Jaw Movements for Chronic Neck Pain: Promising, Unproven

Opening and closing your jaw while you exercise your neck may improve chronic neck pain more than neck exercises alone. A 2024 randomized controlled trial found larger improvements in pain, disability, and neck-muscle endurance with the combined approach. The catch: several reported effects were so large that they need independent replication before anyone treats this as a new standard of care.

The idea has a sound anatomical basis. Sensory signals from the jaw and upper neck meet in overlapping brainstem circuitry, so jaw and neck symptoms can refer pain to each other. That makes jaw-neck exercise integration plausible. Plausible, however, is the start of a treatment question, not the finish.

A surprising result from one neck-pain trial

In a 2024 randomized trial by Akhter et al., 80 adults aged 18 to 50 with chronic non-specific neck pain lasting more than three months received either active neck exercises alone or the same exercises combined with synchronized jaw movements. The study took place at one center in Karachi, Pakistan, and enrolled participants from 2018 through 2022.

The experimental group opened the jaw during neck-extension phases and closed it during neck-flexion phases. The comparison group did the active neck exercises without those jaw movements. After the intervention, the jaw-integrated group had significantly greater improvement on all four reported outcomes: pain on the Numeric Pain Rating Scale, neck-flexion endurance, neck-extension endurance, and disability on the Neck Disability Index.

The reported between-group standardized effects were large for pain reduction (Cohen's d = 1.363) and exceptionally large for the other outcomes: d = 3.027 for neck-flexion endurance, d = 6.303 for neck-extension endurance, and d = 5.934 for Neck Disability Index scores. The paper did not report confidence intervals for those effect sizes in the available results, so readers cannot judge their precision from the published figures cited here.

Both groups improved, which fits the broader evidence that exercise helps chronic non-specific neck pain. The relevant result is the difference between groups: adding jaw movements appeared to improve outcomes beyond the neck-exercise program alone.

Why the jaw could affect the neck

The jaw is not neurologically separate from the cervical spine. The trigeminal nucleus caudalis extends toward the upper cervical region, where trigeminal sensory input from the jaw converges with input from the C1 to C3 segments. This anatomy helps explain why temporomandibular and neck symptoms often travel together.

Akhter et al. proposed that jaw opening co-activates cervical extensor muscles and jaw closing co-activates cervical flexors. The paper also cites jaw-neck coupling during fetal yawning as evidence that the pattern may be innate. The convergence anatomy supports the hypothesis, but it does not prove that this reflex pathway caused the trial's clinical results. Direct, independently assessed electromyography data quantifying the relevant co-activation were not available for evaluation here.

There is limited evidence that the relationship can run in the other direction. In a 2024 double-blinded randomized trial by Saleh et al., 24 people with temporomandibular dysfunction and confirmed forward-head posture received routine physiotherapy with or without proprioceptive neuromuscular facilitation stretching of the masticatory muscles. The added stretching improved all measured outcomes, including pain measures, jaw range of motion, and craniovertebral angle, with p values below 0.05. That study addressed jaw dysfunction, not chronic neck pain, so it supports a jaw-cervical connection without confirming the neck-pain result.

The effect sizes are the reason for caution

A pain effect of d = 1.363 would already stand out in neck-pain research. Effects above 3 for endurance and disability demand even more scrutiny. Such numbers can reflect a real, unusually effective intervention. They can also arise when modest samples, baseline differences, measurement variability, unblinded expectations, or analysis choices magnify a result.

Broader evidence supports active exercise for neck pain, but it does not establish jaw integration as a superior add-on. A systematic review and meta-analysis by Senarath et al. found that exercise-induced hypoalgesia occurs in people with neck pain, with effects generally modest to moderate. That makes improvement in both trial groups unsurprising; it does not explain the enormous gap reported in the jaw-integrated group.

Likewise, a 2025 systematic review by Barbosa-Silva et al. found that Mulligan mobilization-with-movement techniques can improve pain and function in non-specific neck pain. Its results provide a useful benchmark: established neck-pain interventions can help, but systematic-review estimates do not approach the endurance and disability effects reported by Akhter et al. The review also notes that adding manual therapy to exercise has not consistently outperformed exercise alone across prior evidence.

This does not disprove the jaw-exercise trial. Different interventions, populations, outcomes, and comparators can produce different results. It does mean the single trial should be treated as an outlier result, not a settled estimate of what people can expect.

What the trial cannot tell us

The study calls itself double-blind, but participants would know whether they were opening and closing their jaws during exercise, and therapists delivering the program would likely know as well. Outcome assessors may have been blinded, but the movement intervention itself could not realistically conceal group assignment from participants. Expectation, novelty, and additional attention could therefore have contributed to the difference.

The control group also lacked a sham jaw condition. A comparison such as non-therapeutic mouth positioning or another matched movement could help separate a jaw-specific effect from the effect of doing a more complex and attention-grabbing exercise routine.

The study excluded people with temporomandibular disorders. That protects the internal focus on chronic non-specific neck pain, but it leaves a practical gap: people with existing jaw pain, clicking, restricted opening, or diagnosed TMJ dysfunction were not studied. The available report also does not fully disclose all movement parameters needed for easy replication, and it does not characterize adverse events from repeated jaw loading.

A separate 2025 intervention study by Yu et al. examined combined jaw and cervicoscapular exercises in people with a cervical-extension posture pattern associated with prolonged smartphone use. It measured mouth opening and muscle properties rather than neck-pain ratings or endurance. Its different population and endpoints prevent a direct comparison, but it shows that other researchers are testing combined jaw-cervical exercise approaches.

A sensible way to use this information

If you already do active exercises for chronic non-specific neck pain and have no jaw symptoms, synchronized, gentle jaw opening during neck extension and jaw closing during neck flexion is a reasonable modification to discuss with a physical therapist. The intervention costs nothing, and the trial tested it as an addition to neck exercise rather than a replacement for it.

One trial found a striking advantage for jaw-integrated neck exercise. The anatomy makes the result believable; the size of the reported benefit makes replication mandatory.

Do not use jaw movements as a substitute for a broader neck rehabilitation plan. Stop if they provoke jaw pain, clicking, locking, or headache. People with temporomandibular dysfunction should seek individualized advice before adding repeated jaw movements, because the main neck-pain trial excluded them. For everyone else, the honest conclusion is narrower than the headline: this is a credible, low-cost hypothesis with one unusually positive trial behind it—not yet a proven treatment.