The Temporomandibular Joint (TMJ) is the joint connecting the lower jawbone (mandible) and the skull. It’s a sliding hinge joint immediately in front of the ear.
TMD refers to a Disorder or Dysfunction of the joint. TMD covers jaw pain and associated headache, jaw stiffness, clicking, locking, or difficulty with biting, chewing, talking, yawning, facial expression, etc.
TMD can occur following trauma (eg. car accident, blow to the head, or prolonged dental work overstretching and inflaming the joint).
It is more commonly a consequence of stress, anxiety, clenching or grinding teeth (known as bruxism), or parafunction (eg. nail-biting, gum-chewing, tongue or cheek biting) which tightens the muscles around the jaw and puts added pressure on the joint.
Other common causes are prolonged chewing on one side, dental issues causing a bite malalignment, and poor neck and head posture.
Jaw clicking is common and rarely means the joint is dislocating. It often results from displacement of the disc inside the joint due to muscle spasm or uneven motion of the jaw. Sometimes it is caused by osteoarthritis. Physio can help both.
Headaches from the neck (Cervicogenic) are typically one-sided, and radiate from the back of the head forwards toward the forehead, temple or behind the eye. They may or may not be associated with neck stiffness or pain, or triggered by prolonged static postures.
Through specific manual pressures and movement tests of the upper spinal segments, physiotherapists can quickly determine whether your neck is contributing to your headaches.
No, but maybe. Whilst migraine is a distinct neurological condition involving the brain, trigeminal and vascular systems, studies have shown that up to 75% of sufferers experience neck pain before or during migraine attacks. In practice, physiotherapy that alleviates neck muscle tension and joint tightness, and strengthens the postural stabilising muscles, has been shown to successfully reduce the frequency and severity of migraine and tension-type headache.
Neck pain is very common, affecting up to two thirds of the population at some point. Pain can arise from degenerative changes to the bones, joints or discs, from postural or occupational stresses, poor sleeping position, injuries or accidents, or straining (eg. lifting kids). Physiotherapists identify the contributing factors, and help relieve pain and restore movement through treatment and exercise.
Imaging is usually only needed after trauma, or when there are indications of nerve compression (such as arm pain, weakness, numbness or tingling). Scans often show age-related changes that aren’t actually causing pain. A thorough clinical assessment will determine if imaging is necessary and whether it would change your treatment plan.
You’ll be asked to describe your symptoms, their onset and history, and how they’re impacting your daily life. We then examine how you move, your strength, posture, and flexibility, and palpate relevant muscles, joints, and nerves.
By the end of your first session, you should understand what's causing your problem, how long recovery will take, what treatment you need, whether you need imaging, and what you can do yourself to speed up recovery.
No. The goal is to help you recover so that you can do everything you need with confidence and live your best life without ongoing reliance on therapy. However, some conditions do lead to persistent pain or dysfunction and benefit from longer term care.
Cracking or popping of the neck or other joints is common and often harmless. Occasional cracking is usually cavitation, (eg. during a joint manipulation/adjustment), whereby rapid formation then collapse of tiny gas bubbles creates the popping noise.
More frequent cracking or crepitus may be from osteoarthritis, or sometimes from aberrant joint motion due to muscle imbalance or weakness
The occasional crack with movement is fine, but repeated, forceful or end-range cracking carries some risk of creating weakness or instability of the joints, and there is a remote risk of stroke from vascular damage.
Yes physiotherapists are trained to manipulate spinal joints, which may be included with the patient’s consent to assist movement restoration as part of a comprehensive treatment program.
There’s no single “best” exercise for everyone. Evidence supports regular movement and strengthening for neck pain, but rehab programs are always individualised.
The best exercise is often one that is simple, quick, doesn’t need vast space or equipment, and is preferably enjoyable!
Yes, quite possibly. Arm or shoulder pain often originates from the neck, even if your neck itself feels fine. Physiotherapists can assess whether the cause is nerve compression (radiculopathy) or referred pain from tight muscles or irritated joints.
As a guide, any pain on top of the shoulder, or radiating down below the elbow is suspicious for being neck-related.
Most people sleep best on their side with a pillow that supports the natural curve of the neck and keeps the airway open. Consider a contoured memory foam pillow like the Complete Sleeprrr, or try a rolled towel inside the pillowcase to create a contour.
If you’ve tried several pillows without relief, the problem may lie in the neck itself — a physiotherapist can help with improving mobility, strength, posture, relaxation and sleep hygiene to assist sleep.
This varies by condition. Most people improve dramatically within a few sessions, while others with long-standing or more complex issues will need longer treatment. Your physiotherapist will outline realistic time frames and goals.
Some mild soreness during or after hands-on therapy or dry needling is normal. Tenderness lasting more than a day is uncommon. Application of a heat pack at night often assists.
Treatment is not about inflicting pain, but should be a partnership, working together to get better. You the patient are always in control and you may withdraw consent at any time.
Yes! Lasting improvement comes from moving well between sessions. We use Physitrack software to send your personalised program by email, complete with videos, progress tracking, and messaging support.
Physiotherapists are highly trained to assess and treat the entire neuro-muscular-skeletal system. We use a combination of joint mobilisation, massage, dry needling, taping, posture correction, education about your condition, and exercise-based rehabilitation. Whilst physios do perform spinal manipulation / adjustments where helpful, the focus is on restoring movement, building resilience, and helping you understand and manage your condition confidently — without requiring ongoing maintenance treatments.
Pain is an unpleasant sensory and emotional response produced in the brain to a actual or a perceived threat of tissue damage.
Pain can be ramped up in times of stress, sleeplessness, fear or anxiety, or lessened when happy, distracted, feeling valued and productive. So no, pain is in your brain, not in your head or “imaginary”, even when it persists long after injuries have healed.
Physiotherapists are skilled in helping you understand and manage both the physical and psychological contributors to persistent pain.
Disc problems can cause symptoms in the neck, upper back, shoulder blade, or arm. The discs hold the vertebra together and do not slip out, but can bulge or tear become inflamed. While physiotherapy doesn’t “heal” discs directly, we can reduce inflammation, restore movement, and reduce and centralise referred pain through targeted manual therapy and exercise. Many people experience significant reduction in pain and improvement in function over a few weeks.
Dry needling is an established, mainstream treatment using fine needles (0.3mm) to target specific muscular trigger points to relieve localised tension and pain. Evidence shows rapid reduction in muscle tone, improved blood flow, endorphin release and lowered concentration of pain- causing chemicals and inflammatory mediators. It is particularly useful if deep massage is not tolerated or appropriate, and can result on longer effects than massage alone.
Acupuncture by contrast is a traditional Chinese medicine practice that inserts needles along meridians to restore the body's energy flow and balance overall health. Practitioners must re registered with the Chinese Medicine Board.
Yes, Peter continues to treat all areas of the body and is very experienced with sports and occupational injuries, vestibular rehabilitation / BPPV, Spinal, Hip and Knee problems.
Sessions typically last 30 to 45 minutes, depending on your condition and the number of areas being treated.
