Posts for tag: tmj disorders
Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fibromyalgia and Temporomandibular Disorders.”
After ruling out other possibilities for your constant jaw joint pain, your doctor has diagnosed you with a temporomandibular disorder (TMD). Now that you know what you have, what can you do about it?
Unfortunately, it's not always an easy answer. Ideas about treatment are almost as numerous as theories on the causes of TMD. By and large, though, we can classify treatment into two broad categories: conservative and aggressive.
The conservative approach is the result of many years of experimentation and application; it's also much less invasive than aggressive treatments. For most patients, though, these treatments can offer significant relief from pain and dysfunction.
Conservative treatments are based primarily on the philosophy that the temporomandibular joint is like any other joint, and should be treated that way. Treatments include thermal therapies like ice or heat packs applied to the jaw, physical therapy (gentle stretching, jaw exercise, and massage) and pain and muscle relaxant medication. In cases where teeth grinding may be a contributing factor, we might recommend a bite guard worn in the mouth to reduce biting pressure.
On the other end of the spectrum are treatments like altering the bite or the position of the jaw. The purpose of bite alteration is to change the dynamic when the jaws are in contact during chewing or clenching, and reduce pressure on the joints. This is often done by reshaping the teeth's biting surfaces, moving the teeth with orthodontics or performing crown and bridgework. Another possibility, actually modifying the lower jaw location, requires surgery. All of these aggressive treatments are done in order of less to more invasiveness.
These more aggressive treatments, especially jaw surgery, are irreversible. Furthermore, studies on results have not been encouraging — there's no guarantee you'll receive relief from your symptoms. You should consider the aggressive approach only as a last resort, after you've tried more conservative measures. Even then, you should get a second opinion before undergoing more invasive procedures.
Hopefully, you'll see relief from therapies that have made a significant difference for most TMD sufferers. And that's our goal: to reduce your pain and dysfunction and help you regain your quality of life.
If you would like more information on TMD causes and treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).
There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.
It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.
Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.
Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.
Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.
Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.
Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.
If you would like more information on TMD and treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”