TMJ sufferers - some questions

[AllieMackie]

So, I have temporomandibular joint dysfunction - in specific, clicking jaw, I clench (but don't grind) and have bad habits like drinking a bit more caffeine than I should and resting my head on my hands a lot.

For the past two weeks I have had intense pain in my left jaw joint - to the point that I cannot focus when the pain flares up. And it flares up often.

I've seen my dentist - he confirmed that my bite was A-OK, and that no teeth were aiding the pain. He referred me to a few names of TMJ specialists in the city, since it very much seems to be a result of the TMD.

The problem? Like most specialists, there's a waiting list. I can't get in until a month from now. My dentist suggested Advil. Advil? I don't want to be on ibuprofen for a month. That just can't happen, but I also can't deal with unending pain for a month.

So since then, I've been taking ibuprofen only when I sleep (and it works) and applying heat to my face as needed during the day. But the heat is annoying to prep (using a Magic Bag), interrupts my work constantly and can't be done when I'm out and about. I need more solutions.

I've cut out all caffeine except for a small cup of tea in the morning. With the exception of my birthday pub night last night, I haven't been drinking alcohol in case I need emergency ibuprofen. I've been trying progressive muscle relaxation (which I already do for anxiety) but it doesn't seem to help much, nor does relaxation breathing exercises. The only two things that seem to help are heat and drugs.

Has anyone else been in any sort of similar boat? Suggestions?

 

[Red.Apricot]

I have the same problems, and naproxen helps a lot.

I also have a night-guard which helps too; my dentist fitted me for it.

 

[AllieMackie]

I have the same problems, and naproxen helps a lot.

I also have a night-guard which helps too; my dentist fitted me for it.

I forgot to mention that I can't take naproxen. I have very bad reactions to it. Not the first time that's been an annoyance, and I don't know why I react badly to it. For NSAIDs I generally have to stick with ibuprofen.

I dunno if it's different here, or just that my dentist doesn't do it - the night guard has to come from the TMJ specialist. The fitting for it is what I'm booked for at the beginning of April.

ETA: My dentist can diagnose TMD and specific TMJ-related symptoms, but he doesn't have the facilities to do some things in-house, and that includes molds for night guards, so he outsources his patients to a specialist that will receive their insurance if applicable (I just stalked his website haha).

 

[smkie]

This has been my life for 20 plus years. I have had 3 surgeries, 2 on one side, 3 on the other the first couple times they put the discs back, they eventually took them out completely adn according to my d9oc, changed the whole physiology of my jaw. Since I have "flattened the colloidal heads" again I need another, and they do have a joint replacement device now, but my insurance won't cover it. My best advice, get a really good tmj doc and do what they say. For now, eat soft food and give the whole business a rest to see if it gives you eventual relief. My list of cant do's is so long that I won't begin to list. I am sorry you have this. Any pain that is away from my head is nothing to compare. They let mine go too long without doing anything the first time, it was stage 4 with bone splinters. Don't let them let you go that far before you get help. I have always wondered if they had done something when I first started having trouble, if it might have not been damaged beyond repair.

 

[AllieMackie]

This has been my life for 20 plus years. I have had 3 surgeries, 2 on one side, 3 on the other, they eventually took the joints out completely. Since I have "flattened the colloidal heads" I need another, and they do have a joint replacement device now, but my insurance won't cover it. My best advice, get a really good tmj doc and do what they say. For now, eat soft food and give the whole business a rest to see if it gives you eventual relief. My list of cant do's is so long that I won't begin to list. I am sorry you have this. Any pain that is away from my head is nothing to compare. They let mine go too long without doing anything the first time, it was stage 4 with bone splinters. Don't let them let you go that far before you get help. I have always wondered if they had done something when I first started having trouble, if it might have not been damaged beyond repair.

Ugh, I'm so sorry to hear that smkie. I've had TMD for awhile, and have ignored it because the clicking alone wasn't aggravating me and I had a ton of dental work to do (half of it without insurance) so I had to prioritize. Of course, the very month I finally finish all of my dental work I can do until next fall... surprise, intense jaw pain.

I shouldn't have ignored it. But dentistry is expensive and I had infections to deal with. Ugh ugh.

 

[smkie]

Mine got to the point where the discs slipped out of place, I could not bring my back teeth together, and it was horribly painful. I had to go to a teaching hospital and there were mistakes made in treatment. Even so, it just wasn't a choice matter. It was way beyond clicking. Now mine crunches like you would think a zombie might sound. You can hear it a distance away, and people always cringe when they hear it. They should hear what it sounds like in my own ears, which also ring like an orchestra. I can eat now, I don't chew much, just enough to be able to swallow, and I tend to choose things that are thin and dont' require pressure. IT's a serious problem that doesn't get better. Getting good treatment early is paramount. You do not want to be where I am.


Things I avoid, talking for any length of time. Riding a bicycle, pushing a lawnmower, the dangest things cause my pain level to increase. I tried to ride a bike once when the car broke down, I ddin't think about when you go up a hill that it would cause pull on my jaw that it can't take. Falling, is always bad. Those bones hit together, and it is mind blowing. I hate every bit of it, but have learned to live with it. Amazing what you can get use to.

Apparently tho they do have something that can fit in there and act as a joint replacement. They didn't have that when I had mine done, so you would never have to deal with what I do with nothing in there to act as a cushion, or protector, or whatever you call it.

 

[xpaeanx]

You could ask your dentist to prescribe a muscle relaxer. When I was having my really bad flare ups I was given one. That with the combination of soft food only allowed the muscle rest and the pain wasn't so bad. I would use it at night since that's when you clench. Also, our local pharmacy sells cheap mouth guards... Might be worth a shot for the month?

Mine can only be fixed with surgery, which I'm afraid to do. End result... There are days I just don't even use my jaw for pain.

 

[xpaeanx]

I don't know how you feel about putting medicated cream on your face?

But you can ask for a prescription for voltaren. It's a topical NSAID, so you won't be subjecting your entire body to medication, just your jaw. Also, topical has less absorption than oral medication, so less overall drugs in your system period. I use it on my ankle when I'm having pain I can't ignore anymore. I love it. It doesn't take my pain away completely, but it knocks it down tremendously that I have no trouble from it.

 

[GoingNowhere]

I woke up one morning a few years back and couldn't open my mouth more than a half a centimeter. It took about two years, but now it's pretty much back to normal except when my jaw is really stressed, that side will still start to ache.

I didn't have extreme pain, though - just soreness. I first went to an oral surgeon who put me on muscle relaxers and steroids. It helped a bit, but not a lot and eventually I went to see a specialist. It turned out that I was grinding my teeth in my sleep because when I bit down, only one point of one tooth touched from the top to the bottom. He actually filed down that point as well as a few more and I got a really overpriced bite guard. But hey, it seems to have worked.

As I was recuperating, I had a bit of clicking, but it sounds different from what you're describing.

It sounds like your case was different from mine, but if I had to relive my time over again, I'd have bought myself a cheap mouthguard (one of those boil and bite ones) and worn that before it ever became a problem.

Now, although my jaw is basically healed, I would really like to try acupuncture at some point. I heard from my elective chinese medicine class that bone/ear issues, knee pain, lower back pain, and ringing in your ears are all symptoms of being "kidney deficient." Nevermind that I am always cold and don't drink nearly enough water... apparently in Traditional Chinese Medicine (TCM) those things can all be related.... I'm super curious to try acupuncture!

 

[AllieMackie]

Thanks for the tips guys!

I've used a pharmacy night guard (two different types in fact) and unfortunately they cause the pain to be worse. I'm guessing it has to do with the hard plastic wedge along the bottom that doesn't allow my bite to properly align. My jaw feels misshapen in the morning, and very painful.

I never thought about topical NSAID. I will look into it! Muscle relaxers don't seem to do much for this kind of pain, but perhaps perscription ones would be better - I tried store brand extra strength Robax.

 

[AllieMackie]

So... at my wit's end, I went ahead and tried naproxen again, since it's the only decent extended-relief NSAID.

I was okay! And I slept like a baby for nine hours! OMG. I feel so refreshed today. Omg omg.

I spoke to my dentist today because I'm at the end of my rope with the pain. He's seeing me tomorrow to get x-rays and refer me directly, in hopes that will expedit the process.

 

[CharlieDog]

Voltaren is the brand name for diclofenac/diclofenac sodium.

I'm being weaned off of it, was taking it for a different issue and I definitely notice I'm clenching my jaw WAY more than I was while I was on it.

 

[Dreeza]

TMJ issues are often because of upper cervical issues (this creates tension at the jaw musculature & can pull at the joint, affecting it's placement).

You definitely want to avoid any sort of dental intervention if your bite is good until you've had your neck cleared by a physical therapist (I would look for one that has experience with TMJ, or is at least an OCS, and very good with the neck). Sometimes some work at the cervical spine, or even joint work right at the TMJ (depends what the exam find) can make a HUGE difference.

In the mean time, these are the 'standard' PT exercises given: http://www.cyberpt.com/tmj.asp

I'm sure if you google 'Rocabado 6x6' you can find some videos of the exercises too!