Reviewed by Dr. Douglas Lim CH, Registered TCM Practitioner · November 2026
由注册中医师 林江豪医师审阅

下巴痛、張嘴卡卡、咬東西有聲？顳顎關節問題

简单回答：颞颚关节（TMJ）就是耳朵前面、下巴开合的那个关节。张嘴时喀喀响、嘴巴张不大、咬硬的东西会痛、早上起床牙关很酸，或耳朵前面、太阳穴一带酸痛，都是常见的表现。它很少只是下巴的问题：颈部姿势、头往前倾、咬牙习惯、压力，还有脸部或颈部的旧伤、疤痕，都会把下巴往一边拉。醫道閣会一起评估，再用温和的 SRM、针灸或推拿处理。

Short answer: the temporomandibular joint (TMJ) sits just in front of the ear and opens and closes the jaw. Clicking, not being able to open wide, pain when chewing, a tired jaw on waking, or aching in front of the ear or at the temples are common signs. It is rarely only about the jaw: neck posture, a forward head, clenching, stress and old injuries or scars on the face or neck can all pull the jaw to one side. At Virtue TCM we assess all of these, then use gentle SRM, acupuncture or tuina.

你有沒有這些情況？

・张嘴、吃东西时下巴喀喀响，或感觉一边卡住。
・嘴巴张开时下巴会往一边歪。
・早上起床牙关酸、牙齿敏感，伴侣说你晚上会磨牙。
・常常头痛在太阳穴，或耳朵闷、耳朵前面痛。
・脖子、肩膀同一侧特别紧。
・以前做过智齿手术、牙齿矫正、脸部受伤，或下巴、颈部有疤。

Clicking or a catching feeling when you open your mouth or chew; the jaw drifting to one side as it opens; a sore jaw or sensitive teeth on waking, or a partner says you grind at night; headaches at the temples, a blocked feeling or pain in front of the ear; one side of the neck and shoulder much tighter; past wisdom-tooth surgery, braces, a facial injury, or scars on the chin or neck.

為什麼不只是下巴的問題？

下颚是挂在头骨上的，靠两侧的肌肉、筋膜和颈部一起平衡。头往前倾、上背和胸廓扭向一边，下颚两侧的受力就不一样，久了一边紧一边松，关节就开始响、开始痛。下巴或颈部的疤痕也会黏住皮肤和筋膜，让下巴开合时被拉着。压力大、晚上咬牙，则让整组肌肉一直出力。

The lower jaw hangs from the skull and is balanced by muscles and fascia on both sides, together with the neck. When the head drifts forward or the upper back and rib cage turn to one side, the two sides of the jaw are loaded unevenly; over time one side tightens, the joint starts to click and ache. Scars on the chin or neck can stick skin and fascia so the jaw is pulled as it moves. Stress and night clenching keep the whole group working.

醫道閣怎麼處理

先看全身的势。医师会看你张嘴时下巴往哪边偏、头和颈的位置、两边肩膀和上背是否平均。
温和地松开。先处理颈部、上背和胸廓，再松开下巴周围的肌肉与筋膜；有疤痕的话，会用专门松解疤痕的手法让皮肤重新滑动。不会用力扳下巴。
针灸与日常习惯。针灸帮助放松咬肌、改善睡眠；也会提醒一些小习惯，例如舌头轻放上颚、上下牙齿平时不要咬在一起。
做完一定检查。张嘴的幅度、有没有偏、响声有没有减少，医师会和你一起确认。

Look at the whole picture. We check which way your jaw drifts as it opens, how your head and neck sit, and whether the shoulders and upper back are even. Release gently. Neck, upper back and rib cage first, then the muscles and fascia around the jaw; scars are worked with a dedicated scar-release technique so the skin can glide again. The jaw is never forced. Acupuncture and habits. Acupuncture to relax the chewing muscles and help sleep, plus small habits such as resting the tongue on the roof of the mouth and keeping the teeth apart at rest. Check before you leave. How wide you can open, any drift and how much it clicks are checked with you.

如果你有牙科问题，例如咬合板、牙齿矫正，请继续和牙医配合，我们的调理可以同时进行。

If you are seeing a dentist for a night guard or braces, please continue; our care can run alongside it.

第一次來會做什麼？

问诊约 15 分钟：什么时候开始、哪一边、吃东西和睡觉时的情况、牙科治疗和旧伤，也会把脉看舌。之后医师会说明建议的调理方式。初诊问诊 RM60（带 X 光、血液或其他报告 RM100），复诊 RM30；疗程费用另计，开始前会先说明。

A consultation of about 15 minutes covers when it started, which side, how chewing and sleep are affected, and any dental treatment or old injuries, plus pulse and tongue. Your practitioner then explains what they suggest. First consultation RM60 (RM100 if we review X-rays, blood tests or other reports), follow-up RM30; treatment is priced separately and explained before anything starts.

這些情況請先看醫生或牙醫

下巴受伤后咬合突然改变、嘴巴完全卡住张不开或合不上、脸部肿胀发热或发烧、牙齿疼痛或牙龈肿，或脸部麻木，请先看医生或牙医。

See a doctor or dentist first if your bite changes suddenly after an injury, the jaw is locked open or shut, the face is swollen, hot or you have a fever, you have toothache or swollen gums, or part of your face is numb.

延伸閱讀

头痛从后脑勺开始？紧张型头痛与偏头痛

颈肩痛调理 Neck & Shoulder Pain

疤痕调理 Scar Release Therapy

SRM 系统还原手法‧结构疗法

个人情况因人而异，疗程建议需经问诊与医师评估后决定。本文不能取代医疗诊断。
Individual conditions vary. Recommendations follow consultation and practitioner assessment. This article does not replace a medical diagnosis.

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