The Overlooked Connection: Forward Head Posture, TMJ & Upper Cervical Spine

Many people struggle with jaw pain, headaches, neck tension, or TMJ issues, but few realize these symptoms often trace back to the upper neck — specifically the upper cervical spine.

Let’s break down how posture, your jaw (TMJ), and the upper cervical region (C1-C2) are all deeply interconnected.

1. Posture Starts at the Top

The upper cervical spine (C1 and C2) supports your head and directly influences posture. When this area is out of alignment, it can cause your head to shift forward — what we call forward head posture.

Even a small shift forward increases strain on surrounding muscles and joints. This altered posture doesn’t just affect the neck — it disrupts how your jaw functions too.

2. Biomechanical Stress & Muscle Tension

Forward head posture leads to chronic tension in key muscles:

• SCM (sternocleidomastoid)

• Suprahyoid and infrahyoid muscles

• Suboccipital and levator scapulae

• Jaw muscles like the masseter and pterygoid

These muscles form a chain of tension from your neck to your jaw via the hyoid bone, which floats between them. When the upper neck is misaligned, it can alter the biomechanics of the jaw, leading to:

• Clicking or popping in the TMJ

• Difficulty opening or closing the mouth evenly

• Muscle fatigue or tightness while chewing

3. TMJ & Upper Cervical Are a Functional Unit

The jaw (TMJ), skull, and cervical spine don’t work in isolation — they form what’s called the cranial-cervical-mandibular system. Misalignment or imbalance in any one of these structures can cause a ripple effect.

Example:

➡ Misalignment at C1-C2

➡ Leads to muscular compensation

➡ Affects how the jaw tracks

➡ Causes pain, popping, or misalignment of the TMJ

4. Neurological Influence

The trigeminal nerve (which controls the jaw) and the upper cervical nerves (C1–C3) all converge at the brainstem in an area called the trigeminocervical nucleus. This is why tension or irritation in the upper neck can lead to:

• Jaw pain

• Tension headaches

• Facial pain

• Even ear symptoms like tinnitus or pressure

Additionally, misalignment at the upper cervical spine can affect vagus nerve function, impacting stress responses and further increasing jaw tension.

Common Overlapping Symptoms

If you have both TMJ and neck issues, you may experience:

• Clicking or popping in the jaw

• Facial pain or tightness

• Neck stiffness or reduced mobility

• Headaches

• Tinnitus or a sense of ear fullness

• Clenching or grinding, especially under stress

How TMJ and Forward Head Posture Are Connected Through the Upper Cervical Spine

TMJ and forward head posture are more closely related than most people realize. When the head shifts forward, it places extra strain on the upper cervical spine and surrounding muscles, which can alter jaw alignment and increase tension in the temporomandibular joint (TMJ).

This postural imbalance often contributes to jaw pain, clicking, clenching, and even headaches. Addressing both TMJ and forward head posture together through targeted care can help restore balance, relieve discomfort, and improve long-term function.

Why Upper Cervical Care Can Help

Correcting misalignments in the upper neck can:

• Restore normal posture and reduce mechanical strain on the TMJ

• Improve nerve function and muscle balance

• Alleviate tension in connected muscles and fascia

• Improve brainstem regulation of jaw and neck coordination

In many patients, addressing the upper cervical spine is the missing piece in resolving stubborn TMJ symptoms.

If you’ve tried mouth guards, massage, or jaw exercises but still struggle with TMJ pain, consider the role your neck and posture might be playing.

At New York Upper Cervical Chiropractic, we focus on precise, gentle corrections at the cranio-cervical junction to support full-body balance — including your jaw.

📍 505 Northern Blvd, Ste 309, Great Neck, NY 11021

📲 516) 969-3330

References:

- Bogduk, N. (2001). The anatomical basis for cervicogenic headache. Journal of Manipulative and Physiological Therapeutics, 24(7), 532–540.

- Fernández-de-Las-Peñas, C., et al. (2007). Forward head posture and neck pain: A systematic review. Journal of Manipulative and Physiological Therapeutics, 30(4), 295–301.

- Hackney, J. (1999). Relationship between the posture of the head and the temporomandibular joint. Journal of Craniomandibular Practice, 17(2), 109–117.

- Eriksen, K., & Rochester, R. (2006). Upper cervical chiropractic management of a patient with temporomandibular joint dysfunction. Journal of Vertebral Subluxation Research.