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TMJ Disorder -TemporoMandibular Joint Message Board


TMJ Disorder -TemporoMandibular Joint Board Index


Thanks for all your help MountainReader. I'm very wary about tmj specialists after reading through this forum. I'm going to be very cautious as per your advice. I'm a little nervous about anything that could change my bite if it doesn't need to be changed. I'm bringing my mri imaging with me so that they can examine them and see if there's a different conclusion. I remember your ruining to me previously that MRIs don't always prove tmj to a radiologist. They did report jaw misalignment "of unknown significance", so hopefully I can find out for sure what degree of significance this is.
The thing they used for the MRI was a white thing that you bite down on and click it however many amount of times they tell you to open your jaw. I had full opening but after the test, just as I was changing into my clothes, I felt my face get tight and start to ache and what followed was terrible neck and shoulder pain as well as the usual ear symptoms. The only bright side of that day was that my husband bought me 2 new pandora charms for my bracelet because he wanted to cheer me up. He got me my girls initials but I told him he should've asked if they had an ear charm lol.
I have begun to wonder if my flare ups if that's what these are could be related to my menstrual cycle. I'm 4 days from my period and experience flare ups of a bladder condition that I have that's related to inflammation prior to my period as well. I've read only a bit about it, but it seems as though rising levels of estrogen prior to your period can aggravate inflammatory conditions. I'm going to start keeping track of this. I downloaded a headache diary app for my phone and have used it for tracking headaches as well as facial pain/tmj type symptoms. Hopefully ill have a clear picture of patterns if there are any in about a month.
I wanted to ask you- with your tmjd, do you ever get tingling type sensations down your spasming/worse jaw side's shoulder and arm? Today at work I started getting intense jaw tightness to the point where I thought my chin bones were gonna pop out of my skin and my eyes out of my head. The usual ear symptoms came on and then the strangest of all- the tingling that originated somewhere in my head, went thru my neck and shoulder, and down thru my arm into my ring and middle fingers. It lasted a good 20 mins before it stopped. It was obviously nerve pain, it was such a direct line of tingling that I could trace its path down my arm. My co workers were worried that I was having a heart attack (mom died of one in '99 at only 47). Any left arm sensations freak me out because my mom had numbness and tingling in her left ring finger about a month before her massive heart attack. So although I'm only 28, I'm still a bit worried about that symptom. My husband gets occasional migraines and tells me he gets this symptom with his migraines so I shouldn't worry. Trying not to...

Are there any questions that I should ask this tmj guy before I let him charge me $350? Anything I should look out for that may tell me he's not as expert as he might say he is? I'd really appreciate the tips, as I'm worried our precious savings are about to go down the drain...
Thanks as always for your help!
Jen
Jen,

I think it is great that you have such a supportive hubby. I hope it helped take your mind off the spasming some that day. Those flares aren't fun.

I agree with you about not doing anything to permenantly change your bite. With regards to the lower mandibular repositioning splint treatment as Phase I, it doesn't change anything long-term. I had some serious Phase II discussion with my dentist and took time in making my decision before deciding I wanted to try braces. The first option he gave me was to help me wean off of the splint. Because I have joint hypermobility issues already and had lost a significant amount of hearing, I didn't want to chance my jaw ending back up pushing on my ear.

What qualifications does this dentist have that you are being recommended to? Honestly, I ended up preferring the approach of a holistic Functional Orthodontist who has a fellow in craniofacial pain and extensive tmj training. Some people prefer neuromuscular dentists. I considered that route, but am very happy with my choice so far. It is important to get someone who who really understands the function of your bite and how it relates to your whole body health.

TMJ can really mess with your alignment as well as your muscles. With TMJD, most people end up with a head forward position. When your head is forward, it throws off the neck alignment, which throws other things off as well. Every time I had PT, my therapist worked muscles on my neck, shoulders, face, etc... She also did adjustments on the alignment of my neck, first ribs, back, hips, etc... During all of this, I even developed plantar fasciitis which I was told could have been connected. With regards to your tingling, I didn't have that but could easily see the connection since your neck is so influenced by all of this. I will say that I had constant flares of rotator cuff tendonitis and bursitis with the tmjd and had multiple shoulder trigger point injections over time while I was being treated.

I really think there is a major connection with the inflammation. My holistic dentist is very adamant about stressing a healthy diet and using supplements if needed to help provide balance. He doesn't push anything, but when I have flares and my body seems more stressed he will ask about the diet. He wants people to have a good amount of anti-oxidents in the diet as well. His answer to many of my questions is to eat more spinach. He loves the green smoothies to help get more healthy veggies and some fruit into a diet.

I've recently begun doing some serious reading of anti-inflammatory diets and have been considering making the leap to try one for a while to see if it may help with my TMJD and some other health conditions that I've found are connected with body inflammation. It is a pretty serious diet change for me though.

Your diary is a very good idea. Keep us posted as you progress with it.

I fully understand your budget concerns. Mine have really slowed the progress of my treatment over time. I've moved along as I've had the funds to do so.

Have you considered reading the book The TMJ Healing Plan? It may be useful in answering some of the questions you have as well.
Not sure what qualifications other than tmj specialist listed in his site. The site itself is called like tmjpainclinic or something. All I could get out if them when I spoke with them over the phone is that he will be sending me a packet to fill out that would be extensive and that he does a joint/oral examination and ultrasound on the joint and surrounding soft tissues that day to check for any key signs. If he thinks its necessary he refers out for an MRI, but I've already had one so he will review that. That's about it. She said they work closely with neurologists and ENTs on issues that have impacted other systems due to tmjd. I kinda didn't see the point in that for me as far as ent/audiology because they literally think I'm a crazy nutcase whiny baby when I tell them my symptoms vs. their physical exam. I'm pretty sure the last audiologist thought I was making it up. My left ear's Eustachian tube actually functions slightly better than the right and its the left that usually feels clogged/weird. Go figure. I only managed to schedule another round of ear testing because I've decided to pay out of pocket. My drs won't order it anymore, they said tmjd.
I like the idea of a holistic approach to anything. I'd love to try that anti inflammatory diet you've mentioned, but I know how restrictive it is. It was recommended to me by my urologist way long ago (when I was pregnant no less) and I tried it and I'm honestly worried I stunted my older daughters growth. She was 5lbs 12 oz 19 in at full term birth. I barely looked pregnant at 9 months. So yes it's pretty restrictive in my book. I wish it was easier to follow, but then again, many of us are ok with losing some weight anyway. Plus if it helps, even better.
I do agree with you also on your point of misalignment and the stress it could be putting on other areas. I've had a headache now going on 7 hrs with full body pain all originating from my head (jaw) I think. Weird weird tingling shooting feelings back in my arm too. No light/sound sensitivity, nausea only when it first started, so I don't think it's a migraine. I think it's probably tension related. Ugh. I will check that book out, I keep seeing it mentioned here, I guess the only thing stopping me is that I still feel unsure that I have tmj. More so because I feel it so much in the ears, though your story does comfort me that it might be just tmjd messing around with my ears not the other way around. I'm hypersensitive to my ears due to precious Eustachian tube blockage just last yr which I had to have newer surgery to correct. Anything with my ears now just drives me bonkers. I go 'pop crazy' and valsalva through the day to reassure myself that they aren't blocked. I literally could take up diving as a profession because I can equalize like a pro but unfortunately, no amount of equalization rids me of the ear clogginess sensation. I guess I should take that as a clue that its not originating in the ears, but my anxious self cannot.
My husband is very supportive, he fought my dr all afternoon while I was at work to Rx me more klonopin because it seems to work well for daily usage to relax me and my muscle enough to let me get thru the day. I already take klonopin very very occasionally for anxiety attacks but tried it when I was having terrible jaw tightness and it worked. I did try the muscle relaxer zanaflex but probably didn't use enough because it barely worked. I only took half the dosage but felt like I was drunk, heart palpitations, sweating, couldn't walk a straight line etc. So NOT for use during the day, although the dr keeps pushing it on me and saying ill become acclimated to it. Apparently he's scared of the addictive quality of klonopin but seriously, muscle relaxers can become addictive too, I've read about people having withdrawl muscle spasms upon coming off the drug. I only took one half tab last night and had horrific musvle pain today. Rebound spasms? Anyhow my husband won the fight and they gave me klonopin to take during the day so I can drive and work and parent, zanaflex ill save for more severe nights when I don't need to do anything or my off days when I can be a vegetable.
Thanks for your kind listening and support!
Jen
Jen

Sorry to hear what your going through. With respect to the drug reaction, trust your instincts. If you feel you aren't tolerating it well tell your doctor and insist to be put on something else if your doctor doesn't want to prescribe klonapin (hope I spelled that right). There are alot of drug alternatives. After all my experiences with doctors, I have learned to trust my instincts and to listen to my body.

Your neck pain and tingling down your arm can definitely be related to your TMJ. I have chronic neck and shoulder pain. There are a lot of nerves in your neck so if they get irritated, pain can express itself in a variety of ways. However, if you haven't seen a neurologist (I can't remember if you have) you should probably do so just to rule out any neurological issues. TMJ can also be causing our ear issues - I have similar problems with stuffiness; some ear pain etc.

Don't know what your job is - but if you are in front of a computer all day, try to watch your posture - sit up straight; relaxed; try not to jut your chin forward, there is a tendancy to do that which can put strain on the jaw and neck. Try to take frequent short breaks.

It has aslo been my experience too that a lot of dentist, doctors and radiologists do not know the TMJ joint well and its easy for them to think something is normal when its not. I had a CT scan that was misread.

If there is inflammation, while I entirely support avoiding foods that can contribute to inflammation; you should ask whether it would be appropriate to but on anti-inflamatory drug for a short period of time like celebrex or arthotek. Its important to get the inflamation down because inflamation causes pain too.

Try experimenting with hot or cold packs on your jaw and neck to see if that helps. I find soaking in a hot bath up to my neck helps relaxes my jaw and neck. Cold packs can help bring inflammation down. (If the joint "feels" hot = there's inflamation - I can always tell because whenever I drink something hot I feel the warmth in my right TMJ joint which is the joint I have issues with).

I would also eat soft foods for now until you know what's going on to avoid putting further stress on your jaw.

Diagnosing TMJ issues is very difficult, compounded by the fact that what causes the problems are poorly understood and many dentists and doctors have little specialized training in this area. So good luck with your appointment at the TMJ clinic. Ask a lot of questions. Take it slowly, there maybe a lot more tests and xrays or other scans before a final diagnosis can be made. Trust your instincts, if you have any doubts about the dentist or his recommendations, get a second opinion. Check the thread on good TMJ doctors in your area - you may find some more names if need be.

Hang in there.

Marsha





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