tmj pain, experience...advice?

[ThreeBlessings]

My doctor says I have tmj pain. She thinks I've been clenching my teeth in my sleep. I hurt my lower back 1 1/2 months ago and I suspect maybe I was clenching my teeth from the pain? Anyway for 3 weeks now I've had pain and throbbing in my ears, neck pain, headaches, and my neck and the lower back of my head feel like rice crispies, snap, crackle, pop. There's been some other weird stuff like face pain, tingling & numbness in my hands, pain in my wrists and lower arms, and I swear it felt like my arm popped out at the shoulder or something but all of this is not happening *right now*. I do have some pain behind my shoulder blades sometimes.

 

She recommended a cheapo night guard from the drugstore (all of which say DO NOT use if you have tmj problems) and some exercises for the jaw and back. I've been doing the exercises and wearing the night guard for a couple days now. She said it should feel good after 3 days with the guard but I'm doubtful. I feel like my whole spine is jacked up and out of whack. Anyone have experience to share that might be helpful or advice? TIA!

[Momof3littles]

There are physical therapists who specialize in TMJ. They can do things like manually stretch certain oral muscles or the joint capsule, they can give exercises to work on symmetrical opening/closing, help you minimize inflammation, etc. The other thing to consider is that sometimes postural issues (like forward head posture, which is very, very common) and muscle imbalances can contribute to TMJ.

 

I would look for a PT who also does TMJ work, and see if any of it ties into the back injury as part of your evaluation. Numbness radiating into your hands and so forth should be checked and fully evaluated. A PT can do a thorough evaluation to see if the TMJ issue is tied to the other spine/back issues. You might as well IMO address it all at once. What you are being told is TMJ might be other conditions too, or it may be TMJ related to your posture/spine/neck/back issues, or it may be two separate issues. A thorough evaluation will tease that out.

 

There are some PTs trained in Rocabado technique for TMJ, which is a series of helpful exercises for TMJ.

 

(eta: there's a good chance they'll refer you or want you to get some imaging done on your spine, IMO).

Edited August 13, 2012 by Momof3littles

[PeterPan]

Sounds like you need to go to the chiropractor.

[Little Nyssa]

I have a very good PT who helps with this! I also have a nightguard for both upper and lower teeth, not because it helps me stop clenching, but to protect my teeth from damage. They did get a few chips until I started this treatment.

[Lolly]

I had a specially made nightguard. My clenching had been so bad that it took a couple of weeks for the pain and headaches to go away. Then, I was fine for quite a while. Stopped using the guard. In times of stress it comes back, and I have to use the night guard again. Only...I lost it. I got the el cheapo from the corner store. It worked just as well as the one made for me. I wasn't in as bad shape, so it worked faster. Keep up with the one you have and see if it doesn't help. I'd give it a week at least.

[Paige]

Did you get meds? I had a lot of problems about 2yrs ago and the Dr had me take muscle relaxers at night for a while. After about 4 months, I didn't need them every night anymore. I also saw my dentist. He recommended some sort of tooth alignment thing. I forgot what it was called, but he used some sort of machine and evened out the surface of my teeth so when I closed my jaw, they fit together like they should. It helped too. Now, I rarely have pain. My jaw used to lock up and pop all the time. I think it started when I had kids and my joints relaxed. It always got worse after birth, but wasn't so bad with my younger kids.

[Changed]

I used to work with a PT, and if the pain is as bad as you say I'd find one. Its kind of like a chiro for your mouth.

 

Also, I second the cheap night guard.

[ThreeBlessings]

Thanks everyone. I have been wearing the night guard and doing exercises for my back and jaw every day. It isn't as painful as it was a couple of weeks ago, so that is good.

 

I'm not sure how a PT works? Is this usually paid out of pocket or by insurance? I have really crappy insurance that will run out in a few months and I won't likely have insurance after that. Would my doctor have to refer me? She seemed to think this wasn't a big deal and was quite optimistic it would go away just using the night guard.

[Momof3littles]

If you are having tingling and pain down into your hands, I think you should get a thorough eval. I don't think it should be chalked up to the TMJ. It might be related (back issues causing the TMJ), but it might not. Many PCPs don't know much about musculoskeletal stuff beyond the basics. They have to know a huge, broad amount of information, but it isn't uncommon for them to misdiagnose certain issues that PTs handle. I would get a thorough eval so you know what you are dealing with.

 

Physical therapy is often covered by insurance. In some states you can see a PT directly without seeing your PCP first, but your insurance may still require you to get a referral. I would read your plan or call and ask whether you have any coverage for physical therapy.

 

If you don't have coverage, you may be able to find someone who will get you started by seeing you a few times a week, and then decrease to once every week or two weeks or an even longer interval once they have you set up on a home program. Just be honest with them about what you can afford and depending on what diagnosis/diagnoses, they may be able to tell you how many treatments they would anticipate needing, or whether they could spread your visits out and have you do more as part of a home program vs. being in therapy 3x a week.

 

If you can find a PT who is an OCS, that may be a good option. THat's an additional clinical designation. Many wonderful PTs do not have that designation, but going to someone who does can help you find someone very good more easily. Just an idea. Again, if there isn't anyone with that designation in your area, you can still find a great PT; I'm just trying to narrow the pool for your more quickly.

 

http://www.abpts.org/apta/directories/abpts.aspx?navid=10737423513

 

Plug in orthopedic and then your zip, etc.

Edited August 15, 2012 by Momof3littles