# The Tongue's Role in Chronic Pain

Source: https://www.youtube.com/watch?v=eOuXNh0-L2c
Recap page: https://rapidrecap.app/video/eOuXNh0-L2c
Generated: 2025-11-11T10:43:12.023+00:00

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## Quick Overview

Dr. Joe Damiani asserts that many chronic pain issues, including those related to the Temporomandibular Joint (TMJ) and neck, are often rooted in poor tongue posture and resulting airway restriction, which forces the body into compensatory movements that lead to pain and dysfunction, emphasizing that myofunctional therapy directly addresses these underlying postural habits.

**Key Points:**
- Chronic pain conditions like TMJ and neck pain often stem from poor tongue posture, which restricts the airway (00:09, 00:51).
- When the tongue rests low, the body compensates by posturing the head forward, leading to tension and pain (07:38, 08:48).
- Renata Nehme, a dental hygienist and myofunctional therapist, focuses on increasing the size of the oral cavity and ensuring proper tongue position (11:55, 12:00).
- Proper tongue posture involves the tongue resting lightly suctioned against the roof of the mouth, which helps maintain an open airway (05:05, 06:07).
- Myofunctional therapy aims to correct these dysfunctional resting postures, which can alleviate issues like sleep apnea, jaw pain, and headaches (00:09, 01:01).
- Dr. Damiani notes that many patients seeking help for facial pain or headaches have underlying airway restriction or tongue-tie issues (08:05, 08:21).
- The ultimate goal of these therapies is to restore proper function and eliminate compensations caused by poor resting posture (13:44, 14:18).

![Screenshot at 00:04: Dr. Joe Damiani, PT, DPT, and Renata Nehme, CCM, introducing themselves for a live discussion on chronic pain related to tongue posture.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-00-04.png)

**Context:** This video features an interview between Dr. Joe Damiani, a Physical Therapist (PT) and Head & Neck Specialist, and Renata Nehme, a dental hygienist and myofunctional therapist. They discuss the critical, yet often overlooked, connection between chronic pain conditions, particularly TMJ disorders, neck pain, and headaches, and the patient's resting tongue and jaw posture, advocating for myofunctional therapy to correct these issues.

## Detailed Analysis

Dr. Joe Damiani and Renata Nehme discuss how chronic pain, especially TMJ and neck pain, is frequently linked to improper tongue posture and subsequent airway restriction. Nehme, a myofunctional therapist, explains that when the tongue rests low in the mouth, the body compensates by posturing the head forward, leading to hypertonicity in neck muscles, headaches, and jaw pain. She stresses the importance of maintaining proper tongue posture, where the tongue rests lightly suctioned against the palate (the roof of the mouth) to ensure an open airway. This proper posture is essential for functions like nasal breathing and swallowing. Nehme notes that many patients she sees, including adults and children, exhibit signs of this dysfunction, such as mouth breathing, snoring (sleep apnea), and pain, often resulting from underdeveloped oral structures or tongue-ties. She contrasts this with orthopedic issues where the problem might be a structural bone issue; in the case of tongue posture, it's a functional issue. She highlights that many dental professionals, like orthodontists, may focus on correcting tooth alignment (like overbites or underbites) without addressing the underlying tongue posture, sometimes even exacerbating the issue by pulling teeth inward. The key to resolving these chronic issues involves retraining the tongue to rest correctly and function properly, which is the focus of myofunctional therapy.

### TMJ/Chronic Pain Connection

- Chronic pain in the jaw, neck, and head often links to poor tongue posture and restricted airway
- This forces compensatory forward head posture, leading to muscle tension and pain (00:09, 07:38).

### Myofunctional Therapy Focus

- Myofunctional therapy addresses functional issues, primarily retraining the tongue to rest suctioned against the palate to maintain an open airway (05:05, 11:55).

### Common Symptoms

- Patients frequently present with symptoms like clicking/popping in the jaw, ear irritation, headaches, and difficulty breathing through the nose (01:01, 05:05, 08:06).

### Orthodontics vs. Myofunctional Therapy

- Orthodontic work often focuses on teeth alignment, sometimes even creating new issues like dental crowding if underlying tongue posture isn't addressed (09:52, 25:25).

### Importance of Tongue Posture

- Proper tongue posture (up and back against the palate) is crucial for function; low tongue posture leads to mouth breathing and subsequent problems (06:07, 17:18).

### Next Steps

- Dr. Damiani suggests that if people have these symptoms, they should prioritize conservative treatments and work with professionals who understand the whole system, not just isolated symptoms (03:49, 39:50).

![Screenshot at 00:04: Dr. Joe Damiani \(PT, DPT, TMJ, Head & Neck Specialist\) and Renata Nehme \(CCM\) starting their live discussion.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-00-04.png)
![Screenshot at 01:11: Dr. Damiani demonstrates the concept of tongue position by pointing to his jaw/face area, illustrating where the tongue should rest.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-01-11.png)
![Screenshot at 02:24: Renata Nehme demonstrates the incorrect habit of smiling widely \(potentially showing a retracted jaw/tongue position\) versus proper tongue resting position.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-02-24.png)
![Screenshot at 03:48: Dr. Damiani uses his hands to demonstrate the concept of posterior jaw positioning relative to the neck/spine structures.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-03-48.png)
![Screenshot at 05:05: Renata Nehme emphasizes that gagging is normal during some oral function checks, but touching the area is not.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-05-05.png)
![Screenshot at 08:06: Dr. Damiani points to the hyoid bone/throat area while discussing how upper neck muscles stabilize the hyoid.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-08-06.png)
![Screenshot at 11:48: Renata Nehme gestures to illustrate how the maxilla might be too narrow, restricting the space for the tongue.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-11-48.png)
![Screenshot at 15:05: Renata Nehme discusses the responsibility of practitioners regarding tongue releases, noting she prefers to be conservative.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-15-05.png)
![Screenshot at 29:00: Dr. Damiani demonstrates the concept of the tongue being restricted from moving around the palate.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-29-00.png)
![Screenshot at 35:37: Dr. Damiani highlights the importance of having a team you trust to address underlying causes of pain, not just treating symptoms.](https://ss.rapidrecap.app/screens/eOuXNh0-L2c/00-35-37.png)