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December 2nd, 2010
10:38 AM ET

Why does my jaw hurt when I exercise?

Every weekday, a CNNHealth expert doctor answers a viewer question. Today, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Sara from Texas

When I'm exercising, I often get jaw pain. It feels like someone is pressing inward on the joint with their fingers very hard. I've been very careful to maintain a relaxed posture and avoid tensing while I exercise, but the pain still comes. The kind of exercise I'm doing is low impact on the elliptical machine. I've even stopped using the arm holds because I've been worried the back and forth motion was making me tense. I've looked online and found that this could be a sign of heart problems, but I'm only 23 with no family history. Should I be concerned?

Dear Sara:

I am glad you've asked this question, as pains in the chest, left arm and jaw are a very common concern among people beginning an exercise regimen. The bottom line is, anyone who is planning to begin working out should get clearance from a physician before starting. Even children getting into a school sport should get medical clearance. Most importantly, those who begin a regimen and have any unexpected pains and discomforts should stop the activity and seek evaluation from a physician. You should not restart the activity until the cause of the pain is determined and measures are planned to prevent it.

Angina, or pain from the heart muscle not getting enough oxygenated blood, can present as mild to severe chest pain, a pain or numbness running up the left arm, pain in the jaw or even as a headache. Angina is typical in patients with cardiovascular disease undergoing strenuous exertion. Strenuous activity increases the heart's need for oxygen. Partial obstruction in the coronary arteries leads to less than adequate flow of oxygenated blood to the heart. The discomfort usually decreases or goes away with rest. If the heart is deprived of blood long enough, some of the heart muscle will die. This is commonly called a myocardial infarction or a heart attack. Death of heart muscle can lead to heart rhythm problems and difficulty in the heart pumping blood. The latter is known as congestive heart failure.

The typical person with cardiovascular disease and angina is in his or her 50s or older. In younger people, discomfort of the chest, the left arm, and the jaw during exercise is more commonly due to non-heart problems. Physicians will assess the young individual with these symptoms for abnormalities of the heart valves and congenital malformations of the heart. These findings are rare. Even rarer is the young person with coronary artery blockages. Young people with coronary artery disease usually have a family and personal history of high serum cholesterol or serum triglyceride or have a history of radiation therapy to chest for another disease such as a cancer.

Patients under evaluation may get electrocardiograms, ultrasound studies of the heart or exercise stress tests. In an exercise stress test, the heart performance is evaluated during exertion with an electrocardiogram, and often with ultrasound and nuclear medicine - use of traceable material injected into the blood vessels to look for blockages.

Among young people, chest discomfort during exercise is commonly due to indigestion, acid reflux, or even muscular and skeletal pain in the rib cage. Pain in the jaw can be due to tensing of the jaw or malocclusion of teeth (a bad bite). Numbness and pain in the forearm are commonly due to carpal tunnel syndrome from gripping exercise machines.

Again I stress that one should not self-diagnose this discomfort. It should be evaluated by a health professional.

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soundoff (29 Responses)
  1. simpson

    Good CYA advice, but people often self-diagnose because they can't get a straight answer from their doctor anyway. And if they go to more than one, they'll get more than one ambiguous ho-hum answer. That makes people think 'why bother?', and worse, why make a stupid appointment then wait to get in, then wait in the waiting room to be ushered into another waiting room just to meet your doctor who doesn't have time for stuff like this, and that only results in eighteen freakin' bills arriving over the next 6 weeks. No wonder people have decided they need to get educated and learn about their own health. Sometimes they think by posting questions in columns like this it will help, but it only makes it worse because all you're doing is giving them CYA ambiguitires instead of genuine information. If I were this person, I would read and study elsewhere. In the meantime, ease up on the exercise regimen. Do you SERIOUSLY think that a family doctor should order a battery of tests to determine if this person has cancer (PET scan, etc), full blood workup, X-rays or MRI for chest, etc. when they merely complained they're jaw ached when they worked out? They won't.

    December 2, 2010 at 11:07 | Report abuse | Reply
  2. maddawg

    huge lmaos @ the doctor that submitted this.....

    what a suprise.... a doctor telling you to go spend money seeing a doctor before you start a workout routine.

    QUACKS...all of them!

    i have a novel idea....when you want to use your computer, first you should pay a computer engineer to verify you're able to use one before you start.

    December 2, 2010 at 11:11 | Report abuse | Reply
  3. Jason

    Dear Dr. Otis,
    Your reply is bloated and wasted my time. Your answer could have (and should have) been cut down the last 2 paragraphs.

    December 2, 2010 at 11:24 | Report abuse | Reply
    • O157:H7

      Was it the length or the big words that wore out your ability to absorb background information? Look around on the Home Page–I'm sure you can find an article on Brittney more to your liking and intellectual ability.

      December 2, 2010 at 14:48 | Report abuse |
  4. Jim from Livonia, MI

    In a yound person like yourself, I would expect that you may have an abcess requiring a root canal. Same thing happened to me. The exertion of exercise caused a throbbing in my jaw - the root of the affected tooth.

    December 2, 2010 at 11:40 | Report abuse | Reply
  5. VegasRage

    The key to starting exercise is to start slowly and for short periods when you begin, say 30 minutes and work your way up in time, frequency, weight, and intensity. Form is more important than weight. For example if you are just beginning, 3 or 4 times week for 30 minutes in week one, week 2 up it to 45 minutes per session, etc. Most important listen to your body so you know when to stop.

    December 2, 2010 at 11:58 | Report abuse | Reply
  6. tom

    This reminds me of the viagra commercials that advise you to "ask your doctor if you are healthy enough to have $ex" before using viagra. Has anyone ever, in the history of the world, asked their doctor if they are healthy enough to have $ex?

    December 2, 2010 at 12:29 | Report abuse | Reply
    • SilentBoy741

      Just once. I asked my doctor if I was healthy enough for $ex, and he said, "Why don't we just get some drinks first, and see where it goes?". I'm getting a new doctor.

      December 3, 2010 at 03:32 | Report abuse |
  7. mslman71

    Ugh, more, "go ask your doctor" advice. Want to pee? Go ask your Dr. first. Want to have some fun with your spouse? Go ask your Dr first. Want to have a glass of water? Go ask your Dr. first. Want to go upstairs, check with your Dr. to make sure you are physically able. BLAH. So much impractical and unrealistic CYA advice.

    December 2, 2010 at 12:39 | Report abuse | Reply
  8. Lincoln Brigham

    Here's a news flash: hardly any doctors are trained to prescribe exercise.

    Exercise prescription is not part of standard medical school training nor residency. They have not been trained to prescibe different types of exercise for different conditions. As a result, most physicians take a one-size-fits-all approach to prescribing exercise. They either tell you, "Don't" or something safe like "Walking is great exercise".

    Exercise is hardly ever contraindicated for medical conditions. Yes, whether you exercise or not, you should find out from your doctor if you have a medical condition. But you should not take exercise advice from your physician. You should seek a referal to a specialist.

    December 2, 2010 at 12:54 | Report abuse | Reply
  9. Seth

    One possibility, not mentioned here, is the build of of lactic acid that can happen if you push into anaerobic territory while you're working out. It feels like jaw pain that radiates through the back of your teeth. I used to get this when doing interval sprints for track to the point of exhaustion. Hopefully that's the case, and it just means you're working out hard.

    December 2, 2010 at 13:20 | Report abuse | Reply
  10. Capri A.

    My jaw really hurts after I work-out...thanks for the info....
    Especially after Charlie S. in that NY hotel.....

    December 2, 2010 at 14:51 | Report abuse | Reply
  11. Kevin

    My jaw hurt after reading Dr O's long response. Sara should go see a doctor or if she cannot afford it then just go for slow walks for a start until she can increase speed without the pain.

    December 2, 2010 at 14:52 | Report abuse | Reply
    • Lola

      I thought the response was well written, and well considered.

      December 2, 2010 at 15:48 | Report abuse |
  12. Lola

    I've had jaw problems for years, and the pain often increased with exercise. It was a combination of a bad bite, nocturnal teeth grinding, damage in my neck, and an old shoulder injury. It's remarkable how interlinked your jaw, neck and shoulder muscle structures are, and the nerves beneath them. On easy test might be to purchase an over-the-counter night guard for your teeth, and wear it when you do your elliptical machine. If you experience no or less pain, the problem may lie in your jaw alignment.

    December 2, 2010 at 15:48 | Report abuse | Reply
    • Lincoln Brigham

      It's interesting you mentioned jaw alignment, because the one thing the response did not mention was refering the patient to a dentist. TMJ and other dental related problems are certainly more likely than cardiac problems for a 23-year old. The problem is that doctors don't refer patients to dentists, they only refer them to other doctors. When all you have is a hammer, every problem looks like a nail.

      December 3, 2010 at 11:54 | Report abuse |
  13. Phil

    Of course she could also have an anomalous coronary artery travelling between the pulmonary artery and aorta or severe myocardial bridging- setting up for a bad infarction with exercise or even sudden cardiac death.

    December 2, 2010 at 16:17 | Report abuse | Reply
    • SilentBoy741

      That's the same thing my mechanic said was wrong with my Alfa Romeo Spyder...

      December 3, 2010 at 03:27 | Report abuse |
  14. wendy5

    i had this problem and i found it was because of grinding my teeth and my bite being off; so i put a mouth gaurd in my mouth at night be cause i was clenthcing my teeth and i found the side of my mouth tht was higher meaning if you put your teeth togetr as if you had a perfect bite and then relax it and let it go natural you will feel the difference hence at night your teeth are trying to go for the perfect bite and fight to get there hence the grinding and clencing so put a piece of cotton on the side of mouth gaurd to keeping the other side from making a connection. it was majiic no more pain in the jaw, i dont care what anyone says exercise makes you tense we are tighting muscles up thats they reason we exericise. was destroying my gums also and i have beatiful teeth couldnt figure it out or the dentist had to have tooth pulled and a new put in and came down to my clenching no more problems i think there are more people that have this problem then you no i think everyone should wear one i think that why people have mouth problems my is cured i should have been a dentist:) thought about and came up with this; learn to feel your body you would be surprised

    December 2, 2010 at 16:59 | Report abuse | Reply
  15. chele

    I've never noticed jaw pain after working out, but I suppose one solution is to just not exercise if you don't mind flab.

    December 2, 2010 at 17:56 | Report abuse | Reply
  16. Thomas

    I really like all you doctors in here. Just wait until you self diagnose yourself into a casket like I almost did! All that supposed knowledge I had got me a heart attack with 35 % muscle death. As for the O.P do not listen to these people and do what YOU think is right.

    December 2, 2010 at 18:22 | Report abuse | Reply
  17. lance corporal

    I had heart trouble and didn't get better till I removed my self from physicians care, educated my self and treated my self, these idiots wanted to do surgery on me at 40 (there are reasons to not do invasive surgery that young) and where completely arrogant and couldn't be bothered to include me in the decisions, 15 years later I am healthy, asymptomatic and no longer trust doctors, how many times did this guy say see a "pro" physician??? 200 years ago the "pro" physician would have bled the bad spirits out of you, I can't afford hi end doctors and the typical HMO doctors are poorly trained, waaaay too busy and managed by accountants (talk about death panels would the Gov't really be worse???) who will not ALLOW good care because it would cost them money, get online do research, netowrk and get to work on your own body, pay attention, see a doc when you HAVE to or can afford a good one AND this is a big one..... only take the doctors OPINION as that because that's all it is, take charge

    December 3, 2010 at 00:37 | Report abuse | Reply
  18. Duck

    If it looks like a duck, quacks like a duck, then it's probably a duck. When you are working out, no matter what you're doing, your muscles are tensing. Each muscle affects another. On an elliptical, your shoulders are moving, which tenses those muscles, which in turn tenses the muscles in your neck, which tenses the muscles in your jaw, which CAN be the cause of the jaw discomfort. Are you finding that your jaw feels tight for some time after working out? What about when you are stressed or sitting in a poor posture? I would try some simple jaw exercises to loosen those muscles before you work out, and then see if the same discomfort occurs.

    December 3, 2010 at 03:26 | Report abuse | Reply
  19. Marie

    This happens to me, too.... And it really has nothing at all to do with the heart. Although I understand that a warning is necessary (see your doc to make sure it isn't heart issues), the obvious thng is the more likely scenario. Look at your posture, make sure you are doing the exercise correctly, etc... One specific thing that can cause a lot of neck and jaw pain is a forward head posture. In any case, I've found this site helpful for my questions about TMJ... They have a forum where you can ask questions – http://www.tmjhope.org.

    December 3, 2010 at 11:02 | Report abuse | Reply
  20. razzlea

    Check out my health and fitness blog http://razzlea.blogspot.com/

    December 6, 2010 at 10:32 | Report abuse | Reply
  21. gustavo

    hola quisiera que algien me ayude:
    cada ves que juego futbol al correr y empiezo a sudar me empieza doler la mandibula quiosiera que alguien me ayude ya llevo varios años con ese problema.

    July 14, 2011 at 12:14 | Report abuse | Reply
  22. Hest esee

    Acid reflux disorder with or perhaps with out heart problems physicians have started to in conclusion in which acid reflux disease patients that have chest pain and those who do not have chest pain are usually …utstyr til hest

    February 9, 2012 at 10:05 | Report abuse | Reply
  23. Diamondback 1260Ef Elliptical

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    March 10, 2012 at 10:21 | Report abuse | Reply
  24. Diamondback 1260Ef Elliptical

    Excellent web site you've got here.. It’s hard to find good quality writing like yours these days. I really appreciate individuals like you! Take care!!

    March 10, 2012 at 11:29 | Report abuse | Reply

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