A temporomandibular joint (TMJ) disorder involves pain and dysfunction in the jaw joint and the muscles controlling its movement. These complex joints on each side of your head act like sliding hinges, connecting your jawbone to your skull. Many individuals reported new or worsening jaw pain during and after a COVID-19 infection, prompting investigation into the connection. The relationship appears multifaceted, involving direct biological effects from the virus and indirect consequences of the global health event.
Direct Viral and Inflammatory Pathways
The SARS-CoV-2 virus is understood to provoke a significant inflammatory response throughout the body that may extend to the jaw. One theory suggests the virus could directly affect the temporomandibular joint, much like other viruses cause reactive arthritis. The body’s immune reaction is a central part of this process, and in some cases, the immune system can overreact, creating a “cytokine storm.”
This flood of inflammatory proteins, or cytokines, circulates throughout the body, causing systemic inflammation that can settle in various joints, including the TMJ. This can lead to symptoms like sharp pain within the joint, visible swelling in the preauricular area (in front of the ear), and difficulty opening the mouth due to internal joint inflammation.
This direct inflammatory effect is a reason why some individuals with successfully managed TMJ disorders experienced a relapse of symptoms after contracting COVID-19. The inflammatory cascade may also affect nerves in the head and neck, as cytokines can stimulate the trigeminal ganglia, contributing to headaches and facial pain.
Pandemic-Related Stress and Bruxism
Separate from the direct biological impacts of the virus, the psychological fallout of the pandemic has been a significant indirect factor. Widespread stress, anxiety, and uncertainty have been linked to an increase in parafunctional habits. The most prominent of these habits concerning jaw pain is bruxism, which is the involuntary clenching or grinding of teeth, occurring both during the day and while asleep.
This constant muscle activity places the jaw muscles, such as the masseter and temporalis, under considerable strain, leading to fatigue, tension, and pain. Studies conducted during the pandemic found that a significant portion of the population reported an increase in bruxism behaviors, which correlated with a rise in TMJ symptoms. One study found nearly half of subjects reported more bruxism, and over 30% noted more facial muscle pain.
Symptoms directly related to this muscular overuse are distinct from those caused by joint inflammation. People experiencing bruxism-related TMJ pain report a dull, aching soreness in the jaw muscles, particularly noticeable upon waking. This is frequently accompanied by tension headaches, pain that can radiate to the ears, and observable wear on the chewing surfaces of the teeth from the constant grinding.
Postural and Respiratory Changes
Lifestyle shifts during the pandemic introduced another set of indirect contributors to jaw pain. The widespread transition to remote work often resulted in suboptimal ergonomic setups. This gave rise to “tech neck,” a term describing the forward head posture adopted when looking down at laptops and phones for extended periods. This posture strains the muscles in the neck and shoulders, which are biomechanically connected to the jaw.
When the head juts forward, it forces the lower jaw to shift to compensate, creating tension in the TMJ and surrounding muscles. This can lead to referred pain, where tension in the neck muscles, like the sternocleidomastoid, triggers discomfort in the jaw.
Respiratory symptoms associated with COVID-19 can also play a role. Prolonged nasal congestion may lead to chronic mouth breathing, which alters the natural resting posture of the jaw. Holding the mouth open for long periods places a continuous, low-grade strain on the jaw joints and ligaments, contributing to muscle fatigue and pain.
Managing COVID-Associated Jaw Pain
For individuals experiencing jaw pain linked to these factors, a combination of self-care and professional guidance can provide relief. At-home strategies are a practical first step for managing symptoms.
- Eating a diet of soft foods reduces the mechanical load on the jaw.
- Cutting food into smaller pieces can help avoid excessive chewing.
- Applying a moist heat pack can help relax tense muscles.
- Using a cold pack can reduce joint inflammation and acute pain.
Gentle jaw exercises, such as slow, controlled opening and closing movements, can improve joint mobility and stretch tight muscles. Stress-reduction techniques like mindfulness or deep breathing can help address the root cause of stress-related clenching. Simply being aware of your jaw posture—keeping your teeth slightly apart and your tongue resting on the roof of your mouth—can prevent daytime clenching.
If pain persists or worsens, it is important to seek professional help. A dentist can diagnose bruxism and fabricate a custom oral appliance, or night guard, to protect teeth and reduce strain on the jaw during sleep. For more complex cases, a physical therapist or an orofacial pain specialist can offer targeted treatments, including manual therapy and therapeutic exercises.