Meet the Many Faces of TMJ Disorders
So, why are TMJ disorders so difficult to diagnosis, and ever trickier to treat? Part of the answer lies in deciphering the proper cause of your pain.
“Jessica had TMJ disorders,” my friend said over a cup of coffee the other day, “and here is what she did to treat them.” Then she rattled off the list of remedies she underwent to alleviate her pain. “I’m sure they’ll work for you.”
I thanked my friend, but told her that Jessica’s pain had a different cause than mine. And I could not use the same “prescription for healing,” that she used.
My words were met with a blank stare.
And this is not an unusual response. If you suffer from TMJ disorders, then you know exactly what I mean. Each case is somewhat different. Therefore, each treatment plan needs to be tailored to the individual’s specific causes. No wonder it’s so difficult to diagnose and treat!
But before we talk about the specific causes of your TMJ pain, let’s talk in general about what TMJ disorders actually are.
When your health care provider talks about this problem, she’s referring to a group of rather complex problems, all related to the jaw, or the temporomandibular joint. This joint is located on each side of your head in front of your ears. Its exact location is the meeting place of your lower jaw meets your skull.
It actually combines a hinge action with sliding motions. The areas of the specific bones interacting with the joint are covered with cartilage, and are separated by nothing more than a very small disk, which acts as a sort of shock absorber.
But unlike the bones in other parts of your body, the TMJ is actually composed of two joints. This unique make up is what allows it to both rotate and slide. As with any bone, though, eventually the surface area wears down or erodes. Signs of this include a clicking sound, and a popping, as well as changes in the joint’s normal movements.
The surfaces of both the bone and the cartilage are incapable of sending pain signals to your brain. Instead, the surrounding soft tissues become painful. The pain may also manifest in the trigeminal nerve, running through the joint area itself.
Once that happens, then the mandible’s movements are automatically limited. Even when the jaw isn’t in motion, the inflamed joints or the damaged nerve can cause constant pain.
Since the TMJ is located so close to the ear, this pain may very well be interpreted for a typical earache or as facial pain.
There are any number of reasons why you may have a problem with this joint. For example, the disk itself may actually erode or move out of joint, resulting in a misalignment of your jaw.
This joint is incredibly useful, and you prove that every day, by talking, chewing, and yawning to be exact. Remember this is a joint, complete with all the foibles of your other joints.
At times, you may encounter a professional who talks about myofacial pain dysfunction or Costen’s syndrome. They’re talking about the same health concern.
Muscle and joint: A tag team event
It’s true! Muscles and joints work together. That means if you have a problem with either of these in the jaw area, it can cause a host of seemingly unrelated problems including:
- Ear pain
- Bite problems, also called malocclusion
- Clicking sounds
- Locked jaws
- Difficulty in chewing
- Discomfort when chewing
- Pain in the jaw
- Tenderness in the jaw
- Facial pain
The clicking sound mentioned above occurs when you open and close your mouth. For some individuals, they hear this when they chew as well. Many people experience this without any pain at all. HereHearing this sound alone is not an indication that you have a health concern. Only those who experience pain along with the sound would be diagnosed as having TMJ disorders.
What Causes This “Malfunction” Of My Jaw?
You can develop disorders of the TMJ if the disk, which acts as a shock absorber, slides out of place or erodes. The problems may occur if the cartilage of the joint is damaged by arthritis.
Of course, your jaw may have been damaged if it withstood some type of trauma. You may have fallen, and the jaw was subjected to a blow. But the problem may also be related to the muscles in the area as well. This is especially true if they become fatigued from overuse.
How can you “overuse” your jaw? Well, before you accuse anyone of talking too much, this is usually the cause when you clench or grind your teeth.
But, even with this wide diversity of causes, many individuals never are able to discover the exact cause of their jaw troubles. And that, ultimately, makes its treatment very tricky, indeed.
Here’s another common cause of as that can contribute to the condition. Have we mentioned lately that life tends to be unfair at times?
Now that I have your curiosity piqued about this, you undoubtedly want to know how this happens. Sleeping on your stomach automatically forces your head to move to one side, which in turn places stress on the joints in your neck.
It’s far better to sleep on your side, but even this can still press one side of the face more than the other. So what’s the ultimate sleeping position to help your TMJ pain? You guessed it: on your back.
Try this, it may be the relief you’ve been searching for. But, if you do sleep on your back, and still experience jaw joint pain, and then your TMJ problems may be due to your grinding or even clenching your teeth at night.
How can you find out, since obviously while you’re sleeping you’re unaware of what your jaw is actually doing throughout the night. As soon as you wake up in the morning, focus your consciousness on your jaw. Then answer this simple question: Is your jaw relaxed? Are your teeth set apart, or are they clamped together tightly?
If your teeth are clamped shut, then your dentist may recommend you wear a specialized splint that prevents the grinding and clenching.
The Anteater Pose
Another cause of TMJ disorder, one that’s often overlooked, is what Sue Carver, a physical therapist in Little Rock, AK, calls the “anteater” pose. This involves unconsciously jutting your head forward while you’re sitting and even while you’re standing.
Some people do this because the head is pretty heavy, physically speaking. It weighs approximately nine to 15 pounds. This weight, in turn, strains the neck and jaw. In addition it may even cause your bite to actually shift so that your teeth aren’t properly aligned.
You may think this “anteater” pose is uncommon. You’d be wrong though. It is a very popular position with those individuals who work at a desk all day. And these days, that includes quite a few of us.
But don’t despair. There are simple ways you can prevent this. Carver recommends to her patients that they view their shoulders and their pelvis as an invisible rectangular box. “You want to keep your head over this box,” she instructs them
If you must spend long periods sitting, first ensure your lower back is supported. Then keep your lower back supported. You’ll also want to keep your feet flat on the floor. Another item to check for is that your desk is at the proper height that your forearms are level with your keyboard if you’re typing.
And probably the most important piece of advice Carver provides is not to sit for more than 20 minutes at a time without getting up and moving about some. (And that is the hardest advice for me to follow!)
Even More Possible Causes
Just when you think it’s safe to wrap up the list of potential causes your TMJ Disorders, I’m adding yet another list for you to drink up (I’d say chew on but we don’t want to tax that jaw joint any more than it already is!)
Check out these possible causes of this ubiquitous disorder:
- Autoimmune Diseases
- Various Infections
- Jaw Injuries of Just About Any Kind
- Certain Dental Procedures
- Stretching your jaw — as in done at times with certain surgical procedures
- Poor Dental Work
Is There A TMJ Disorders “Profile”?
Many individuals grind their teeth and never develop TMJ problems. Many of us, likewise, go through the day not thinking about how we sit or even how long we sit. Why do some individuals seemed destined to develop it while others are untouched by it?
But more importantly, you may be wondering right about now what the odds are that you’ll develop a TMJ disorder. You may be wondering if there’s a TMJ Disorders profile, a snapshot of the kind of person who’s likely to develop this problem.
As a matter of fact, there are several risk factors that can increase your odds of being plagued with this pain. The first is your age. Are you between the ages of 30 and 50? If so, you’re more at risk than those younger or older than you.
Then there’s the issue of your gender. Women seem to develop TMJ problems more often than men. The medical community isn’t quite sure why, though.
Another factor, which increases your chances, is having a deformity of the jaw. If you were born with an abnormality in the bones of your face, especially those that affect the workings of the jaw, your odds of developing problems increase.
Other specifics, which may boost the chances of needing to deal with TMJ disorders, include the presence of other diseases or disorders. Those individuals with rheumatoid arthritis, sleep disorders, fibromyalgia or chronic fatigue syndrome are more at risk than others.
HOW DO You Know When To See A Doctor?
Oh, you’ll know! You’ll know! Seek out the opinion of your qualified health care practitioner when your pain or tenderness is persistent or when you can’t open or close your jaw completely.
She’ll not only diagnose the problem, but if it’s truly a TMJ problem, she’ll help you pinpoint the cause. But you don’t always need a medical professional to tell you what causes your pain.
If it’s associated with bad habits you’ve acquired through your daily lifestyle, you may be able to deduce the cause yourself. You after all know your body, and what you put it through in a day, better than anyone else.
Before walking into your doctor’s office, though, it’s a good idea if you prepare for your visit. You want to be able to describe, succinctly and accurately, the type of symptoms you’re experiencing. This is important because of the variable origins of TMJ. Different types of symptoms can give your health care practitioner a clearer picture of the underlying cause or causes of the problem.
You’ll also want to give some thought to roughly when the symptoms began. Of course, you probably gave the pain no thought the first several times you felt it. If you’re like most of us, you dismissed it, chalking it up to “just one of those things.” But as it persisted, you, no doubt, became more concerned about it. Try to remember how long you’ve been struggling with this.
Can you associate this pain with any particular activity? If so, be sure to tell your doctor that. This information, too, can help in detecting an accurate cause of your problem, which in turn can help with a more effective not to mention quicker treatment plan.
If your jaw clicks or pops, tell your doctor or dentist this. Also inform him if you’re experiencing problems sleeping at night. All of this is important.
And finally, if you view your life as stressful, by all means mention this. Without at doubt, stress in our life manifests in any number of ways through our physical bodies. This could be why you’re grinding your teeth at night.
What The Doctor Will Do?
Sometimes the most frightening or intimidating aspect of a doctor’s visit is simply not knowing what’s going to happen. Having an idea of what happens during allays many of these fears. That in turn helps you to concentrate on what the doctor is saying.
If you think you’ll miss some vital aspect of this discussion, or won’t be able to remember something, take a friend or relative with you who can be more objective. Ask him to listen closely. And be honest with him. Tell him you may not remember everything the doctor tells you. Between the two of you, you’ll emerge from the visit with a much fuller understanding of what the doctor said.
One of the first things your doctor will have you do is simply open and close your mouth. Among other traits, he’s observing the range of motion your jaw has. He’ll also undoubtedly check to see what your bite looks like. Here, he’s checking for any abnormalities, which may be prompting the pain.
He’ll also examine your mouth for other conditions that may cause TMJ disorders. These may include fillings that are too high, teeth that have been displaced due to an earlier loss of other teeth, as well as traits that you’ve inherited. All of these can cause the misalignment of your mouth, which can trigger or aggravate TMJ disorders.
Next, he’ll examine your teeth more carefully. He’ll inspect them for specific patterns of wear that could be clues that you’re grinding your teeth at night — without you even being aware of it.
Don’t be surprised — or alarmed — if he presses on the areas surrounding your jaws. In doing so, he’s identifying areas of pain or discomfort. Your job is to be honest when he asks those questions, “Does this hurt?” “Does this feel uncomfortable?”
Finally, he’ll take the time to ask you — if you haven’t already told him — about the level of stress or anxiety in your life. More importantly, he’ll also question how you handle it. This could be some of the most telling testimony of the entire office visit.
What Comes After the Initial Exam?
If your health care practitioner believes that your symptoms may be due to TMJ disorders, he may order a few tests. He’ll probably start out with an x-ray. From there you may also be asked to undergo a CT scan, commonly called a “cat” scan. The images produced by this device can provide him with detailed images of the joint bones.
Finally, he may even ask that an MRI be taken. This specifically reveals the condition of the shock-absorbing disk.
If you visit an allopathic doctor, (a physician with an M.D. behind his name), his advice will probably be scripted from the conventional medicine rulebook This isn’t necessarily a bad thing – especially if it helps you. Before you jump into anything, it’s nice to know what lies ahead. In the following chapter we talk about the treatments conventional, allopathic medicine may recommend.