I first noticed pain in my left shoulder when I was eight months pregnant. I was 25 and had just taken a leisurely stroll with my toddler. Nothing had happened — no injury or event. The muscles just felt increasingly tight. I rolled my shoulders, practicing light stretches that had done the trick for years when I worked in restaurants. When the stiffness didn’t let up, I pivoted: We headed to the playground so I could try hanging from the monkey bars. That didn’t work, either. I went home, plugged in a heat pack and attributed the unyielding sensation to a random third-trimester ache.
Six months later, I sat with my child and new baby at a play group, rubbing my shoulder. Another mom made a joke about how I was always stretching and giving myself massages. I felt embarrassed, but I realized she was right. I couldn’t remember a day when I didn’t feel a dull throb, the muscles unwilling to release. I went to the doctor for the first time a few weeks later.
Over the next decade, I had X-rays, MRIs and CT scans to rule out conditions like frozen shoulder, and dozens of treatments to try to relieve the pain. I finally found an approach that worked after my physical therapist said, “I’d like to try working inside of your mouth.”
She wanted to try what’s known as intraoral myofascial therapy, during which a therapist uses their fingers to massage the inside of your mouth in an effort to release the muscles and surrounding connective tissue — called fascia — in the face. To my surprise, this is what finally did the trick.
My treatment journey
Between 15 and 25 percent of adults at any point in time have ongoing shoulder pain, with a higher prevalence in middle age and among health care workers (which I am). Up to 40 percent of cases become chronic; in other words, they don’t resolve within three months with traditional treatments like physical therapy.
Jie Yao, a shoulder and elbow surgeon at NYU Langone Health, said shoulder pain can come from anything from tendon or muscle injuries to arthritis or as a result of the normal aging process. “Most people will have some sort of musculoskeletal problem in their life,” Yao said, with the shoulder being one of the most common areas.
When I first sought help over 10 years ago, I had a short exam at my general practitioner’s office, then went in for scans, which showed no tears or injuries. My doctor then sent me to physical therapy. I stuck with it religiously, although it didn’t seem to help that much.
From there, I tried acupuncture, chiropractic care, massage, ultrasound therapy, dry needling, and steroid and trigger point injections. At the time, I was also practicing yoga regularly and lifting weights, hoping that might also help. I even took up cold plunging and went to a center where two fitness instructors would stretch my body for me. Everything probably kept my shoulder from getting worse, my doctors and therapists insisted. Nothing really made it get better.
What happens during intraoral myofascial therapy
Over the years, dentists had casually asked whether I clenched my teeth at night. I always answered the same way: “I have no idea. I’m asleep.” Then we laughed it off and moved on. I never noticed pain in my jaw, and I’ve been lucky to have great teeth, so my physical therapist’s suggestion to stick her fingers in my mouth just felt like another in a long line of bizarre attempts to convince my shoulders it was time to let go. I was up for anything. I joked once, “I’ll learn to sing opera while hanging upside down if you think it’ll work.”
So, I lay on my back with my mouth open. The therapist put their gloved fingers in my mouth and pressed gently on my teeth, jaw and inner cheek, telling me when to bite down or relax. I felt pressure, but it didn’t hurt. It only took up about 10 minutes of the appointment, but the effects were immediate. I felt no pain or tension for hours after.
I was also seeing a Rolfing practitioner. Also known as structural integration, Rolfing is a form of bodywork that is focused on manipulating the fascia specifically. I told my Rolfer about the intraoral therapy, and she said she could do the same thing. I started to notice a significant reduction for weeks after these two back-to-back treatments.
Why intraoral therapy may help shoulder pain
After I’d seen so many doctors and tried countless treatments, this simple approach felt like a miracle. It does, though, have a scientific basis. “Pain begets pain,” said Heather Jeffcoat, a physical therapist who specializes in chronic pain. Jeffcoat explained how the sensory receptors in different areas of our body overlap “so felt sensations in one area can ‘spill over’ to adjacent areas.” She said the trapezius muscle, which covers the top of the shoulder and part of the upper back and neck, connects to the jaw. So it makes sense that treating one of these areas could help resolve problems with another.
The fascia adds another layer of connection. “Think about it as a rubber suit under the skin that covers and supports your muscles throughout your entire body,” said Sherryl DeVries, a physical therapist who specializes in myofascial work in Seattle. “It connects every part of our body in a three-dimensional way. So when you’re clenching in the jaw, you are absolutely affecting not only all the muscles around the face, but also the neck, and the neck then is affecting the shoulders.”
While some people may notice shoulder pain first, for many people, the problem starts with pain or tightness of the face and jaw. A 2015 study showed that 70 percent of people with temporomandibular disorders (TMD) experienced neck pain. Another 2025 study suggests that a little more than half of those who visited the doctor for facial tightness or pain also experienced significant shoulder problems.
As a physical therapist told me once: “The body is like a map. Sensation goes up and down the muscles. Follow the muscles like you’d follow a road. Everything is connected.” Studies show that pain can move between related structures in the face, head, shoulders and neck, making the process of finding the initial source more challenging — hence why it was so hard to pinpoint where my shoulder pain originated.
To find a practitioner who can perform this kind of work, DeVries suggested looking for a physical therapist who has specific training in myofascial release.
The road to recovery
Chronic shoulder pain is a common experience, and I’m lucky I’ve found an answer — a combo of intraoral myofascial therapy and shoulder exercises — that seems to be working. While I’m incredibly grateful for the team of people who eventually led me to an effective treatment plan, I know it’s up to me to stay committed to it.
“One of the biggest things that dictates how well somebody does with physical therapy is their engagement [in the program],” Yao said. Seeing a therapist once or twice a week will keep you on track, but staying consistent with at-home exercises is essential for meaningful change.
I’ve seen that play out in my own life. I have way more pain when I get too busy with my kids or job to take care of my body. The good news is, after a few months of weekly intraoral treatments and an at-home shoulder exercise program, I feel great for days at a time. Sometimes I skip a week of doctor’s offices, trusting myself to follow the steps I’ve developed with my therapists. Sometimes I go a long time without whipping out my massage gun or taking an Aleve just to relax my shoulder enough to fall asleep.
Recovery is hard work, sometimes frustrating, sometimes satisfying, but once you’ve found a treatment that helps, the results completely belong to you.
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