Pain in the Upper Quarter

The upper quarter is comprised of the shoulder, head, neck and mandible.  The upper quarter is essentially a functional unit on a neurological and musculoskeletal level. The trigeminal nerve controls the muscles that move the mandible and the structures of the temporomandibular joint.  Additionally, the trigeminal nerve controls essentially all sensations in the face, teeth, temples sinuses and mouth.  The trigeminal nerve connects to the upper cervical nerves (C-2, 3, 4 & 5) in the brain stem.   The upper cervical nerves control all sensations including pain and pressure in the upper shoulder, neck and head.  Once the trigeminal and the upper cervical nerves have converged, they travel together intracranially to control all sensations inside the brain and skull.  These nerves integrate with the special senses of vision, smell, hearing and balance. Additionally, they control blood flow to the brain.  When the trigeminal and upper cervical nerves have been irritated, they can severely alter the function of the special senses causing such symptoms as dizziness, blurred vision, light sensitivity and ringing in the ears.

What is the TMJ/ TMD?

The TMJ is the Temporomandibular Joint, or jaw joint.  This joint works with the muscles of the jaw, head and neck so that the jaw can function on a daily basis so that you can chew, speak, swallow, breathe and move the head, neck and shoulders.

TMD stands for Temporomandibular Disorders. 

What are the symptoms of TMD?

  • Pain in the TMJ and/or the surrounding areas of the head, neck and/or shoulders
  • headaches or facial pain
  • Clicking, popping or grinding noises in the TMJ's and/or neck
  • Limited jaw and neck movement
  • Biting of the tongue or lip
  • Difficulty or pain with chewing and swallowing
  • Pain in and around the ears or a feeling of the ear being “full”

Some of the most common causes of TMD

  • Unconscious habits such as grinding or clenching the teeth
  • Poor Posture
  • Trauma related to an accident or fall
  • Stress or Anxiety
  • Arthritis or a degenerative process

Orofacial Pain

Orofacial pain may be pain or abnormal sensations such as muscle tightness, pressure, burning, numb or pins and needles feeling, throbbing or shooting electric-like pain in the face, head, jaw, neck, upper shoulder or even the teeth.


Headaches are most commonly related to muscle pain, pinched nerves, TMD and orofacial pain.  Headaches of this nature are often treatable with stretching, physical therapy, ergonomics, good posture, stress management and a pain reduction diet.

About Us

Dr. David G. Austin's Bio

Sleep Apnea

What You Need to Know About TMD/Orofacial Pain and Sleep Disorders
What Causes Snoring
Health Risks Associated with Untreated Sleep Apnea


Symptoms of TMD
Common Causes
Orofacial Pain


TMD Pain
Sleep Apnea

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