Classical Acupuncture Approaches for TMJ Disorder｜古典針灸治療顳顎關節紊亂的方法

By Jade Health Acupuncture．玉衡針灸

Overview

Temporomandibular joint (TMJ) disorder involves jaw pain, tightness, clicking, or limited mouth opening. From the perspective of Traditional Chinese Medicine (TCM), TMJ dysfunction often reflects obstruction of qi and blood along Yang meridians that traverse the face and neck — notably the Foot Yangming Stomach, Hand Yangming Large Intestine, Foot Shaoyang Gallbladder, Hand Shaoyang Sanjiao, and Hand Taiyang Small Intestine channels — as well as the Foot Taiyang Bladder channel that passes through the posterior neck. When this flow is disrupted by muscular tension, wind-cold, or emotional constraint, it can lead to jaw pain, restricted opening, or radiating discomfort to the ear.

概述

顳顎關節紊亂常見症狀包括下頜疼痛、緊繃、彈響聲或張口受限。中醫視角認為，本病多與顏面與頸項部多條陽經的氣血受阻有關，尤以足陽明胃經、手陽明大腸經、足少陽膽經、手少陽三焦經、手太陽小腸經為主，並與通過後頸的足太陽膀胱經相連。若因肌肉緊張、風寒阻滯或肝氣鬱結致氣血不暢，便可出現下頜疼痛、張口受限，或牽引至耳部不適。

Acupuncture Treatment

Acupuncture focuses on relaxing the masticatory and cervical muscles, restoring local circulation, and unblocking the meridians around the jaw–ear–neck region. Points are selected by pattern (excess vs. deficiency, local vs. distal) to address both symptoms and root disharmony.

• Jiache (ST6) — directly relaxes the masseter.
• Xiaguan (ST7) & Quanliao (SI18) — both at/near the masseter origin; release chewing-muscle tension and improve opening.
• Jiaosun (SJ20) — with ST6 for chewing difficulty or jaw tightness.
• Yifeng (SJ17) — loosens SCM, splenius/longissimus capitis and posterior digastric to facilitate smooth opening.
• Hegu (LI4) & Taichong (LR3) — “Open the Four Gates” to regulate qi/blood and balance yin–yang.
• Taiyang (EX-HN5) — relieves temporal tension and pain.
• Fengchi (GB20) — promotes qi–blood circulation in the neck/occiput.
• Jinggu (BL64) — Yuan-Source of the Bladder channel; guides head/neck qi stagnation downward, easing cervical tension.

針灸治療

治療重點在鬆解咀嚼與頸項肌群、改善局部血流、疏通顳顎—耳—頸部經絡，並依證型兼顧本末：

• 頰車 ST6 — 直接鬆解咬肌。
• 下關 ST7、顴髎 SI18 — 皆位於咬肌起始部，放鬆咀嚼肌、助張口。
• 角孫 SJ20 — 配 ST6 改善咀嚼困難與緊咬。
• 翳風 SJ17 — 鬆胸鎖乳突肌、頭夾肌、頭最長肌與二腹肌後。
• 合谷 LI4、太衝 LR3 — 「開四關」，調和氣血、平衡陰陽。
• 太陽 EX-HN5 — 疏經止痛，緩解顳側緊張。
• 風池 GB20 — 促頸項氣血運行。
• 京骨 BL64 — 足太陽原穴，引導頭頸氣滯下行，減輕頸部緊繃。

Clinical Notes

• Combine with gentle heat therapy and myofascial release for better outcomes.
• Address perpetuating factors: bruxism, prolonged screen posture, stress, or cold exposure to the jaw/neck.
• A typical course starts 2–3 sessions/week for acute flares, tapering as symptoms improve.

臨床提示

• 可配合溫熱敷與筋膜放鬆強化療效。
• 調整誘因：夜間磨牙、久坐低頭、情緒壓力、受寒。
• 急性期建議每週 2–3 次，症狀穩定後逐步降頻。

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