Left TMJ pain accompanied by pain around the ear while chewing

This de-identified clinical story concerns a patient who visited in July 2026 with left temporomandibular joint pain and pain extending around the left ear during chewing. The right side was not troublesome.

Symptoms had begun about one month earlier. They were mild at first but became more noticeable over time, especially during the two weeks before the first visit.

Why can jaw-joint pain and pain around the ear occur together?

The TMJ lies directly in front of the ear. The joint, masticatory muscles, and nearby sensory pathways can refer pain toward the preauricular area, below the ear, temple, or cheekbone.

This does not mean that every ear-area pain comes from the jaw. Ear disease, dental disease, salivary-gland problems, neuralgia, and other conditions can feel similar, so location alone cannot establish the cause.

What symptoms were present initially?

Pain in the left TMJ while chewing.

Pain in the left TMJ while opening the mouth.

Pain extending toward the area around the left ear.

No notable discomfort on the right side.

Symptoms present for about one month and more pronounced during the preceding two weeks.

Pain varied with the situation. After anti-inflammatory pain medication, chewing discomfort felt about 5 on a 10-point scale, but it became more unpleasant again as the medication effect wore off.

For that reason, the assessment did not rely on a single pain score. Changes during chewing and opening and the course across follow-up visits were considered together.

What care had been received before the first visit?

The patient had taken anti-inflammatory pain medication prescribed elsewhere for about six days and had stopped it. Medication had also been prescribed at another dental visit.

The patient arrived wearing cosmetic tape in an effort to reduce a sense that the jaw was shifting. Opening pain and chewing pain were present at the first visit.

Because the movement direction was not consistently reproducible and posterior tooth contact also needed review, no disc injury or specific structural lesion was diagnosed from a single movement observation.

What ear-related warning signs were separated first?

When pain around the ear persists or is accompanied by hearing change, ear discharge, fever, severe dizziness, swelling, or rapidly worsening pain, otolaryngologic assessment may need to take priority.

In this case, the pain was more closely linked to movement of the left jaw and chewing. That pattern supported examining the TMJ and masticatory muscles, but did not by itself prove the source.

Was injection or oral-appliance treatment required?

No injection treatment or oral appliance was used in this course. The patient attended five outpatient visits, with conservative assessment and management selected according to pain, opening, movement, medication response, and daily function.

Jaw pain does not automatically require injection or appliance therapy. Additional treatment can be considered only when the course, severity, functional limitation, and response make it appropriate.

What was checked at the first visit?

Whether pain appeared during opening or chewing.

Whether pain extended in front of or around the ear.

Whether right and left jaw movements differed.

Whether the jaw deviated during opening.

Whether posterior tooth contact felt different between the sides.

How much medication changed the symptoms and whether the recent course was worsening.

Left-joint pain was reproduced during opening and chewing. Because the movement pattern was not fixed in one direction, pain and movement were reassessed at later visits rather than interpreted from one observation.

What changed at the second visit?

On July 20, the patient said that pain while opening toward the left had improved somewhat, while chewing pain was about the same.

Jaw movement and posterior tooth contact were checked again. Because the patient had gastrointestinal sensitivity, the possible burden of medication and the need to reduce it as pain improved were discussed.

How much had pain decreased by the third visit?

On July 24, the patient reported substantial improvement. Chewing had become comfortable, although some left-joint pain remained during opening.

Using the initial discomfort as 10, the patient rated it at about 3. A small amount of ear-area pain remained, so a short additional period of previously prescribed medication was considered.

Chewing pain improved before opening pain had completely settled. Follow-up therefore continued rather than ending care at that point.

Had the pain around the ear improved by the fourth visit?

On July 27, only mild discomfort during opening remained. The patient rated pain at about 2 compared with 10 initially.

The pain around the ear had disappeared. Medication was being taken only about once every three days, and observation continued without an additional prescription.

Chewing pain had largely decreased.

Ear-area pain was no longer present.

Only slight opening discomfort remained.

Medication use had markedly decreased.

Why was care ended at the fifth visit?

On August 3, TMJ pain was rated at approximately 0 to 0.5. The patient said there was no meaningful pain and almost no remaining daily inconvenience.

After five outpatient visits, no injection or oral appliance was added because symptoms and function had stabilized sufficiently for care to end.

What did the before-and-after opening radiographs show?

On the post-treatment open-mouth radiograph, the mandibular condyle appeared to translate farther forward than on the initial image. This change was in the same direction as the increased opening movement observed clinically.

Differences in magnification and positioning mean that exact millimeter opening cannot be newly calculated from the composite image. A standard radiograph also cannot establish disc position or other soft-tissue status.

The images were used as supporting information alongside the patient's pain report and observed jaw movement, not as stand-alone proof of treatment effect.

Five-visit course at a glance

July 16: first visit

Left TMJ pain during chewing and opening, with pain around the ear.

Symptoms had begun about one month earlier and worsened during the previous two weeks.

Conservative outpatient care began without injection treatment.

July 20: second visit

Opening pain was somewhat lower, while chewing pain remained similar.

Jaw movement and posterior tooth contact were reassessed.

July 24: third visit

Chewing pain had markedly decreased; some opening pain remained.

The discomfort score had fallen from 10 to about 3.

July 27: fourth visit

Only mild opening discomfort remained and pain was about 2.

Pain around the ear had resolved, and medication use had become infrequent.

August 3: fifth visit

TMJ pain was approximately 0 to 0.5 with almost no daily inconvenience.

Care ended without injection or oral-appliance treatment.

What is the clinical meaning of this story?

The left TMJ and ear-area pain changed together as chewing and opening symptoms improved. This course supports a possible jaw-related contribution in this patient only.

It does not show that every ear pain is caused by TMD, that everyone improves in five visits, or that injections and appliances are unnecessary in every case.

The course of TMD pain can differ according to symptom duration, structural findings, opening range, disc movement, muscle tenderness, clenching, sleep, neck and shoulder tension, trauma, dental contact, medication tolerance, and daily load.

How long can mild TMJ pain be observed?

Mild fatigue or temporary muscle soreness may improve with rest.

In-person assessment is reasonable when pain during chewing or opening persists, pain spreads toward the ear, opening becomes limited, catching or locking occurs, symptoms worsen over one or two weeks, pain returns when medication is stopped, one-sided chewing develops, or eating and oral hygiene become difficult.

Sudden marked limitation, facial sensory change, severe swelling, fever, ear discharge, or hearing change requires prompt assessment that also considers causes outside the TMJ.

How should the outcome be interpreted?

This story was reconstructed from clinical records after identifying information was removed. Pain decreased to approximately 0 to 0.5 after five visits, and daily inconvenience was minimal when care ended.

Individual diagnosis and outcome vary with the cause, severity, general health, and habits. An online story cannot diagnose a reader or predict the same response.

How to read this story

The absence of injections or an oral appliance describes this patient's course, not a universal treatment rule. Persistent or concerning symptoms require direct examination and appropriate medical or dental assessment.