Jaw Pain Isn’t Just in Your Head: What Physical Therapy Can Teach Us About Bruxism and Muscle Tension

Chronic jaw pain, headaches, and facial tension are more common than most people realize—and often misunderstood. If you clench your teeth, wake up with a stiff neck, or suffer from persistent head pain, you’re not alone. Many of these symptoms trace back to a surprising source: your muscles. In this episode of the Clenching Chronicle, physical therapist Dr. Chase Everwine shares practical insights into how physical therapy can help people with bruxism and chronic jaw tension get their lives back. This article unpacks that conversation and outlines the muscular roots of jaw pain—and what you can do about it.

Why Muscles Matter in Jaw, Head, and Neck Pain

When people feel pain in their face or jaw, they often assume something is wrong with their teeth or jaw joint. But in reality, it’s frequently the muscles doing the damage. Muscles like the masseter, temporalis, and pterygoids are all involved in chewing and clenching. When overused—such as during nighttime teeth grinding or daytime jaw clenching—they become tight, inflamed, and sore.

Dr. Everwine explains that these muscles can generate trigger points, or localized knots, that radiate pain to other areas like the temples, forehead, behind the eyes, and even the ears. This referred pain makes it tricky to pinpoint the source without understanding how muscles behave.

He also notes that the temporomandibular joint (TMJ) is directly impacted by muscle tension. Tight surrounding muscles compress the joint, worsening discomfort and limiting function. And since muscle tissue is richly connected with nerve endings and pain receptors, even minor strain can feel amplified.

Understanding the muscular component of jaw pain is key. It’s not always the joint, the teeth, or the bite—it’s often the surrounding muscle groups overworked and stuck in tension. The good news? Muscles respond well to care when properly assessed and treated.

Posture, Tech Neck, and the Impact on Facial Pain

Posture may seem unrelated to jaw pain, but it plays a bigger role than most people realize. The term “tech neck” describes the strain caused by constantly looking down at phones and laptops. When your head juts forward, it adds unnecessary weight on your cervical spine and forces muscles in your neck and jaw to compensate.

Dr. Everwine explains that the body works in chains. When one part—like the upper back or spine—is out of alignment, it causes the muscles around it to work harder to stabilize posture. This includes the small but powerful muscles at the base of the skull, the shoulders, and the jaw.

He also points out that perfect posture isn’t the answer. Holding yourself rigidly upright all day can be just as damaging as slouching. The key is movement—shifting your position throughout the day and keeping your spine and muscles flexible and mobile.

Spinal curves like kyphosis (rounded upper back) or lordosis (arched lower back) affect head position, which then influences jaw alignment and function. A head that's constantly craned forward shortens muscles in the front of the neck and overworks the ones in the back. This sets up a cycle of tension that extends into the face and jaw.

If you're dealing with jaw pain or headaches, a physical therapist can evaluate your posture and help you identify movement patterns that may be contributing to your symptoms. Even small changes in how you sit, stand, or hold your phone can help relieve stress on the jaw and neck muscles—and break the pain cycle.

Bruxism as a Muscle Overuse Condition

Bruxism—chronic clenching and grinding of the teeth—isn’t just a dental problem. It’s also a muscular one. Most people don’t realize they’re doing it, especially at night. But this unconscious activity puts intense pressure on the jaw muscles, forcing them to stay contracted for far longer than they were designed to.

Dr. Everwine describes how the jaw-closing muscles—like the masseter and temporalis—are built for short bursts of force, like chewing or biting into something tough. But clenching transforms them into endurance muscles, holding tension for minutes or even hours at a time. This overuse causes fatigue, inflammation, and even tendinopathy—an irritation of the tendons connecting muscles to bone.

It’s not just the duration that’s a problem—it’s the repetition. Daily clenching, especially when combined with stress, poor sleep, or bad posture, creates a feedback loop. The muscles never get a chance to relax or recover. And because the pain can radiate, people often mistake it for sinus issues, earaches, or migraines.

Physical therapy can help by restoring balance and function to these overworked muscles. Gentle stretching, hands-on release techniques, and exercises to retrain jaw movement can ease the tension. Just as important is awareness: understanding that bruxism is often unconscious makes tools like biofeedback critical. Devices like ClenchAlert give users a nudge—literally—when they clench, helping them learn to stop before pain sets in.

Breaking the cycle of bruxism requires a new way of thinking. Instead of treating symptoms in isolation, we must address the muscle mechanics behind the habit.

The Role of Sleep and Hydration in Muscle Recovery

It might sound simple, but sleep and hydration are two of the most overlooked tools in managing muscle pain. According to Dr. Everwine, poor sleep hygiene can derail your body’s natural recovery processes—especially if you’re someone who clenches or grinds your teeth at night.

During sleep, the body goes into repair mode. It rebuilds tissues, regulates hormones, and reduces inflammation. But if you’re tossing and turning, or waking frequently with tension headaches or jaw pain, that recovery never happens. Sleep-deprived muscles are sore, tight, and more prone to overuse.

Hydration is just as important. Muscles are mostly water, and dehydration can cause them to stiffen, spasm, or fatigue faster. It also affects the nervous system, reducing your body’s ability to manage pain and stress.

New wearable technologies make it easier to track these factors. Tools like Eight Sleep or the Apple Watch can monitor your sleep stages, heart rate variability, and recovery quality. These are wellness tools—not diagnostic devices—but they give users valuable insight into how their habits affect their body’s performance.

Improving sleep and hydration doesn’t require a complete lifestyle overhaul. Small shifts—like drinking more water during the day or setting a consistent bedtime—can help your muscles recover more efficiently and reduce the frequency and severity of bruxism episodes.

Pain relief doesn’t always come from a pill or a procedure. Sometimes, it starts with a glass of water and a good night’s rest.

How Physical Therapists Assess Jaw and Head Pain

When patients walk into a physical therapy office complaining of jaw pain or headaches, they’re often surprised to learn that their symptoms may be muscular—not structural. Dr. Everwine explains how PTs use both subjective and objective assessments to determine the true cause of pain.

Subjective assessments include conversations about pain history: When did it start? What makes it worse? Is the pain dull or sharp, constant or intermittent? These descriptions help clinicians differentiate between muscular pain, joint dysfunction, and nerve issues.

Next comes the objective exam. Physical therapists will palpate (press on) specific muscle groups to check for tenderness, tightness, and trigger points. They’ll also observe jaw movement patterns: Does the jaw deviate to one side when opening? Is there pain during muscle contraction?

In some cases, nerve involvement may be suspected, especially if there’s tingling, numbness, or radiating pain. Terms like paresthesia—describing those crawling or pins-and-needles sensations—can signal that the nervous system is involved. But even then, muscle tension often plays a contributing role.

What sets physical therapy apart is its holistic approach. Rather than chasing symptoms, PTs look for the underlying cause. Is poor posture stressing the neck muscles? Is one side of the jaw working harder than the other? Are compensatory movements creating pain elsewhere in the body?

This differential diagnosis is key to building an effective treatment plan. Identifying the real source of discomfort—whether muscle, joint, or nerve—sets the stage for targeted interventions that bring lasting relief.

Practical Techniques to Reduce Muscle Tension

Once the cause of jaw or head pain is identified, physical therapists use a range of hands-on techniques to address muscle tension. According to Dr. Everwine, treatment plans are never one-size-fits-all. Each patient is evaluated individually, and interventions are tailored to their specific muscular imbalances, postural challenges, and pain patterns.

Common techniques include manual stretching of tight jaw muscles like the temporalis, masseter, and suboccipitals. These stretches can involve gentle guided movements—like stabilizing the head while moving the jaw to one side—to lengthen overused tissues. Suboccipital stretches, like chin tucks with downward pressure, help relieve base-of-skull headaches. Intraoral techniques, such as pressing on the masseter muscle from inside the mouth, can help release deep tension.

Therapists also focus on restoring mobility in the neck and improving alignment in the upper back. Strengthening scapular stabilizers (mid-back muscles that control shoulder blade movement) is crucial. These muscles influence posture and, by extension, jaw position and function. It’s all connected through what Dr. Everwine calls the “kinetic chain.”

While techniques like dry needling and cupping are used in some states, California restricts their use by physical therapists. Even without those tools, a combination of active stretching, soft tissue release, and mobility work can significantly reduce jaw pain.

Patients are often given homework—simple exercises they can do at home between sessions. These might include jaw mobility drills, neck stretches, or posture cues. Empowering patients to take control of their healing journey is a big part of the process.

Ultimately, the goal isn’t just short-term relief. It’s long-term resilience. By retraining the body to move in healthier ways, patients can reduce pain and prevent future flare-ups.

 

The Unconscious Nature of Clenching and How to Raise Awareness

One of the biggest challenges with bruxism and jaw tension is that they’re often unconscious. You don’t realize you’re clenching until the pain sets in—or your dentist spots the damage. That’s where awareness becomes a critical part of healing.

Dr. Everwine explains that many people only become aware of their parafunctional habits—like clenching and grinding—once they’ve caused headaches, earaches, or jaw stiffness. That’s because these behaviors are often linked to stress, anxiety, or sleep disturbances, making them hard to detect and even harder to control.

So how do you break a habit you’re not even aware of? Start with mindfulness. Taking a few moments each day to scan your body, check in with your posture, and observe any areas of tension can make a big difference. Dr. Everwine recommends building this self-check into your daily routine—whether it’s while driving, watching TV, or sitting at your desk.

Biofeedback tools like ClenchAlert can also help. These devices sit inside your cheek and vibrate when you clench your teeth, gently alerting you to the behavior. Over time, this repeated feedback helps your brain build a new pattern—replacing unconscious tension with relaxation.

The goal isn’t to eliminate all clenching overnight. It’s to develop awareness and gradually shift your habits. The same way fitness trackers help you hit your step count, biofeedback devices give you real-time data to improve your jaw health.

By combining self-awareness with physical therapy and other lifestyle strategies, you can retrain your muscles—and your mind—to break the cycle of pain.

 

Why a Holistic, Multidisciplinary Approach Works Best

Chronic jaw pain rarely stems from a single issue. It’s usually the result of multiple overlapping factors—stress, muscle imbalance, posture, poor sleep, and sometimes emotional strain. That’s why the most effective approach is a holistic one.

Dr. Everwine emphasizes the importance of multidisciplinary care. While physical therapy can address muscular and postural dysfunction, long-lasting results often require coordination with other professionals. Dentists can help evaluate occlusion and recommend oral appliances. Mental health therapists can address the emotional and behavioral side of chronic pain. Nutritionists may assist with inflammation and recovery through diet. And tools like ClenchAlert offer behavioral feedback that bridges the gap between awareness and action.

This team-based model empowers patients to tackle pain from all angles. It’s not about choosing between therapy or a mouthguard—it’s about integrating multiple strategies that work together.

Lifestyle also plays a major role. Patients are encouraged to journal their pain, monitor hydration, get enough sleep, stretch daily, and exercise regularly. These aren’t just wellness tips—they’re therapeutic strategies backed by research.

The good news is that you don’t have to do everything at once. Start with what’s accessible. Maybe that’s adding a 15-minute walk to your day. Maybe it’s seeing a physical therapist or finally tracking your headaches. Each step adds up.

If you’ve been chasing symptom relief without success, it’s time to zoom out and look at the bigger picture. Pain is complex. The solution should be, too.

 

Busting the Biggest Myth About Pain

One of the most powerful takeaways from this conversation with Dr. Everwine is this: pain doesn’t always show up where the problem starts. That’s a common—and costly—misunderstanding.

He explains that pain is not just a physical phenomenon—it’s deeply rooted in the brain. Our brains contain a “motor homunculus,” a map of the body that guides sensation and movement. When pain becomes chronic, it can spread beyond the original injury through a process called cortical sprain. This means your brain starts interpreting input from nearby areas as pain, even if those tissues aren’t actually damaged.

For example, you might start with jaw pain—but over time, feel discomfort in your neck, shoulders, or even upper back. That doesn’t mean the pain isn’t real. It means your brain has expanded its pain perception zone. This is why simply treating the symptom often doesn’t work. You need a strategy that addresses the whole system—body and brain.

Another myth? That rest and avoidance are the best remedies. In reality, avoiding movement often makes things worse. Dr. Everwine urges patients to engage with their pain—gently, progressively, and with guidance. Healing often involves some discomfort, but facing it head-on is more effective than tiptoeing around it.

Whether it’s through biofeedback, therapy, exercise, or collaboration with other providers, the key is action. The people who get better are the ones who commit to the process—even when it’s uncomfortable.

 

Conclusion: You’re Not Alone—And You Can Get Better

Jaw pain, headaches, and bruxism are not just nuisances—they can derail your sleep, your concentration, and your emotional well-being. But as Dr. Chase Everwine reminds us, these symptoms are treatable. And more importantly, they’re not a mystery. The body has patterns. Muscles have memory. And pain has a purpose.

The first step is awareness—recognizing that your pain may stem from habits you didn’t know you had, like unconscious clenching or forward head posture. The second is action—taking steps to break the cycle. That might mean seeing a physical therapist, investing in a biofeedback device like ClenchAlert, improving your sleep, or simply getting more hydration and movement into your day.

Bruxism isn’t “just stress” and it’s not “just dental.” It’s a complex interaction between muscles, nerves, posture, sleep, and emotion. That means it deserves a multi-pronged, patient-centered approach. No one tool will fix it all—but when you layer awareness, exercise, treatment, and self-care, change becomes possible.

If you’ve been dealing with chronic head, neck, or jaw pain, know this: you are not alone. And help is out there. The answers don’t have to be complicated. They just have to start somewhere.

So take the walk. Stretch your neck. Track your symptoms. Use the tools. And most of all, don’t give up. Relief is not only possible—it’s achievable.