Treating TMJ issues: restless legs and sleep bruxism

A new clue about bruxism.

A neurology practice noted that of its patients who had restless legs syndrome (RLS), 60% also had bruxism (grinding teeth during sleep). Eighty-three percent had RLS and migraines, and 52% had RLS, migraines, and bruxism.

Do you relate?

The lead neurologist for this study speculated there is a gene that links these conditions.

It gets more interesting. Both restless legs syndrome and bruxism are involuntary movements occurring during sleep. Is bruxism “restless jaw syndrome?”

I’m always happy to see new research about TMJ-related issues, especially because there are so many factors that play a role in jaw dysfunction and pain.

This may be something to show your doctor, or you may be interested in taking a supplement or adding foods to your diet that help your body produce more dopamine (more info below).

More about bruxism.

Bruxism includes clenching and grinding the teeth. Some distinguish these as “waking bruxism” and “sleep bruxism”.

They may have different causes.

Sleep bruxism, in contrast to daytime clenching, is harder to treat because it occurs when you’re unaware of your behavior and unable to change it.

Waking bruxism is a habit that can change with awareness and practice. I’ve helped many clenchers learn how to relax their mouth position.

Some things I’ve noted about bruxism in my manual therapy practice:

  • Many people don’t know they grind during sleep until a dentist tells them they have damaged teeth.
  • Sometimes the noise of grinding during sleep is loud enough to wake up family members or housemates, and that’s how people learn they have sleep bruxism.
  • People who grind at night often wake up with jaw, face, or neck pain, earaches, and/or headaches.
  • Bruxism often results in the need for expensive dental work: mouthguards or splints to prevent further damage, crowns to fortify cracked or broken teeth, and sometimes implants.
  • Over time, bruxism can seriously damage the temporomandibular joints to the point of requiring surgery. It’s so much better to address jaw issues before it gets that bad.

Dentists and jaw issues.

Many people expect dentists to be experts on jaw issues, yet their domain is treating the teeth and gums.

Learning about TMJ disorders is not required in dental school. It’s an elective.

General practice dentists can prevent further tooth damage with appliances like mouthguards and splints. They can repair existing tooth damage or replace teeth with implants.

Some dentists may try to adjust the positioning of the TMJs, and a few more recently-trained dentists also address airway issues (like sleep apnea, which may accompany sleep bruxism) in their work.

Dentists do not address stress or tension in the jaw muscles, which contribute so much to jaw pain. Any overworked muscle will tighten, be painful, and perhaps spasm. The jaw muscles are no different. Sometimes they get taut bands within the muscle tissue that limit range of motion.

Working with muscles is the domain of massage therapists.

I receive referrals for TMJ Relief consultations and sessions from some of the best dentists and hygienists in Austin.

Solutions to try.

If you grind your teeth during sleep, it is possible to stop by using hypnotherapy or EFT (tapping).

I often recommend a recorded hypnotherapy session for bruxism that’s available on YouTube to listen to before sleep.

I don’t know if it works for everyone, but it’s soothing — I always fall asleep before it ends.

Less stress is always desirable.

I’ve also heard from someone who did this that starting a regular meditation practice can reduce or stop bruxism completely over time. There are many types of meditation. If you want to try this, choose a type of meditation that is relaxing and includes body awareness. Mindfulness-Based Stress Reduction is taught online.

As mentioned above, dopamine agonists are prescribed for low dopamine levels.

Dopamine is released when your brain is expecting a reward — when you anticipate a pleasurable activity such as eating a delicious meal, spending time with someone you love, or receiving a big check.

It’s sometimes called “the happy hormone” because it affects your enthusiasm, motivation, and focus.

If you suffer from bruxism, before going the pharmaceutical route with dopamine agonist drugs, you may want to consider nutrition — consuming foods or taking supplements that raise your dopamine levels.

In particular the amino acid tyrosine increases dopamine.

I found a few links that may be helpful:


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.

Treating TMJ Issues: choose a practitioner who works on your lateral pterygoids

Recently I’ve had two clients come in for TMJ relief sessions who have previously seen multiple practitioners who worked inside their mouths. Between them, they have seen chiropractors, chiropractic neurologists, Rolfers, dentists trained by the Las Vegas Institute (LVI), and/or other massage therapists.

These clients both told me, “No one has ever touched me there,” after I worked on their lateral pterygoid muscles.

That surprised me.

These small muscles are hard to access, being nearly surrounded by bones (cut away in the image below so you can see the two-headed muscle), and in my opinion, they are often the keys for releasing jaw tension and also for relieving clicking and popping noises. (Notice that the upper head is attached to the articular disc that separates the temporal bone and the mandible —the two bones of the TMJs.)

anatomy of the jaw muscles

It’s not that the other jaw muscles don’t contribute. They do. I’ve found tension in the temporalises, trigger points in the masseters, and taut bands in the medial pterygoids.

I usually save the lateral pterygoids for last when working on someone’s internal jaw muscles, because they are harder to access. It helps to have tiny pinky fingers, and even then sometimes I need to ask a client to shift their jaw to the side so I can reach them.

Sometimes I can’t reach them on the first visit, but any release of tension in this area near the joint is therapeutic.

People are not aware that there are jaw muscles here! I’m touching in a place where people never get touched. This area can be sensitive.

When I get on or near a lateral pterygoid, it can be a revelation. “That’s the place!” they exclaim when I remove my finger.

Once I get there, I don’t need to stay long.

It’s not that these other intra-oral practitioners mentioned above (at least in these two clients’ experiences) have nothing to offer. I’m not familiar with all of them, but chiropractors, Rolfers, and massage therapists have all helped me.

But if jaw pain and tension are your major complaint, and you’d like a sense of spaciousness in your jaws (if you can even imagine how great that would feel), find a practitioner that works on the lateral pterygoids.

I hope this information helps you ask informed questions when choosing a practitioner to relieve your jaw tension and pain.


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.


Free consultation for TMJ issues

I’m please to announce I’ve added a new service. If you have jaw pain or dysfunction and are wondering if I can do anything for you, please schedule a free 30-minute consultation.

A lot of people, including dentists, are not aware that appropriately trained massage therapists can work on relieving your TMJ issues that are due to muscle tension or trauma. 

Screen Shot 2018-05-30 at 8.44.49 PMI’ll ask about your symptoms and your history. I’ll also evaluate your body, including your neck and jaw.

Then we can talk about treatment options. If you’ve never had manual therapy for jaw pain and dysfunction, or if you’ve received it previously from a different practitioner, I’ll be happy to tell you what a typical session is like and the typical progression if you are curious about buying a series of sessions.

Please note: What I find once I start working and how well your system responds are variable with bodywork.

I’ve been doing TMJ Relief sessions since 2013. My teacher was Ryan Hallford of the Craniosacral Resource Center in Southlake, TX. I’ve taken his cranial base/TMJ class twice and been a teaching assistant for it when Christian Current taught. In addition, I’ve studied craniosacral therapy with the Upledger Institute.

Most recently, I studied TMJ Mastery in London, Ontario, with John Corry, a massage therapist and teacher with 26 years of experience working with TMJ issues.

Please let me know if you have any questions, and don’t hesitate to read the testimonials on my What People Are Saying page.

Treating TMJ issues: types, causes, and exercises

I have discovered an excellent source of information about TMJ pain and dysfunction. It’s a great website called Be My Healer offered by a doctor of physical therapy, Sophie Xie.

She’s got a couple of posts about TMJ issues. I am impressed with the quality of her posts in terms of credible information, writing to a lay audience, and her images. You go, Dr. Sophie Xie!

First, this article helps distinguish between types and causes of TMJ dysfunction. In short:

  • Type 1 is arthrogenous TMJ, meaning the problem is related to the functioning of the bony temporomandibular joint. There are two causes: arthritis and disc displacement. She recommends the best treatments for each cause. (Exercises* can help .)
  • Type 2 is myogenous, meaning muscle-related. Causes include bruxism (clenching and/or grinding), muscle imbalance (such as forward head posture, chewing on the same side, playing the violin), and systemic influence causing muscle tension (such as chronic stress, fibromyalgia, PMS).

Dr. Sophie Xie writes, “TMJ massage therapy can help by releasing the tense mastication muscle and provide pain and stress relief. However, you will need to call around to find a massage therapist who is specialized in intraoral release to receive the most targeted treatment.”

Here’s me raising my hand, signaling “Pick me!” I can help with all of the muscle-related types of TMD. I offer intra-oral work, help relieve forward-head posture, and help you relax from stress.

Again, exercises* can also help.

  • Type 3 is idiopathic, referring to a single cause: trauma impacting the joint  from accidents, injuries, dental treatments, even violent laughing or yawning.

Dr. Sophie Xie writes, “Post-traumatic TMJ pain is highly preventable. Early intervention such as physical therapy and massage therapy are excellent in preventing scar formation and muscle stiffness​. Gentle and progressive jaw stretching and exercises* will build a strong muscle function to keep chronic and repetitive TMJ pain away.”

Again, I can help.

*In her post Say goodbye to TMJ pain with these 5 convenient jaw exercises, Dr. Sophie Xie describes and shows (with delightful illustrations) exercises to strengthen and balance your jaw muscles.

She writes, “Most people experience significant TMJ pain reduction with daily exercises after 5-6 weeks. You should experience even faster results if you are also combining TMJ massage therapy with a nightly mouth guard.”

Her website has a contact page if you want to work with her. (I believe she’s practicing in Washington state.)

If you are in Austin, Texas, I’m happy to help.


Treating TMJ issues: de-stress quickly with these breathing techniques

Learning how to de-stress yourself is huge. Everyone experiences stress. It’s just part of life.

Stress becomes an issue when there’s too much of it, and your system has trouble rebounding resiliently to a calm, alert state.

How is this relevant to TMJ issues? So much TMJ misery is related to chronic and acute stress. It’s one of the major contributors to TMJ issues. People clench and grind due to stress, and stress is always accompanied by muscle tension, which causes a lot of jaw issues. 

Staying stressed for too long is bad for your well-being. It affects your digestion (including absorption of nutrients and detoxification) and creates unnecessary wear and tear on your vital organs.

I’m talking about bad stress as opposed to good stress, such as the anxiety before a performance that makes you a better performer, or the adrenaline you feel when a bad driver nearly hits you that helps you react quickly and successfully avoid being hit.

In my opinion, bad stress includes most news about politics (just donate money and volunteer for candidates you like) and traumatic events (there’s always something awful happening in the world).

Also, the desire to control others’ behavior can bring about bad stress. Better to focus on accepting them as they are and work on a healthy path for yourself.

Maybe they’ll witness you and want to change themselves.

You can still care and have a constructive strategy to manage stressors.

You can do these things from a calm, alert state. Imagine that.

The beauty of using a little breathwork to get yourself out of an unhelpful state of stress (any stressor that does not require immediate action) is that breathwork bypasses your mind.

Has “you need to calm down” ever helped anyone to actually calm down, whether it’s yourself or someone else telling you this?

Breathwork is also quick. You can simply do a little breathwork when stressed, and your system starts shifting into parasympathetic mode.

A note to the chronically stressed: here’s how to tell when you’re in a parasympathetic state. Your whole body starts to feel a softness and relaxation because you have let your guard down. You notice your that breathing has changed, to becoming slower, deeper, with longer pauses. 

If this is hard, because maybe you’ve been carrying the guarding that often occurs after a trauma, try this: Imagine yourself in a completely safe environment where you don’t have to be guarded against anything. Maybe you are surrounded by softness, or floating in body-temperature water. You may have any objects (real or imaginary) that bring you comfort. 

Let go of your thoughts and just be. 

The more you practice breathwork and conscious relaxation, even when not stressed, the more it gets wired into your neurology.

The physiological sigh

The physiological sigh is breathwork technique that’s getting a lot of attention now. It’s been recognized for 80 years as a behavior people do automatically when claustrophobic and in other stressful situations.

Now you can put it to work for yourself when you need to de-stress yourself.

I learned about it from Dr. Andrew Huberman, a Stanford University professor who runs a neurobiology lab and has a podcast.

In brief, it’s two inhalations through the nose, and one longer exhalation through the mouth. (I think of it as the “sniff sniff ahhhhh” breath.)

Here’s a video demonstrating technique.

Dr. Huberman says sometimes people fall asleep if they do it 15 times in a row, but just three of these physiological sighs are enough to start slowing your heartbeat down in 20-30 seconds.

I nearly always yawn when I start doing physiological sighs.

4-7-8 breathing

Another fairly quick breathwork technique for reducing stress is the 4-7-8 breathing (the Relaxing Breath). Dr. Andrew Weil, who has been practicing and writing about holistic health and integrative medicine for 30 years, came up with it.

Dr. Weil recommends doing four of these breath cycles at least twice a day for two months to get the benefits. This wires it into your neurology.

He recommends slowing the cycle down, with the limiting factor being how long you can comfortably hold your breath.

It can also help with cravings and falling asleep.

In essense, you are retraining your nervous system to be more relaxed.

You may become less stressed from using either or both of these techniques and still benefit from receiving a TMJ Relief session to retrain your jaw muscles into relaxation. The breathwork will help your body retrain itself more quickly and prevent relapses.

If you’re ready to have that conversation with me, please connect. I’d love to hear from you.


What to do if you have jaw issues? I offer a 30-minute in-person TMJ consultation to gather information and evaluate your issues. I also teach clenchers an alternative to clenching and provide known ways to stop grinding, from those who succeeded.

These habits are major contributors to TMJ issues, and you can change them.

If you’re not in Austin, I can do the above as well as help you learn what to ask about when seeking TMJ relief near you. Just let me know if you need a phone or Zoom consultation.

I offer a combination TMJ Consultation plus TMJ Relief session in person in Austin, Texas, and in Taos, NM, in sumemrs. The consultation serves as an intake, so I have a better idea of what your issues are and how we’ll measure progress. Your consultation is free when combined with your first TMJ Relief session. This is a two-hour session.

To be fair, when you’ve had TMJ issues for a long time, or they are acute, you may need multiple sessions to retrain your system to retain the ease and alignment, along with doing your homework to stop clenching or grinding your teeth.

I offer a package of four TMJ Relief sessions for 10 percent off single sessions, best done a week or two apart. These sessions are 90 minutes and integrate various bodywork modalities — including work in your mouth — so that you feel great when you get off the table. They are best done over 4 to 6 weeks.

If you’re really adventurous, you can schedule a 75-minute Self-Treatment for TMJ Issues session on Zoom where we’ll do an intake and I will teach you how to work on releasing the tension patterns that cause problems, including working in your own mouth. You’ll need clean hands and short nails. It’s really not that hard! Learn more about it here.