makes it worse, whether you clench or grind, and whether headaches or neck pain travel with it.
- Hands-on palpation. Dr. Koser presses along the masseter, the temporalis, and the muscles of the neck to find exactly which muscles are tender and reproducing your pain. This part is done by feel. Ultrasound is not used to guide the jaw portion of the exam or any needling in the jaw.
- Jaw motion and bite. How far you can open, whether the jaw tracks straight or deviates, and whether opening reproduces your click or your pain.
- Neck evaluation. Motion and muscle tone through the neck, since neck muscles frequently contribute to jaw symptoms and sometimes drive them.
- Findings explained the same day. You get told what was found and what he recommends, before you leave.
How We Treat It
What you're offered depends on what the exam finds. These are the services that may be recommended to you, not a fixed plan for everyone.
| Option | What it's for |
|---|---|
| Hands-on muscle work | Manual work on the masseter and temporalis to address tightness and tenderness found on exam. |
| Dry needling, hands-on technique | Thin needles placed by feel into the masseter, temporalis, or neck muscles to treat trigger points or myofascial pain. Ultrasound is not used to guide needling in the jaw. This is a hands-on technique, in the jaw and only in the jaw. |
| Chiropractic care for the neck | Adjustment and manual therapy for the neck when restricted motion or muscle tension there is feeding into jaw symptoms. |
| Ultrasound-guided dry needling, cervical muscles | Where the exam identifies deeper neck muscles contributing to your jaw pain, live ultrasound can guide needling of those neck muscles. That's a separate area from the jaw itself, treated with a separate technique. |
| Habit and posture guidance | Practical changes to clenching habits, sleep position, and desk posture that keep feeding the problem. |
To be clear: needling anywhere in the jaw, the masseter or the temporalis, is performed by hands-on technique, by feel, without ultrasound. Ultrasound guidance is not used in the jaw. On this page it applies only to the neck muscles described above.
Waking up with a sore jaw most days? An exam tells you which muscles are involved before any treatment starts.
Book Your Exam Call UsJaw Muscles Are Our Lane. Teeth and the Joint Are the Dentist’s.
Jaw and facial muscle pain is often muscular, and that's the part a chiropractic physician can evaluate and treat. But the jaw joint itself, the teeth, and the bite are outside that scope, and some jaw problems need a different provider.
Two jaw patterns need medical care the same day, not an appointment here.
Jaw pain that comes on while you chew and eases when you stop. Especially over the age of 50, and especially alongside a new headache, tenderness of the scalp or temple, or any change in your vision. One cause of that combination is treatable and can affect eyesight if it waits, so it is seen the same day.
Jaw or lower jaw pain that comes on with exertion, or that arrives with chest discomfort, shortness of breath, sweating, or nausea. Call 911. Jaw pain is one of the ways a heart problem shows up.
See a dentist if you have tooth pain, a bite that feels off, visible tooth wear from grinding, or a jaw that locks open or closed, what some people call lockjaw. A dentist can also fit a night guard, which is a dental device outside what's offered here. Some jaw problems belong with a dentist, an oral surgeon, or a physician rather than here. If Dr. Koser finds something on your exam that points that direction, he'll tell you and point you to the right provider rather than treat around it.
Book the exam and we’ll sort it in the room.
What the Research Shows
Jaw pain has been studied less than the back and neck, so there is less to report here. Here is what has been studied, cited in full.
On hands-on care. A systematic review of 48 clinical trials found that hands-on therapy for the jaw and neck, alone or combined with exercises, showed promising results for TMJ pain and jaw movement.1 The reviewers noted study quality was mixed and called for stronger research. Treating the neck alongside the jaw is not a detour, either: the review looked at both, and the exam here covers both because the two so often travel together.
On dry needling. Research on dry needling for jaw muscle pain is still developing. A 2019 meta-analysis found it reduced pain more than comparison treatments,2 and a 2023 analysis found it performed about as well as hands-on therapy.3 Both research teams noted the studies so far are small, and results across the field remain mixed. Where a trigger point in the masseter or temporalis reproduces your pain on exam, it is a reasonable target, and we will tell you honestly whether it is responding.
On acupuncture. A 2023 review of randomized trials reported that acupuncture improved pain in people with temporomandibular disorders, both compared with other active treatments and when added to them.4 The authors rated the overall evidence quality as low and called for better studies. Acupuncture here is its own visit, on a different framework from dry needling. Dr. Koser is certified in acupuncture by the Florida Board of Chiropractic Medicine.
1. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: systematic review and meta-analysis. Phys Ther. 2016;96(1):9–25. PubMed
2. Vier C, Almeida MB, Neves ML, Santos ARS, Bracht MA. The effectiveness of dry needling for patients with orofacial pain associated with temporomandibular dysfunction: a systematic review and meta-analysis. Braz J Phys Ther. 2019;23(1):3–11. PubMed
3. Menéndez-Torre Á, Martín Pintado-Zugasti A, Cuenca Zaldivar JN, et al. Effectiveness of deep dry needling versus manual therapy in the treatment of myofascial temporomandibular disorders: a systematic review and network meta-analysis. Chiropr Man Therap. 2023;31(1):46. PubMed
4. Park EY, et al. Is acupuncture an effective treatment for temporomandibular disorder?: a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023;102(38):e34950. PubMed
What it costs to start
$195Regular price $330
Self-pay only, one per patient.
Pain has a source. This visit looks for where it is coming from.
- A complete examination with Dr. Koser, which may include a live ultrasound look at the muscles and soft tissue where it hurts.
- Treatment the same visit unless the examination finds a reason it should not: a chiropractic adjustment, dry needling, cupping, laser, or electrical stimulation with infrared, chosen from what the examination finds and what is safe for you.
- Your findings explained the same day.
You’ll leave knowing what we found and what it means. First visit with us, one per patient.
Not ready to begin a membership? Start here and pay as you go. Membership rates apply only under a signed membership agreement. See membership plans.
Self-pay patients only. Not valid with insurance, PIP/auto claims, Medicare, or Medicaid. Injured in a car accident? Book the Auto Accident Injury Visit instead.
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
Every other bookable price is on our pricing page.
Common questions about jaw pain
Can a chiropractor treat TMJ or jaw pain?
A chiropractic physician can evaluate and treat the muscles involved in jaw pain, including the masseter, the temporalis, and the neck muscles that often contribute. Dr. Koser examines those muscles by hand and treats trigger points or myofascial pain with hands-on muscle work, dry needling, and chiropractic care for the neck. Problems with the teeth, the bite, or the joint itself fall outside that scope and are referred to a dentist or physician.
Is ultrasound used to guide needling in the jaw?
No. Needling in the jaw, the masseter and the temporalis, is a hands-on technique here, done by feel, without ultrasound guidance. Live ultrasound guidance is only used on certain neck muscles, when the exam finds a deeper neck muscle contributing to your jaw pain. It is never used to guide needling inside the jaw.
What causes jaw and facial muscle pain?
Common contributors include clenching and grinding, forward head posture, and tight neck muscles that can refer pain up into the jaw and temple. Repetitive habits like gum chewing and nail biting, and old neck injuries, can also feed it. Most patients have more than one contributor at once, which is why the exam covers the neck as well as the jaw.
Can teeth grinding cause jaw pain?
Yes, grinding and clenching are among the most common contributors to jaw and facial muscle pain. Clenching holds the masseter and temporalis tight for minutes at a time, and night grinding works those muscles in short, repeated bursts through the night. Many people wake with a sore jaw for exactly that reason. A hands-on exam checks whether those muscles are tender and whether pressing on them reproduces the pain.
Do you fit night guards for teeth grinding?
No. A night guard is a dental device, and fitting one is a dentist's job. HealthSpine Chiropractic evaluates and treats the muscular side of grinding and clenching: overworked, tender jaw and neck muscles found on a hands-on exam. Plenty of patients see a dentist about a guard and have the muscle work done here. If the exam points to a dental problem, Dr. Koser will say so and refer you.
Does dry needling for jaw pain hurt?
The needles are thin, and most people feel a brief, deep ache when the muscle responds rather than sharp pain. Temporary soreness afterward is common and usually settles within a day or two. Dr. Koser will tell you what to expect before he starts.
When should I see a dentist instead of a chiropractor for jaw pain?
See a dentist for tooth pain, a bite that feels off, visible wear from grinding, or a jaw that locks open or closed. A dentist can also fit a night guard, which isn't offered here. See a physician or oral surgeon for jaw pain after trauma, with fever or swelling, or with facial numbness. If Dr. Koser finds something on exam that points that direction, he'll refer you rather than treat around it.
How much does a jaw and facial muscle pain evaluation cost in Tampa?
New patients start with the Pain Source Exam at $195, an introductory price (regular price $330), one per patient, self-pay only. It includes a complete exam of the jaw and neck muscles and treatment the same day when appropriate. Our other prices are time-of-service rates, available when you pay in full at the visit. Care billed to a third-party payor, including auto insurance under Florida PIP, health insurance, Medicare, or workers' compensation, is billed on our standard fee schedule without either discount.
Top 3 Finalist: Best Chiropractor
Creative Loafing Best of the Bay 2025 · Readers Pick
Quoted in National Press
See the coverage →
This page is general health information and is not medical advice for any individual. The studies summarized describe groups, not any one person’s outcome, and whether a finding explains your symptoms can only be determined by examination. Talk to Dr. Bobby Koser, DC, about your own situation, and seek emergency care immediately for the warning signs described on this page.
Find Out What's Actually Involved
Jaw pain is often more than the jaw. Dr. Koser examines the jaw and neck muscles together and tells you what he finds, the same day.