As a massage therapist and human anatomy enthusiast, I often think about two simple questions: “How?” and “why?”. Or, more specifically, “How are things connected and why is that connection related to something?”. The something in these scenarios is the unpleasant pains and sensations our bodies tend to experience.
A great example of one such sensation is ear stuffiness, tinnitus, and/or pain. Often the cause is not related to your ears at all, as the above list features common symptoms of TMJ dysfunction. In other words, that pain in your ear might actually be a pain in your Temporal Mandible Joint or TMJ as my fellow anatomy geeks call it. I wanted to explore this connection to explain the cause and treatment to my clients. The fact that I am not immune from ear fullness sensations also sparked my interest in the subject.
This interest led me down a rabbit hole of research, as it often does. Now that I have emerged on the other side of it, with new knowledge in hand, I am excited to share it with my readers in hopes of helping them understand their bodies more fully. Let us start with a bit of anatomy to lay the foundation. Many are aware the middle ear contains a tube; called the eustachian tube by its scientific name. This tube provides a connection from the ear to the nasopharynx. The nasopharynx is the upper throat & back of the nasal cavity, as you may or may not have guessed by the name.
The job of the eustachian tube is to control the air pressure within the ear by equalizing the pressure inside the ear with the pressure outside the body. The tube remains closed the majority of the time except during yawning, chewing or swallowing. During these short periods of activity, the tube is open and allows airflow to pass from the inner ear to the nasopharynx.
If air can’t pass from the inner ear to the nasopharynx, it creates negative pressure within the ear which then causes ringing in the ears (tinnitus), ear fullness or stuffiness, along with vertigo.
Connecting the Dots
While all this may be both painful and irritating, you may be wondering how it relates to TMJ pain & dysfunction. If you take a look at the diagram below, you see there is a thin piece of bone that divides the middle ear from the TMJ, called the temporal bone (highlighted in purple).
When I look at the purple highlighted area, I know this is the exact location of our ears. The ears, as well as the TMJ, share the same nerve supply from the mandibular branch of the Trigeminal nerve.
I should now add that this nerve can become trapped between 2 muscles of the jaw called the medial and lateral pterygoids. As a result, pain is referred along the side of the jaw.
When I put the following factors together, this alone makes a strong case for why the ear is affected by a problem with the jaw.
structural & anatomical locations
identical nerve supply
teammates working together to balance the air pressure inside our ear to the nasal region.
Although the details we covered so far make a compelling argument, I also found myself looking at the muscles involved in the passage of the airflow discussed in the beginning. A duo pair of muscles called the Tensor Veli Palatine & Levator veli Palatine are at the top of the list for culprits of the problematic ear symptoms that occur with TMJD.
Why, you may ask? These culprit muscles control the soft palate of the mouth, located on what many of us refer to as the “roof” of the mouth.
The main purpose of the soft palate is to prevent the passage of food and beverages from entering the nasopharynx. This action occurs with the Levator Veli Palatine muscle. I have talked a lot about the eustachian tube, but what controls the opening of it? The Levator Veli’s counterpart, the Tensor Veli Palatine acts as the pulling force to open the tube.
In a somewhat complicated nutshell, both the jaw and the ear share anatomical structures and functions. If the Tensor Veli muscle can’t act to close the eustachian tube located inside the ear, negative pressure gets stuck within the inner ear and causes an array of unpleasant symptoms. The next time you notice unpleasant ear sensations, ask yourself if you are actually experiencing issues with your jaw, and consider calling your friendly local Jaw Mechanic ™.