Best Exercises for Clicking in Ears Due to TMJ and Eustachian Tube Dysfunction
The most effective exercises for alleviating ear clicking due to TMJ and Eustachian tube dysfunction include nasal balloon auto-inflation, regular Valsalva maneuver practice, and the Buteyko breathing technique, which should be performed multiple times daily for optimal results. 1, 2
Understanding Ear Clicking Causes
Ear clicking occurs primarily through two mechanisms:
- TMJ-related clicking: Due to dysfunction in the temporomandibular joint affecting the tensor veli palatini muscle
- Eustachian tube dysfunction: When the eustachian tube opens abnormally during swallowing or other pharyngeal movements 3
The close anatomical relationship between the TMJ and middle ear explains why TMJ dysfunction can lead to eustachian tube problems, as both share connections to the tensor veli palatini muscle, which controls eustachian tube function 4.
Recommended Exercises
1. Nasal Balloon Auto-inflation
- Technique: Use a specialized nasal balloon device or simply pinch your nose closed, close your mouth, and attempt to gently blow air through your nose
- Frequency: 3-4 times daily
- Evidence: Recommended by the American Academy of Otolaryngology-Head and Neck Surgery for eustachian tube dysfunction 1
- Benefit: Creates positive pressure that helps open the eustachian tube and improve middle ear ventilation
2. Valsalva Maneuver
- Technique: Pinch your nose closed, close your mouth, and gently attempt to exhale through your nose
- Frequency: Several times daily
- Evidence: Standard conservative management recommended by otolaryngology guidelines 1
- Benefit: Helps equalize pressure between the middle ear and environment
3. Buteyko Breathing Technique
- Technique:
- Sit upright in a comfortable position
- Take a small breath in through your nose
- Exhale slowly through your nose
- Hold your breath after exhaling for as long as comfortable
- Resume normal breathing and repeat
- Frequency: 10-15 minutes, twice daily
- Evidence: Clinical studies show 50% normalization of symptoms at 12 weeks compared to 24.3% with conventional treatment alone 2
- Benefit: Particularly effective for obstructive eustachian tube dysfunction that is refractory to medical treatment
4. TMJ Relaxation Exercises
- Technique:
- Gentle jaw stretching: Slowly open and close your mouth several times
- Jaw resistance exercise: Place your thumb under your chin and apply gentle resistance as you open your mouth
- Frequency: 5-10 repetitions, 3 times daily
- Benefit: Improves TMJ function which can indirectly improve eustachian tube function 4
Complementary Approaches
Daily Nasal Saline Irrigation
- Technique: Use a neti pot or saline spray to irrigate nasal passages
- Frequency: 1-2 times daily
- Evidence: Recommended by the American Academy of Otolaryngology as part of initial management 1
- Benefit: Reduces nasal inflammation that may contribute to eustachian tube dysfunction
Address Underlying Allergic Rhinitis
- If allergic rhinitis is present, treat with appropriate medications (particularly intranasal steroids)
- Untreated allergic rhinitis can worsen eustachian tube dysfunction 1
Important Considerations
- Consistency is key: These exercises must be performed regularly as recommended to see improvement
- Avoid forceful maneuvers: Excessive pressure during Valsalva can damage the eardrum
- Seek medical evaluation: If symptoms persist beyond 4-6 weeks despite these exercises, otolaryngology referral is recommended 1
- Avoid ineffective treatments: Antihistamines, decongestants, and routine antimicrobials are generally ineffective for otitis media with effusion and may cause adverse effects 1
When to Consider Additional Interventions
If conservative exercises fail to provide relief after 4-6 weeks, more advanced interventions may be considered:
- Balloon dilation of the eustachian tube
- Tympanostomy tubes (for persistent middle ear effusion)
- Evaluation for TMJ-specific treatments
These exercises represent the first-line approach with minimal risk and potential significant benefit for improving quality of life and reducing ear clicking symptoms.