Eye Pain, Swelling & Twitching

Learn about the link to TMJ

Has eye pain, swelling or twitching just become too much of a strain?

tmj-eye-painDo you sometimes feel a ‘stabbing’ sensation behind your eyes or do they swell up or twitch unexpectedly making it difficult to concentrate on everyday things? Have you tried everything to relieve these painful sensations and haven’t yet come up with a solution?

When you have ruled out organic causes of eye pain with your ophthalmologist it is likely your pain is related to jaw, muscle  and TMJ function.

These sorts of symptoms could be due to a dental problem related to your jaw and neck muscles and your temporomandibular joint (TMJ). These  are  the joints that act like a hinges on both sides of your face. These joints allow you to speak, chew and yawn, amongst other things.

Some problems with the joint can lead to referred pain behind the eyes and the eyebrow area via the Trigeminal Nerve.  The TMJoints  are some of the most complicated joints in your body.  Each TMJ joint is actually two joints in one, a ball and socket joint and a sliding joint.  The entire ball and socket portion can slide forward and back as well as side to side.

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The nerve that just might be behind your eye pain

If your bite is not properly lined up, you have what is often called a ‘bad bite’. This can cause friction or uncoordinated motion in one or both of your  (TMJ) TMJoints.

If it stopped right there you would probably never know about it, but unfortunately a nerve runs right past the joints, called the trigeminal nerve.  The Trigeminal Nerve goes to the teeth, the jaw muscles, the jaw joints as well as to the sinuses especially directly behind the eye.  Retro-orbital or behind the eye pain is mediated by the Trigeminal Nerve. This nerve is responsible for passing the message about friction through to the brain and somehow the message is transferred right on through to the eyes as well. The result is that you feel pain behind the eyes and sometimes they cause swelling and twitching because of the pain.

The trigeminal nerve is a cranial nerve, or actually made up directly of brain cells. The impulses of the trigeminal nerve ultimate are more than 50% of all input to the brain after they are amplified in the reticular activating system.  This is similar to music coming out of an amplifier at a concert.  Good input can be amazing but bad input is intolerable noise.  In this example the bad input or noise is what patients percieve as pain. What we call eye pain is nociceptive input perceived as eye pain.  The pain is absolutely real but the cause is often different than expected.  This is called refered eye pain.  Pain that is perceived in the eye but is actually from elsewhere.

These eye pain symptoms are common in the disorder known as temporomandibular disorder or TMD.  Myofacial Pain and Dysfunction (MPD) refers to the pain coming from trigger points in the muscles.  90-95% of all pain is actually muscular in origin.  The muscles work overtime to protect us from problems.  When they are overworked we have myofascial pain and TMD, both repetitive strain disorders.  More commonly known repetive strain disorders include carpal tunnel and tennis elbow.

There are many other symptoms  of TMD and MPD as well so it’s not surprising that it’s hard to work out exactly what is behind all these varied pains and sensations.  Physiologic dentists are experts in understanding patterns of referred pain in the head and neck .

The ‘bad bite’ that causes the problem in the TMJ is actually a poor alignment of the upper and lower teeth. When they don’t match up properly it puts extra pressure on the jaw and the muscles are used incorrectly causing repetitive strain injuries  like a chain reaction.  These problems affect head position posture and the body as a whole. The bad bite affects the muscles and the TMJ (TMJoints) which triggers the trigeminal nerve causing referred pain that eventually makes your eyes hurt.

The swelling around the eyes and dark circles under the eyes are actually secondary results of unhealthy muscles blocking normal drainage creating venous back-ups.  The dark area under the eyes is due to blood that is not receiving enough oxygen.

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Dental treatment may be pain resolution

By now you will be wondering if anything can be done to help relieve the symptoms of eye pain, swelling and twitching. Fortunately, we might be able to provide a solution through the use of a diagnostic physiologic orthotic placed in your mouth that realigns your bite and allows your healing.  The orthotic is used to eliminate the impediments to healing. Doctors who allow the body to heal understand the process of health far better than those who promise magic cures.

An ultra low frequency TENS machine (MYOMONITOR) is used to create minute electrical impulses to stimulate your jaw and neck muscles so they  relax and the jaw and TMJ joint takes up a better position. This makes it easier for a dentist who specializes in physiologic treatment of TMJ and other jaw disorders to pinpoint where your bite should be.  Once the bite is idealized postural changes occur in the neck and throughout the entire body.  The diagnostic orthotic is corrected to reflect these postural changes.

When your bite is kept in the correct place then your TMJoints and jaw muscles will not be triggering the trigeminal nerve and resultant  pain will not be referred to  your face and neck. Effective dental treatment may eliminate or improve your eye pain and allow you to reclaim your normal life.

It may be time to seek TMJ relief

tmj-reliefYou shouldn’t miss out on enjoying life because eye pain is distracting you and painkillers have become a way of life. As it is possible that your TMJ is causing your eye pain, then it may be time for you to take the next step.

A diagnosis of TMD will be required, and we will need to make a thorough examination and eliminate any other potential causes of your eye pain. From there, we can determine what the best step would be for you. TMJ relief may be possible if you have bad bite and it can be realigned successfully.

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  1. Greetings from Idaho! I’m bored at work so I decided to browse your blog on my iphone during lunch break.

    I love the information you provide here and can’t wait to take a look when I get home.
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    I’m not even using WIFI, just 3G .. Anyhow, good site!

  2. Hi recently I have had headaches that hurts the top of my head, eyes hurt on top, and pain on sides of head. Also I’ve had some pain on cheek bone and on eye brows. I’m confused if this is sinus related as I also had post nasal drip, nasal congestion,pressure on teeth and the above symptoms. It’s very hard to tell. Can you please help.

    Thank you

  3. The pain is likely either Myofascial Pain. The most common cause of pain in muscles especially in the head. The cheek bone pain could be masseter muscle origin. It is possible there is also sinus issues but it is very rare the pain is from a sinus infection. The chronic sinus congestion can be neurally mediated due to the pain.

    Check out TriggerPoints.net to see patterns of pain. I have numerous patient testimonials with similar pains that were easily resolved.
    Please view the videos at : https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg

    My website http://www.IHateHeadaches.org goes into different types of headaches in detail.

  4. Can you recommend treatment in the New York City area as I have severe TMJ issues ?
    Thank you so much

  5. Hi-
    I love your website! It is through and clear and very informative. I have RA and my jaw joint is the worst affected. At least, it’s the most painful! I have pain behind my eyes as well as swelling, dark circles and twitching. Wondering if you can recommend a specialist in Los Angeles? I live in Santa Monica. Otherwise, my in laws live in Northbrook and I’m coming to see you! Thank you!!

  6. RA is a serious problem. You should definitely consider starting treatment with a diagnostic physiologic orthotic. I work with Dr Steve Best of the Neuroscience center in deerfield and a trial of hyperbaric oxygen is a easy way to address RA. Dr Best can go further i nto treatment possibilities. Most important is the orthotic to allow healing.

  7. Great information, thank you. Can you recommend anyone in the NE Oklahoma area? We are at the state corners of OK, MO, KS, AR. Here in NE OK, the dentists have said they have never heard of tmj/tmd.

  8. I have had pain behind my eye for a year. I have gone to a family practioner, opthalmologist and an ENT specialist and all they could tell me was it could be allergies or dry eye. I now have twitching in my left eye and random swelling. After reading this, I am wondering who I could go to to see if this is my issue. I live in Kansas. Would my regular dentist be able to help?
    Thank you for this detailed information!

  9. Dear Rebecca,

    Each patient and doctor is unique. I would recommend visiting ICCMO.org to find a physiologic dentist. Ideally you want a doctor trained in sleep, and pain management as well as physiologic dentistry. I frequently see long distance patients in Chicago and in a couple of days can often make life changing progress.

  10. A pain behind the eye is almost certainly coming thru the trigeminal nervous system and is likely myofascial referred pain. A trigger point injection and/or spray and stretch may provide instant relief which would be diagnostic. Most general dentists have some awareness of these conditions. I frequently see long distance patients who cannot find answers elsewhere.

  11. car accident when young, many years of dental work and implant! Now latest dental work left me with a edge bite! Pain in temple, behind eye and in neck radiating into ear!

  12. You are describing a typical pattern of referred myofascial pain fron active trigger points. Correction of bite can help eliminate TP’s long trem

  13. You are describing a typical pattern of referred myofascial pain from active trigger points. Correction of bite can help eliminate TP’s long trem

  14. Hi, my eye has been twitching for a full week. (it started last Friday and is almost completely constant) Before this I had random eye twitches just every so often. I am also experiencing stabbing pains in the same eye and it feels warm and semi swollen. I have been diagnosed with TMJ previously, but have never experienced problems like this. Would this be related to TMJ, or do you think it could be something else?

  15. The symptoms are commonly seen i patients with TMJ disorders. This has to do with the common innervation be the trigeminal nerve and the facial nerve as well as autonomic nerve fibers that travel with them. This does not rule out other disorders. Typically the ULF_TENS used in Neuromuscular dentistry will eliminate these symptoms and relax jaw and facial muscles. TMJ problems often add new troublesome symptoms over time.

  16. Hi! Can you recommend any doctors/dentists in CT to help with, throbbing eyes, TMD, trigeminal nerve, and nerve pain in neck/shoulders.
    Thank you!

  17. Sorry, I looked for ICCMO mebers in CT but found none. You definitely want a knowledgable neuromuscular dentist who also understands SPG Blocks.

  18. Hey Dr. Shapira, I’ve stumbled upon this post which made some sense of my eye problem. For almost two years my left eye started having spasms, at first I thought is because of tiredness/diet/hydration, before even trying to change my habits, it went away for some good couple of months, then came back, went away, and now is back, and is been on for the past three months.

    So the eyeball, not the lid, nor the facial muscles, is twitching, my left’s eye vision is shaking (as you’d vibrate a phone camera). Never had glasses, never had problems with vision, both eyes sees equally sharp. I am having plenty of sleep, healthy diet, hydrate myself, not stressed at all – so I’m guessing is not the lifestyle which is the problem.

    After reading the article it reminded me of a hint; A year ago or so I woke up one day with pain on the mandible on the left side (eye’s side) and lasted for a week after it completely vanished. It wasn’t crazy pain, but was a new unfamiliar stress on the mandible joint (right under the ear), which was stronger in the morning, as if my mandible was doing something during the night.

    Another hint that my dentist pointed me a while ago is that my left upper molar doesn’t have a lower molar to sit on (it was extracted when I was younger) which might lead to irregular sitting position, but nothing to worry as she said.

    And the last hint which I realised a week ago, when I clean my ears after shower I’ve noticed that the cotton stick is more yellow on the left one (the eye’s side).

    So to finish, I don’t know if these hints are pointing to some kind of TMJ, or if even my analogy is correct, as I don’t really have any other symptoms, no head-ache, no nausea, no other pains. But the shaky eye worry me a bit too much and I would like your opinion on this and if you could point me to which type of doctors to seek or any advice.
    Thank you very much for what you are doing.

  19. I would alys star with an Opthamologist and rule out primary eye issues. There is a jaw muscle, the sphenomandibularis that goes from the coronoid process of the mandible to the back of orbit of the eye and can deform it. Treatment would focus on balancing bite to see effect, possibly starting with an Aqualizer Appliance to see effect. You might also consider behavioral optometrist.

  20. thanks for the post on TMJ and treatment. can you recommend a doctor in sunnyvale, 94087 california area

  21. MY PLEASURE. In general I suggest looking for a doctor who is a member of ICCMO. http://www.iccmo.org

    I frequently have long distancre patients come to see me in Chicago, especially those with sevdere or long standing pain.

  22. I have an underbite that wore away my upper incisors that seems to be the result of my early teen braces from before my adult jaw grew in. I have had really bad TMJ and a collapsed bite. The number ten tooth has been really sensitive to nerves in my eye in the past and is a crown now, and I didn’t want to move it, but the dentist said I needed braces before getting reconstruction now as a thirty-four year old. While doing Invisalign I asked them again not to move that tooth, but they decided to move my upper center alignment to the left, and are also pushing this number ten and the neighboring teeth upward into my face. They kept insisting they had to do this and didn’t seem worried about my past history or any possible complications to it. They already had been paid so I tried the treatment and the upper tray started causing severe pains and swelling after a few transitions. My eye would not stop leaking thickly out of the side and the whole area twitched constantly.

    The walk in clinic doctors I saw couldn’t say for sure if the physical stress was the actual cause. The only relief came from removing the tray but when I went to see my dentist they insisted it was all stress in my head and made me wear the tray again. It was terrible and everything got worse so I stopped after one night and went to see my orhodontist who kept saying it was impossible for the tray to effect my eye and it was just stress, just like the referring dentist said, and he put the tray back in and said to wear it or switch to regular braces but he would not otherwise look at adjusting my treatment plan. That night with the tray on I suffered severe damage and now everything I see in my left is shrunken much smaller and stretched wide.

    I had to go see a specialist the eye doctor referred me too that ruled out some other things and supported my opinion about the cause. Finally I got the orthodontist to agree I could stop wearing the top tray and reevaluate it after the bottom is done.

    The injured eye is sensitive and painful and the other eye feels a bit off now, as well, from the stress and mismatched image. I have always had good vision and was not having problems before the Invisalign, but my left eye had nerve pain in the past and my face had been injured badly before. I am not committed to any certain doctor for the reconstruction of my upper incisors but I am currently finishing the lower Invisalign tray by itself to keep working on the underbite. I am in West Washington State and I found your expert website when looking for help. I see you seem to be great at responing with recommendations to people! The eye specialist says he thinks there is a lot of deep scar tissue in the area making it hard to work with, based in my history of injury and nerve damage. Any advice?

  23. I would start by trying self administered SPG Blocks to rset your autonomic nervous system that could eliminate all of your symptoms. Cranial work could also improve these symptoms and I usually utilize a diagnostic orthotic early on. I would only do reversible treatment until symptoms abate to prevent making the issues much worse. It is frequently possible to alleviate most symptoms in just a few visits.

  24. I am in severe pain for 12 yrs after having several teeth extracted. Now the pain is excruciating to the point where I can barely eat and just had a four day headache with a swollen eye lid leaving me with a dark line running from the corner of my eye that looked like blood under the skin. I hurt so badly I do not know how long I can deal with this agonizing pain before getting help. Do you know any dentists in NL that can help me. Thanks so much !!!

  25. I frequently see long distance patients in my Illinois office and a two day visit is often life changing. Learning to self administer SPG Block puts you in control of pain. I suggest visiting http://www.ICCMO.org to find a neuromuscular dental expert.

  26. Is the eye pain like a nerve pinched nerve tingling calling dull.constan pain on top.of the eye under the brow??? An my eye also feels numb and hard.to.open it,

  27. Almost 100% of eye pain is related to the trigeminal nerve and the autonomic nervous system. Treating of TMJ disorder combined with SPG Block may give excellent to complete. Always be evaluated for eye issues with opthamologist or optometrist as the first step.

  28. You just described me. Now im almost sure that my debilitating “migraines”, which come without sensitivity to light but excruciating pain behind and around my eye, are actually tmj related. So thankful. Do you know of any specialists in Israel?

    Dr Shapira response:
    Dr Larry Lockerman is a good friend and practices in Boston and in Israel.

    These are videos of a disabled Israeli Veterans treated with an SPG Block.

    There are additional videos of other patients:

  29. Hi, I’m using a pallet expander to finish up aligning my bite. I initially was having clicking when chewing, no pain but irritating; so I would avoid chewing on the right. Last week, was the 3rd week of wearing the expander, One day that week, I felt pressure on the left under my eye; felt a little bruised. I expected the sensations into my nose and bones with the appliance. The next morning I woke up with bruising under my left eye which looked like a black eye. No one could figure why and thought maybe a spider bite in the night! Eek! Now into the 4th week I noticed my nose is straighter..I’m wondering if the pallet expander caused movement that created the bruising.. I’m older; so thinking blockage in the sinus cavity or stagnation perhaps was released so I bruised…wondering what your opinion is..? Best regards!

    Dr Shapira’s Response:
    Dear Sharon, You have described typical Myofascial Pain Patterns that are commonly seen secondary to TMJ disorders or part of TMD in general. Extractions of third molars, ie wisdom teeth frequently is traumatic and can set off a series of problems with both muscles and joints.
    You should have an examination by a doctor who understands Myofascial Pain and Dysfunction and neuromuscular dentistry. I can help. Please contact my office.

  30. Hi
    I have been having pain on the right side of my face in my cheek eyes jaw and nose and noticed that at night I wake up with headaches and seem to be really grinding my teeth badly. Based on what I’m reading sounds familiar to TMJoints issues!
    I live in the Caribbean but going to Florida next Tuesday for 3 weeks and was wondering if you can give me an idea of who to visit in the Pembroke Pines area or surrounding areas that can help me deal with these issues!

    Thank You In Advance

  31. These are definitively symptoms related to a TMJ disorder. Much of the pain is often Myofascial (MPD) in origin. These problems can be relateed to sleep disorders and stress
    your symptoms did not indicate specifically joint issues. When there is no specific TMJoint issues your TMD may be primarily MPD