TMJ Dysfunction After Head & Neck Cancer Treatment: How Physiotherapy Can Help

by Tiffany Cheung   MScPT
Registered Physiotherapist
updated Sept 28, 2026

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Treatment for head and neck cancer can affect much more than the area where the cancer was treated. Surgery, radiation therapy, and the healing process can all affect the jaw, face, neck, and surrounding muscles and tissues.

One of the common challenges patients experience is temporomandibular joint dysfunction (TMJ-D) and reduced jaw movement, also known as trismus.

 

What is TMJ dysfunction?

The temporomandibular joints (TMJs) are the joints that connect your jawbone to your skull. They work together with the muscles of your jaw, face, and neck to allow you to chew, speak, swallow, yawn, and open and close your mouth.

TMJ dysfunction can cause symptoms such as:

• Difficulty opening or closing your mouth
• Jaw stiffness or a feeling of tightness
• Pain around the jaw, face, or temples
• Clicking, popping, or locking of the jaw
• Difficulty chewing or biting
• Pain or fatigue when talking or yawning
• Headaches or neck pain
• Changes in how your jaw moves

 

How can cancer treatment affect your jaw?

Head and neck cancer treatment can cause changes to the tissues and muscles around your jaw and neck.

Surgery can result in changes to the muscles and other tissues that help your jaw and neck move. As your body heals, scar tissue can also develop and affect how these tissues glide and move.

Radiation therapy can cause changes in the skin, muscles, and connective tissues. Over time, these tissues may become tighter and less flexible, a process known as radiation fibrosis. This can contribute to reduced jaw opening, stiffness, pain, and trismus.

These changes can make everyday activities such as eating, speaking, brushing your teeth, yawning, and maintaining oral hygiene more difficult.

Symptoms can develop during treatment or become more noticeable in the months following treatment. For this reason, it is important to monitor your jaw movement and address changes early.

 

How can physiotherapy help?

Physiotherapy can play an important role in helping you maintain movement and function throughout your cancer treatment and recovery.

Your treatment will be individualized to your cancer treatment, symptoms, goals, and stage of recovery.
Physiotherapy may help with:

• Understanding your symptoms and how they relate to your surgery, radiation treatment, and daily movement habits
• Managing pain and stiffness in the jaw, face, neck, and surrounding areas
• Maintaining or improving jaw movement and mobility
• Improving the mobility of scar tissue and treated tissues
• Maintaining strength and coordination of the jaw, neck, and upper back
• Improving posture and movement patterns that may be contributing to your symptoms
• Supporting everyday activities, including eating, speaking, yawning, and oral hygiene
• Providing hands-on treatment to help relieve pain and improve tissue and joint mobility when appropriate
• Giving you a personalized exercise program that you can continue at home
• The goal is to help you move more comfortably and confidently and maintain your ability to do the things that are important to you.

 

When should I start physiotherapy?

You don’t necessarily need to wait until you have significant jaw stiffness or pain before seeking help.

Physiotherapy can sometimes begin before surgery or radiation therapy. Establishing a baseline of your jaw and neck movement before treatment can help identify changes that occur during recovery and give you strategies to maintain mobility.

Depending on your surgery and treatment plan, physiotherapy may also begin during radiation therapy or after surgery, once your medical team feels it is appropriate.

Starting early can give you the tools to manage changes as they occur rather than waiting until they become more difficult to address.

 

What can I expect at my first appointment?

Your first appointment is an opportunity for us to understand you, your treatment, and how you are feeling.

We will look at factors such as:

• Your jaw movement and function
• Your pain and symptoms
• Your neck and upper-body movement
• Surgical scars and tissue mobility, when appropriate
• Your eating, speaking, and other daily activities
• How your symptoms are affecting the things that matter to you

From there, we will develop a treatment plan that is specific to your needs and your stage of cancer treatment.
You will also learn exercises and strategies that you can use at home to help maintain your progress.

 

You don’t have to wait until treatment is finished

Changes in jaw movement, stiffness, and tissue mobility can be a normal part of the recovery process after head and neck cancer treatment, but that doesn’t mean you have to manage them on your own.

Whether you are preparing for treatment, currently going through radiation or recovering from surgery, or are months or years into survivorship, physiotherapy can help you understand the changes in your body and work toward maintaining or improving your function.

Our goal is to help you move, eat, speak, and live as comfortably and confidently as possible throughout your cancer journey.