Tuesday, February 1, 2011

Temperomandibular joint syndrome (TMJ)

Chiropractic Monthly - February 2011

Just a note before we begin...

Welcome to another edition of our newsletter. This month we're going to talk about an odd pain in the jaw. What better way to do that than to relate a patient's story for your consideration.

Here's George's story, a 30 year old came in complaining of pain in the back of his head. He explained it was a dull pain but constant, day and night. George also mentioned getting a sudden sensation that he was spinning or that the inside of his head was spinning. This condition is also known as positional vertigo.

Notice that he didn't mention jaw symptoms per se, but the jaw was definitely involved with all the other symptoms. He had prior Chiropractic and Physical Therapy care he even received cortisone shots which gave no relief.

The patient's vertigo, neck and shoulder tension were relieved quickly but the jaw symptoms took longer to improve. It turns out that his father was horsing around swinging a branch and accidentally hit him in the right side of the jaw! This was when he was only 7 years old. We knew this wasn't a recent problem but an old injury that the patient had completely forgotten about.

This came to light as a result of our pre- treatment history questions. We see this quite often. Explaining this to the patient helps them understand when symptoms don't resolve as quickly as they'd like.

We look forward to seeing you through 2011 to help you have your best health ever.

Yours in Health,

Dr. N

Does This Sound Familiar?

Temperomandibular joint syndrome (TMJ) or jaw pain is much more common than you might think and it can have far-reaching effects. Most people don't associate their chiropractor with this type of problem. They relate jaw pain to tooth pain and indeed T.M.J. can cause tooth pain thus off to the dentist they go. Not a bad place to start to rule out a cavity or gum disease with an exam and an X-ray, but when the dentist says, "your teeth are fine, there is nothing wrong with them", what do you do? The dentist might recommend a dental appliance or splint since their main focus is to protect the teeth from cracking. Unfortunately all too often the pain remains.

Visually, at first sight you may not notice anything different about a person who has this condition but, if you press firmly into the jaw muscles right below the cheek bones, one often finds spasm and pain on one or both sides. Pressure in the temple area may also be painful. Most people don't know that the temple muscle is a chewing muscle! Other signs include the jaw moving from side to side on opening instead of moving straight down or a limitation of movement. In general you should be able to put three fingers side to side into your mouth. Go ahead give it a try, see if you can do it.

As far as history we have many patients who, for example, fell off a deck and hit their jaw on the way down or fell at the park and hit their jaw on a bench on the way down. They might remember as a child, fighting with siblings, someone gets hit in the jaw by accident. Playing sports can also lead to unintentional accidents like being hit with a baseball bat or ball. Even gum chewers are at risk! The constant mastication can fatigue the muscles. We have seen all these conditions and the interesting thing is that often the symptoms don't come up right away and so often the cause is forgotten.

Over time the symptoms slowly develop and possibly years later patients will come to 3D Chiro for other health problems and we find they have symptoms related to T.M.J. through the course of our treatment. As we said before, most people don't think about a chiropractic solution for what they believe to be a "dental" problem.

Using the 3D chiropractic principles we analyze the whole system from front to back, side to side and top to bottom. Once we have taken a detailed history we often find there has been trauma to the jaw from a fall or from being hit in the jaw from various accidents or during sports. Naturally we evaluate the patient's stress level and how they handle stress.

Our philosophy in 3D chiropractic is that many chronic problems in the body stem from dysfunctional habits that we developed growing up in a stressful environment. Do you, the patient tend to externalize or internalize your emotions? On a scale of 1 to 10 what is your stress level, considering work and personal issues, do you feel you are over extending yourself? Is the stress constant or intermittent?

People who are at 8+ or higher stress level on a routine basis over the past six months to a year and who internalize their emotions are on a collision course with health issues that could vary from mild to severe.

Once we diagnose the problem most T.M.J. issues can be successfully treated in a very short time.

We treat the spasms, re-align the jaw and adjust spine related issues. We also teach you how to use Pressure-Plus-Motion (PPM) techniques to relieve muscle tension. This is part of a PPM workshop that 3D Chiro periodically offers to its patients. The PPM techniques we teach you can be used at home and work to lessen the pain and discomfort of T.M.J.

Remember, our goal is not to develop dependence on 3D Chiro, but to help you to help yourself!

Yours in good health,

Dr. Al Nunez, DC

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