Ano ay TMJ?

Ang temporomandibular joint, o madalas na tinatawag bilang TMJ, ay ang magkasanib na ng panga. Mayroon kaming dalawang temporomandibular joints na gumagana sa pagkakaisa, isa sa ang alinman sa bahagi ng panga. Ito nakuha ang pangalan nito dahil sa pilipisan buto at ang sihang that forms the joint.

Ito ay ang pinaka ginagamit na joint sa aming katawan. Ito ay may 6 pangunahing bahagi at sila ay ang mga mandibular condyles, ang kapsula, ang articular ibabaw sa pilipisan buto, ang articular disc, pag-ilid pterygoid at ang mga ligaments.

Ano ang TMJ Dysfunction?

Ang kondisyon na ito ay karaniwan at nakakaapekto sa higit sa 10 million Americans today. It is affecting the mastication muscles and the tissue components. It can be a medical or a dental condition or a collection of conditions.

Ano ang mga dahilan ?

May iba't ibang mga kadahilanan na maaaring maka-impluwensya ang pamamaga ng Temporomandibular joints tulad ng mga ngipin paggiling, isang direktang pisikal na trauma na nagiging sanhi ng disc pagkabaliw, stress, hypermobility ng ang kasukasuan, hypomobility ng ang kasukasuan, osteoarthritis, rheumatoid arthritis and many others.

Ano ang mga sintomas ?

Pananakit sa panga kalamnan at pangmukha ay isa ng mga unang sintomas ay mapapansin mo na kapag mayroon kang ang TMJ dysfunction. Ito ay maaaring kahit na sumingaw sa iyong leeg at balikat. Maaari mong pakiramdam ang sakit na ito kapag makipag-usap ka, maghikab o ngumunguya. The pain is usually felt in front of the ear or on the jaw itself.

Tainga sakit, sumakit ang ulo, Ingay sa tainga and hearing loss may also be a symptom of Temporomandibular joint dysfunction. Ito ay maaaring makakuha ng nakalilito bilang ilang maaaring sa tingin nila isang impeksyon sa tainga o tainga problema kapag sa katunayan, the pain is radiated because of TMJ dysfunction.

Maaari mong marinig ang isang pop, ng pag-click o agatat kapag ilipat mo ang joint. Ito ay sanhi ng isang abnormal na posisyon ng disc. Others may also hear the popping sound.

Swelling of the mouth or the face can also occur due to inflammation.

Lock jaw whether opened or closed is also a common symptom of TMJ dysfunction.

Hindi maaaring ihanay ang mga ngipin ng maayos at hindi na ugnayan ng kagat mo sa pagkain. Teeth can also start to loosen or get broken or become sensitive.

Swallowing may become difficult because the muscles on the jaw area start to spasm.

You may feel nauseated or have a headache or dizziness.

How is TMJ Dysfunction diagnosed?

A health professional can properly diagnose a dysfunction by beginning with a thorough evaluation of the patient’s medical history. After which the health professional would make a physical examination on the patient to identify the disorder.

Isang programa ng paggamot ay tinukoy sa pamamagitan ng kalusugan ng propesyonal ayon sa ang kalubhaan ng kaguluhan. Mga programa Paggamot ay maaaring magsama ng pamumuhay pagbabago, mga pamamaraan para sa sarili pagpapahinga, proper education regarding Temporomandibular joint dysfunction, pagpapanumbalik ng mga hanay ng paggalaw ng panga, pagpapakilos ng soft tissue, joint mobilizations, palakasin ang loob pagpapasigla, pagbabagong-tatag, at iba pa

Ang programa ng paggamot ay isang per-pasyente na batayan. Kaya, na maaaring mayroon ka ng ibang programa ng paggamot kumpara sa isa pang pasyente na rin ang paghihirap mula sa TMJ dysfunction. Bahagi 2 is going to be about specific treaments options for this debilitating codition.

Tanong: Have you or anyone you know had a TMJ Dysfunction ? Anong uri ng mga otions ng paggamot na mayroon kang?

Home paggamot para sa TMJ Dysfunction

Maaari mong gawin ang sarili-aalaga na paggamot sa tahanan para sa TMJ dysfunction. Madalas, the Temporomandibular joint dysfunction does not develop into a full disorder and the symptoms would disappear after it is able to recover and have enough rest.

Pananakit gamot tulad ng aspirin, ibuprofen o acetaminophen Maaari kadalian ng sakit ang pinagdudusahan dahil sa TMJ dysfunction. Dahil ang sapa ay maaaring masyadong masakit para sa sufferers ng TMJ dysfunction, it is advised to eat soft foods during this time. Apply ice packs on the injured area when the injury is still present. Rest your jaw as this could help in healing your TMJ.

Warm compress application is also advised to be put on the area where you feel pain. 20 minuto pagkatapos nag-aaplay ng mainit-init masiksik, maaari mong subukan ang home therapy pagsasanay tulad ng pagbubukas at pagsasara ng panga na ang paglipat mula sa gilid sa bahagi. Ulitin ito hanggang sa 5 beses sa isang araw sa limang minuto bawat session para sa 2 sa 4 linggo. Make sure you don’t open your mouth wide while doing this exercise.

Medikal na paggamot para sa TMJ Dysfunction

Konserbatibo medikal na paggamot ay maaari ring kailangan. Doktor na maaaring hilingin sa iyo upang maisagawa ang magiliw na lumalawak para sa mga kalamnan sa iyong panga. He or She may also require you to perform relaxation exercises. Stress can be a factor that will affect TMJ treatment thus stress-reduction techniques that manages the stress will help the patient relax his or her jaw alongside with the rest of his or her body.

Isang kagat plate o magsuot ng palapa ay maaari ding gamitin. Ito ay tulad ng isang bibig bantay na makakatulong sa pagbabawas ng ngipin paggiling o clenching lalo na kapag ang pasyente sleeps sa gabi. Ito rin ang kadalian ng kalamnan igting sa panga. Gayunman, Kung ang gamit ng magsuot ng palapa ay taasan ang sakit, the patient must stop using it.

Kung konserbatibo paggamot ay hindi gagana, a doctor may require you to go a step further and consider some of the invasive techniques to treat TMJ dysfunction.

Cortisone iniksyon ay maaaring maging lubos na helpful sa relieving ang sakit at pamamaga ng panga. Another procedure that would help in relieving the pain quickly is done at the doctor’s office and under local anesthetics. The doctor would insert 2 karayom ​​sa iyong TMJ para sa paghuhugas. Isa ng ang karayom ​​ay konektado sa isang hiringgilya na may hugas solusyon at labasan sa pamamagitan ng iba pang hiringgilya. Kung minsan, bukod sa mga hugas mga ahente, the doctor may also inject pain medication this way as well.

Kung ang mga hindi pa rin magtrabaho para sa mga pasyente, pagtitistis ay maaaring kinakailangan kahit na ito ay isinasaalang-alang bilang ang huling pagpipilian. Artipisyal implants ay maaaring gamitin bilang isang kapalit na ang joints ng panga. This is an irreversible method and must be avoided if other options are still available.

Chiropractic paggamot para sa TMJ Dysfunction

Ito ay isang protocol na namin gamitin sa aming opisina: Electrical stimulation ay ginagamit para sa 15 minuto sa effected bahagi. Deep tissue massage ng masseter kalamnan bilaterally. Using rubber gloves on one hand perform a deep tissue massage of internal pag-ilid pterigoid kalamnan (masakit ngunit lubhang kapaki-pakinabang at mabisang pamamaraan). 5 minuto ng Erchonia Cold Laser PL 5000 sa masakit na bahagi ng isang TMJ. Upper cervical chiropractic adjustment.

Tandaan na ang karamihan ng mga kaso ng TMJ dysfunction ay hindi maaaring cured na ito ay madalas isang paikot disorder. Modifications in lifestyle and proper treatment could improve the patient’s life without any limitation in function or pain.

Questiom: Was impormasyon ito nakatulong sa iyo? What kind of therapy have you had for your TMJ Dysfunction?

Ang blog na ito post ay batay sa pamamagitan ng ugnayan sa isang AskDrBurt Tanong Blog. Ito ay isang tunay na kaso, tunay na mga pasyente na naghahanap para sa isang solusyon sa kanyang hindi nagtatapos sakit. Ito ay isang mahabang post at kung ikaw ay isang health practitioner aalaga atubili na idagdag ang inyong propesyonal na pagpapayo sa lugar na comment. Kung ikaw ay isang mambabasa, at mayroon din sa kalusugan kaugnay na problema nang walang solusyon mula sa iyong kasalukuyang medikal practitioner mangyaring makipag-ugnay sa akin sa pamamagitan ng AskDrBurt isang Tanong?

Salamat para sa mga tunay maigsi at nakapagtuturo blog Dr. Burt! I would like to ask for advice on presenting my symptoms to health care providers. I have been suffering TMJ sintomas para sa hindi bababa sa dalawang dekada kung hindi mas, but none of my health care providers wanted to consider TMJ disorder as a cause. Instead they seem to dismiss the idea and only treat symptoms when they’ve become severe and pretty blatantly obvious. Background/History:

1. Nagkaroon ng isang mahulog sa edad na 10 (Kukunin ko ang 40 sa taong ito) that fractured/dislocated my jaw. No treatment at the time, as it appeared the injury would self heal and any manipulation might affect growth. Since that fall my jaw has always locked, binusa,and grinded. It is also very small and my lower teeth have always been crowded.

2. Had ‘braces’ mula sa edad 12-14, doc tila na itulak ang aking mga mas mababang panga likod kapag angkop sa isang kagat ng posisyon para sa akin, and it was always uncomfortable. My lower teeth are extremely crowded and within 2 buwan pagkatapos ng pag-alis ng mga tirante / abay ilang ng ang ngipin inilipat pabalik muli dahil sa paggitgit, affecting any hope of a normal bite.

3. Mayroon makabuluhang Ingay sa tainga and frequent unexplained ear aches and jaw pains for years. Was told in early 2000′s that I grind my teeth very loudly at night.

4. Sa 2005 I cracked a 2nd to back/upper molar by night grinding. Began wearing a ‘boil and bite’ bibig bantay’ (hindi may dental insurance, ay hindi unahin o hindi maaaring kayang bayaran ng isang pasadyang bantay).

5. Sa 2006, Basag ko ng isang mas mababang 2nd/back bagang, and had to have it crowned. Still wearing a mouth guard, I cracked both the temp crown and the permanent crown through night grinding.

6. Bought a tempurpedic matress topper and tempurpedic cervical pillow in hopes the highly recommended product/brand would alleviate some of the grinding. It has helped and improved sleep quality too!

6. Matapos na karanasan, Ako nagbigay up kapeina, tumigil sa anumang gum nginunguyang (hindi kailanman ay magkano ito papaanuman), nagsimula pagkain organics, regular na yoga at masahe, at sa pagitan 06 at kasalukuyan consulted sa isang therapist ng pamilya para sa trabaho stresses as needed. I do regular cervical stretches (na ibinigay sa pamamagitan ng pisikal na therapist) get massages and do TMJ self-massages. Life is very low stress right now (nakuha ang aking mga Masters sa 2010 at ito ang aking lamang utang, Yehey!) ngunit ang aking mga sintomas ay patuloy na lumubha, which is pretty stressful as now I’m in constant pain. I am very fit and active, but very gentle on my neck/head with any activities. Unfortunately I’ve had to eliminate all but gentle stretching over the last 6 months due to neck/jaw/upper trap muscle spasms.

7. Sa 2008, pagkatapos ng paghihirap sakit, nasusunog at pamamanhid sa aking mukha, leeg, balikat, arm at kamay, sa pagkawala ng pinong kasanayan ng motor sa aking mga kamay / daliri, I was diagnosed with a completely dessicated C-6/7 and a nerve-compressing herniation at 5/6. Orthopod performed dual discectomy and fusion with plate and screws. He informed me my pain tolerance was very high and I should be cautious of anything ‘uncomfortable’ vs. letting things become painful before seeking medical care. He tried Flexeril (at pagkatapos Amrix), Mobic, at Vicodin bilang kinakailangan para sa 3 months before surgery. I asked if I would participate in physical therapy after surgery, but he said no the surgery should fix everything. There was no trauma, walang aksidente, no specific injury that lead to this situation. Doc even diagnosed ‘undetermined’ for the cause. Seems a bit unusual to do that much damage and not want to find or diagnose a cause?!?

8. Tungkol sa 6 buwan mamaya ako nagsimulang pagpuna ang pagbabalik ng hypertonacity sa aking SCM, levators,Palabas, at rhomboids. Last summer I gave up working out all together (iba kaysa stretches), aking doktor ilagay sa akin sa flexeril, na kung saan ay napakaliit para sa 6 buwan. In December she sent me to physical therapy (malubhang pagkawala ng hanay ng mga galaw sa gilid sa mga bahagi na paggalaw ng leeg, at malubhang pagkawala ng motor gumagana sa aking mga kamay na may bagong nasusunog / pamamanhid). PT performed chiropractic manipulations from the thoracic region up to my c-spine, ng kaunting (siguro 2-3 minuto max) halaga ng pagmamanipula ng kalamnan (lugar ng direkta sa alinman sa bahagi ng aking mga gulugod, thoracic up sa c-gulugod), at traksyon 3x sa isang linggo para sa 6 linggo. He also gave me some shoulder stabilizing exercises which did provide great and quick relief to a quickly rounding posture. I continue those at home. The PT provided temporary relief of the symptoms in my hands/arms but the neck/jaw/upper back symptoms remained, at anumang mga linggo na na ako ay hindi upang makakuha ng

lahat 3 sesyon (Pasko at Bagong Taon sa opisina sarado), aking mga sintomas ay dumating bumalik sa loob 3-4 araw. 2 linggo pagkatapos ng dulo ng PT, I was back to my original limitations and pain.

Huling linggo ang aking pangunahing ay nagpadala sa akin para sa X-ray (TMJ tiyak) and a new C-spine MRI. She also ordered a TMJ specific MRI but that has not yet been scheduled. Waiting for the doc to call for my follow up post radiologist report. A good friend of mine is a radiologist in CA, kaya ipinadala ko sa kanya ng isang kopya ng aking mga pelikula, at anecdotally (bilang isang kaibigan at ako mapagtanto na hindi ito ang itinuturing na ang pinakamahusay na kasanayan) he noted what appears to be a significant herniation at C-3/4 on the MRI. The x-rays were not of very good quality and he suggested I may need new films, ngunit siya sinabi na ito ay malinaw na ang aking disc ay hindi na makikilala sa joints TMJ, may makabuluhang condyle (SP) degredation and evidence of adhesions.

Sa karagdagan, Ako ay ginagamot sa parehong opisina ng dentista sa pamamagitan ng 2 dentista dahil 2008 at palaging itinatanong tungkol sa mga isyu ng aking panga, and noted that the only way the dentist could even work on my back teeth was for me to manually dislocate my jaw to open it wide enough. My dentist has been replacing amalgam fillings with composite to ensure better strength of those teeth that formed cavities in my childhood (havent’ nagkaroon ng lukab dahil 1982). At one point, ang aking orihinal na dentista nakasaad gusto siya sa akin upang makita ang isang maxillo pangmukha siruhano bago makumpleto ang aking trabaho, ang huling na kung saan ay upang palitan ang korona ko nawasak sa 06 (oo, I dealt with the searing sensitivity of a ‘nub’ para sa 5 taon ... Maaari ko bang tiisin ang isang makabuluhang halaga sa sakit, at laging ako ay napaka-partikular na sa aking pangangalaga sa ngipin). She left the practice before finishing the work, and my new dentist avoided the subject on several occasions when I mentioned the referral. He said ‘we don’t refer unless things are bad’…na kung saan ipaalam ko siya kung ang aking kasaysayan ng mga sintomas, sarili paggamot, and injury from ‘unknown cause’. His reaction ‘yeah, a na AY ng uri ng masamang”. End of discussion. He encouraged me to have the last crown placed, sa kabila ng aking mga voicing alalahanin na ito ay taasan ang TMJ paggiling, but he said it wouldn’t be a problem if he gave the crown a low profile. He was absolutely wrong. I have had to go back for 2 sesyon ng dental na trabaho na kung saan ang mga ibabaw ng korona ay lowered, at mga ang dalawang ngipin na pumapalibot sa korona, and one on the top jaw have also needed reduced as they are not under greater pressure with the new crown placement.

Ang tanging pagbabago sa 30 taon ay gabi ang bruxism. The rest of my spine is happy and healthy, at sintomas ay progressively radiated mula sa lugar ng TMJ down aking ulo, neck and arms.

Humihingi ako ng paumanhin para sa mini-nobelang, and if you can give any guidance I will be extremely grateful. I’m at the end of my wits as to why practitioners continually ignored that something was at the root of my symptoms as the symptoms have been significant. I now am wondering what can possibly be done if 3/4 ay malubhang herniated bilang Mayroon na akong 3 vertabra fused sa aking C gulugod?!? I don’t want to become disabled or severely limited, and if that’s the case I’m beyond frustrated that none of my practitioners ‘stepped up’ to give this proper attention. Any suggestion made by a practitioner has been followed to a T, but those have been rare. As of late, Sinimulan ko nakakakita ng isang bagong pangunahing at siya ay masyadong interesado sa pagtulong sa akin dumating sa root ng aking mga sintomas, thank goodness.

Pakiramdam ko ako nakapagsasalita (pinagsisisihan, Alam ko maligoy magkasya ang tala na ito pati na rin) matalino, pasyente, motivated, masyadong malusog, aktibo, -kamalayan sa sarili, maiwasan ang mga gamot ang anuman at lahat ng maliban kung kinakailangan, at hanapin ang preventative pangangalaga (tulad ng mga pampalusog pamumuhay, stress pagbabawas, masahe, kayropraktik, atbp) to be the best way to lead a healthy life.

Kaya, paano ko ibahagi ang succinctly sa mga propesyonal na bilang namin pumunta forward sa ang proseso ng discovering isang dahilan at sana paghahanap ng mga solusyon para sa dahilan ng vs. remedying damaging and continual symptoms? I don’t want to sound whiny or self-involved, ngunit pagkatapos 30 taon na ito, at hindi bababa sa 10 taon ng kamay sa ibang tao o ilang iba pang mga practitioner….lamang upang gamitin ang kanilang bawat mapagkukunan at mayroon pa ring mga isyu (kumusta, TMJ disorder sinuman?) Ko na nanirahan sa pamamagitan ng higit pang sakit, limitation and frustration than a person should expect in this day and age with our advanced medical system.

Thank you so very much for your time. I appreciate any advice. Confidentiality and discretion is also appreciated

Dr. Burt ang Sagot:

May ang iyong mensahe sa pamamagitan ng AskDrBurt ng isang katanungan. Long history ng mga problema na ay iwasan, pinansin o misdiagnosed sa nakalipas na. Ang aking pangunahing alalahanin ay ang pagtitistis na ginanap sa iyong servikal gulugod. Post kirurhiko pagbuo peklat tissue ay ang pangunahing sanhi ng labis na sakit sa iyong servikal gulugod. Walang mga Post kirurhiko pagbabagong-tatag ay ginanap, tulad ng pisikal na therapy. Hindi ko maintindihan kung paano dumating ang iyong siruhano sinabi:”Ang pagtitistis ay ayusin ang problema.” WOW. Limited ROM ay paggawa ng mga bagay kahit na mas masahol pa sa iyong leeg. Intervertebral discs ihinto ang pagkuha ng kanilang nutrisyon sa sandaling ang dalawang katabi vertebraes ihinto ang paglipat – proseso na tinatawag na imbibition. Solusyon – buhay mahaba manual servikal pagkataranta at pagpapanatili ng anumang kaliwa ng isang servikal lordosis. Mayroon akong ilang mga produkto sa aking blog na nais ng isang mahusay na makikinabang sa iyo. If you are interested I could send you direct links and you can evaluate them.

TMJ – TMJ ay masyadong malapit na nauugnay sa isang servikal gulugod. Mayroon ng isang malapit na neurological ugnayan sa pagitan ng TMJ at servikal makagulugod Joints. Ang katanungan Ang ay – ang iyong panga bahaw maayos pagkatapos ito ay bali? Kung oo, pagkatapos ay doon pa rin ang ilang-asa sa Inaayos ng espesyal na cranial trabaho (Maglalasing. pamamaraan – Sacro ng kukote diskarteng) Ito ay napakahirap para sa akin upang magbigay ng higit pang mga rekumendasyon bilang Gusto ko talagang kailangan upang makita ang, suriin, suriin at gumawa ng aking sariling pagsusuri sa mga lugar ng alalahanin. Mga doktor ng Chiropractic tumingin sa kalusugan ng kaugnay na mga problema mula sa pagsasagawa ng punto ng tingnan at hindi sintomas punto ng tingnan. Hanapin ang dahilan at ang problema ay maaayos. Huwag mag-atubiling hilingin sa anumang karagdagang mga katanungan. Marahil sa pamamagitan ng pagtulong sa upang mahanap ang tamang solusyon sa iyong problema ay pagpunta sa ay ang unang hakbang, second would be to find the proper health care practitioners.

PS: Gusto mo ba ako sa post ang iyong kasaysayan ng kalusugan at ang mga problema na nagkaroon ka sa nakaraang doktor sa aking blog? can keep your name confidential if you like, kaya walang ay makilala kung sino ka. This will open a door to many other health care providers reading your story and possibly commenting and adding valuable advice to your health related problem.

Makipag-usap sa iyo mamaya

Reader ng Tugon:

A, salamat sa iyo kaya magkano ang para sa iyong prompt tugon! I couldn’t agree more with your statement that fixing the cause usually resolves the symptoms, and that is my main mission now.

Sa kasamaang-palad, the jaw was never re-evaluated after the initial fracture/dislocation at age 10. If I had to estimate, Gusto ko sabihin sa 'hindi' bilang na tiyak kapag ang pop, naisasara, grinding sounds upon movement began.

Isinasaalang-alang ko lang ang axis, atlas, 3 at 4 discs kaliwa sa aking c-tinik (hindi ba ang nakuha ko anatomya wastong makikilala na may mga term na iyon) I have always done as much to keep range of motion functional post surgery. 2×3 beses sa isang araw gamitin ako ng init pack (tuyo kanin na balot sa pranela) lumalawak sa ilalim ng mainit-init shower, at PT binuo servikal stretches (Din ako gumamit ng isang strap ng lumalawak, theracane, pro-kahabaan para sa mga binti at mini-matigas na tennis ball sa roll ang bola ng aking mga paa, at isang bula pison para sa release ng myofascia), at ngayon gastusin ang karamihan ng aking oras sa mesa ng isang nakatayo, bilang lamang nakatayo at flat tinatamad pagtula down ay hindi maging sanhi ng makabuluhang sakit / pamamanhid ... kung ito ay makakatulong sa, at ito ay hindi kirurhiko o gamot, I’m willing to try it. Please do send me links to the products you mentioned and I will determine if they are within my budget. Unfortunately I’ve not been able to work much due to the pain and the limited amount of time I can spend seated during travel, he!

Isa pang alalahanin .... Ang dapat kong maging maingat ng x-ray kamakailan-lamang na kinuha ... bilang ang tech ay ako kasinungalingan sa isang makiling posisyon at inilagay ang aking ulo sa kung ano ang tulad ng isang bahagyang hilig na plataporma sa x-ray table? How could joint position possibly be properly evaluated since I have a hard time with ROM on rotation, at ang presyon ng point natapos pakanan SA ang TMJ lugar? Tech had to take 5 pagtatangka sa kaliwang bahagi, 8 on the right. In addition the MRI tech decided against the deliberately ordered contrast for the MRI, and there appears to be a black blurred area around my fusion and above due to the titanium. I would certainly have traveled to a larger metropolitan area if I had the funds available, but as an entrepreneur I’m without health insurance at present. I KNOW things will get better, I KNOW this will pass.

I suppose it can’t be too terribly invasive to post my information after removing identity…please feel free to edit anything as you see fit if it will make it more relevant to other practitioners.

I understand you cannot evaluate beyond the anecdotal information but I cannot tell you how absolutely grateful I am for your consideration and suggestions.

Muli, salamat sa iyo mula sa ilalim ng aking puso para sa iyong reply, suggestions and care. If there is anything I can do to promote your business, ang iyong blog (sa pamamagitan ng aking blog) or your products please do not hesitate to share that process with me. I will oblige and remain extremely grateful.

Naka-attach ang x-ray na kinuha ng ilang linggo pagkatapos ng pagsasanib 09 Hunyo 2008. What lordosis, ay!?! Sorry that IS humor albeit sarcasm…if we can’t laugh at ourselves…… ;0)

Very mapasalamat,

Reader wished to keep his identity anonymous.

Dr. Burt ang Sagot:

Hello muli,

Sumasang-ayon ako sa iyo 100% na ang iyong X-Ray tech lamang radiated sa iyo para sa walang. Gulugod ay isang tindig ng istraktura ng timbang at tumugon sa mga stresses ng timbang tindig. Maaari mong makita ang mas mahusay na kung ano ang pagpunta sa ang gulugod kapag shoot ka ng X-ray sa posisyon ng isang nakatayo. Full gulugod ng X-ray ay isang optimal kung maaari. Mas mababa likod problema ay may kaugnayan sa iyong mga problema sa leeg. Tuwing solong subluxation at curve sa isang servikal, thoracic at panlikod tinik ay dapat ay dadalhin sa pagsasaalang-alang upang makamit ang pinakamahusay na mga resulta na posible. Hindi ko ilantad ang aking sarili ng isang pangalawang pagkakataon sa isang karagdagang dosis ng radiation sa puntong ito at oras. Ay pa rin ng isang maliit na presensya ng servikal lordosis kung saan ay isang positibong mag-sign. May ay wala na maaaring gawin sa puntong ito at oras sa iyong mas mababa servikal gulugod. Paumanhin sabihin, ngunit masyadong maraming pinsala ay tapos na sa pamamagitan ng iyong ortopedik siruhano. Ang layunin sa puntong ito ay upang panatilihin ang mga vertebraes at IVD (Intervertebral discs) mula sa degenerating malayo. Kung gusto ko sa iyo Gusto ko makakuha ng dalawang produkto na ito: #1. Bodyline BDL127 Ang Neck Decompressor at #2 Asta Pro Corp. POS107 Deluxe Full Spine Posture Pump Model 4100

Neck Decompressor ay panatilihing iyong IVD malusog at pumustura bomba ay makakatulong upang mapanatili ang servikal at panlikod na lordosis upang. I use these products on myself and the members of family.

Kapag ang blog post ay live na maaari mong ipagpatuloy ang-uusap pamamagitan ng DISQUS, thus many other doctors can add value to your condition.

PS: Kung ikaw ay isang practitioner ng pangangalaga ng kalusugan at nakuha sa dulo ng post na ito ng blog huwag mag-atubiling magdagdag ng anumang mga rekomendasyon para sa pasyente. Thank you.

What is TMJ?

The temporomandibular joint, or often called as TMJ, is the joint of the jaw. We have two temporomandibular joints that work in unison, one on the either side of the jaw. It got its name because of the temporal bone and the mandible that forms the joint.

It is the most used joint in our body. It has 6 main components and they are the mandibular condyles, the capsule, the articular surface to the temporal bone, the articular disc, lateral pterygoid and the ligaments.

What is TMJ Dysfunction?

This condition is common and affects over 10 million Americans today. It is affecting the  mastication muscles and the tissue components.  It can be a medical or a dental condition or a collection of conditions.

What are the causes ?

There are different factors that can influence the inflammation of the Temporomandibular joints such as teeth grinding, a direct physical trauma that causes disc derangement, stress, hypermobility of the joint, hypomobility of the joint, osteoarthritis, rheumatoid arthritis and many others.

What are the symptoms ?

Pain on the jaw and facial muscles is one of the first symptoms you would notice when you have TMJ dysfunction. It may even radiate to your neck and shoulders. You may feel this pain when you talk, yawn or chew. The pain is usually felt in front of the ear or on the jaw itself.

Ear pain, headaches, tinnitus and hearing loss may also be a symptom of  Temporomandibular joint dysfunction. This can get confusing as some might think they have an ear infection or ear problem when in fact, the pain is radiated because of TMJ dysfunction.

You may hear a popping, clicking or grating sound when you move the joint. This is caused by an abnormal position of the disc. Others may also hear the popping sound.

Swelling of the mouth or the face can also occur due to inflammation.

Lock jaw whether opened or closed is also a common symptom of TMJ dysfunction.

Teeth may not align properly and no longer touch as you bite on food. Teeth can also start to loosen or get broken or become sensitive.

Swallowing may become difficult because the muscles on the jaw area start to spasm.

You may feel nauseated or have a headache or dizziness.

How is TMJ Dysfunction diagnosed?

A health professional can properly diagnose a dysfunction by beginning with a thorough evaluation of the patient’s medical history. After which the health professional would make a physical examination on the patient to identify the disorder.

A treatment program would then be specified by the health professional according to the severity of the disorder. Treatment programs may include lifestyle modification, techniques for self relaxation, proper education regarding Temporomandibular joint dysfunction, restoration of the jaw’s range of motion, mobilization of the soft tissue, joint mobilizations, nerve stimulation, rehabilitation, etc.

The treatment program would be a per-patient basis. Thus, you may have a different treatment program compared to another patient who is also suffering from TMJ dysfunction. Part 2 is going to be about specific treaments options for this debilitating codition.

Question: Have you or anyone you know had a TMJ Dysfunction ? What kind of treatment otions have you had?

Home Treatments for TMJ Dysfunction

You can perform self-care treatments at home for TMJ dysfunction. Most often, the Temporomandibular joint dysfunction does not develop into a full disorder and the symptoms would disappear after it is able to recover and have enough rest.

Pain medications such as aspirin, ibuprofen or acetaminophen can ease the pain suffered due to TMJ dysfunction. Since chewing can be quite painful for sufferers of TMJ dysfunction, it is advised to eat soft foods during this time.  Apply ice packs on the injured area when the injury is still present. Rest your jaw as this could help in healing your TMJ.

Warm compress application is also advised to be put on the area where you feel pain.  20 minutes after applying the warm compress, you can try home therapy exercises such as opening and closing of the jaw moving from side to side. Repeat this up to 5 times a day at five minutes per session for 2 to 4 weeks. Make sure you don’t open your mouth wide while doing this exercise.

Medical Treatments for TMJ Dysfunction

Conservative medical treatments may also be necessary. The doctor may ask you to perform gentle stretching for the muscles on your jaw. He or She may also require you to perform relaxation exercises.  Stress can be a factor that will affect TMJ treatment thus stress-reduction techniques that manages the stress will help the patient relax his or her jaw alongside with the rest of his or her body.

A bite plate or splint may also be used. This is like a mouth guard that will help in reducing the teeth grinding or clenching especially when the patient sleeps at night. This will also ease the muscle tension on the jaw. However, if using the splint will increase the pain, the patient must stop using it.

If conservative treatments won’t work, a doctor may require you to go a step further and consider some of the invasive techniques to treat TMJ dysfunction.

Cortisone injection can be quite helpful in relieving the pain and inflammation of the jaw. Another procedure that would help in relieving the pain quickly is done at the doctor’s office and under local anesthetics.  The doctor would insert 2 needles in your TMJ for washing. One of the needles would be connected to a syringe that has a cleansing solution and it exits through the other syringe. Sometimes, aside from cleansing agents, the doctor may also inject pain medication this way as well.

If these still won’t work for the patient, surgery may be necessary though this is already considered as the final option. Artificial implants may be used as a replacement to the jaw joints. This is an irreversible method and must be avoided if other options are still available.

Chiropractic treatment for TMJ Dysfunction

This is a protocol that we use in our office: Electrical stimulation is used for 15 minutes on effected side. Deep tissue massage of the masseter muscle bilaterally.  Using rubber gloves on one hand perform a deep tissue massage of internal lateral pterigoid muscle (very painful but very useful and effective procedure). 5 minutes of Erchonia Cold Laser PL 5000 in the painful side of a TMJ.  Upper cervical chiropractic adjustment.

Do take note that most of the cases of TMJ dysfunction cannot be cured as it is most often a cyclic disorder. Modifications in lifestyle and proper treatment could improve the patient’s life without any limitation in function or pain.

Questiom: Was this information helpful? What kind of therapy have you had for your TMJ Dysfunction?

This blog post is based via interaction on the AskDrBurt a Question Blog. This is a real case, real patient who is searching for a solution to his never ending pain. It is a very long post and if you are a health care practitioner feel free to add your professional advice in a comment area. If you are a reader, and also have health related problems without a solution from your current medical practitioner please contact me via AskDrBurt a Question?

Thanks for the very concise and informative blogs Dr. Burt!  I would like to ask for advice on presenting my symptoms to health care providers.  I have been suffering TMJ symptoms for at least two decades if not more, but none of my health care providers wanted to consider TMJ disorder as a cause.  Instead they seem to dismiss the idea and only treat symptoms when they’ve become severe and pretty blatantly obvious.  Background/History:

1. Had a fall at age 10 (I’ll be 40 this year) that fractured/dislocated my jaw.  No treatment at the time, as it appeared the injury would self heal and any manipulation might affect growth.  Since that fall my jaw has always locked, popped,and grinded.  It is also very small and my lower teeth have always been crowded.

2. Had ‘braces’ from age 12-14, doc seemed to push my lower jaw back when fitting a bite position for me, and it was always uncomfortable.  My lower teeth are extremely crowded and within 2 months after removal of braces/retainer several of the teeth moved back again due to crowding, affecting any hope of a normal bite.

3. Have had significant tinnitus and frequent unexplained ear aches and jaw pains for years.  Was told in early 2000’s that I grind my teeth very loudly at night.

4. In 2005 I cracked a 2nd to back/upper molar by night grinding.  Began wearing a ‘boil and bite’ mouth guard’ (haven’t had dental insurance, didn’t prioritize or couldn’t afford a custom guard).

5. In 2006, I cracked a lower 2nd/back molar, and had to have it crowned.  Still wearing a mouth guard, I cracked both the temp crown and the permanent crown through night grinding.

6. Bought a tempurpedic matress topper and tempurpedic cervical pillow in hopes the highly recommended product/brand would alleviate some of the grinding.  It has helped and improved sleep quality too!

6. After that experience, I gave up caffeine, stopped any gum chewing (never was much for it anyhow), began eating organics, regular yoga and massage, and between 06 and present consulted with a family therapist for work stresses as needed.  I do regular cervical stretches (provided by physical therapist) get massages and do TMJ self-massages.  Life is very low stress right now (got my masters in 2010 and it’s my only debt, woohoo!) but my symptoms continue to worsen, which is pretty stressful as now I’m in constant pain.  I am very fit and active, but very gentle on my neck/head with any activities.  Unfortunately I’ve had to eliminate all but gentle stretching over the last 6 months due to neck/jaw/upper trap muscle spasms.

7.  In 2008, after suffering pain, burning and numbness in my face, neck, shoulder, arms and hands, with loss of fine motor skills in my hands/fingers, I was diagnosed with a completely dessicated C-6/7 and a nerve-compressing herniation at 5/6.  Orthopod performed dual discectomy and fusion with plate and screws.  He informed me my pain tolerance was very high and I should be cautious of anything ‘uncomfortable’ vs. letting things become painful before seeking medical care.  He tried Flexeril (and then Amrix), Mobic, and Vicodin as needed for 3 months before surgery.  I asked if I would participate in physical therapy after surgery, but he said no the surgery should fix everything.  There was no trauma, no accident, no specific injury that lead to this situation.  Doc even diagnosed ‘undetermined’ for the cause.  Seems a bit unusual to do that much damage and not want to find or diagnose a cause?!?

8. About 6 months later I began noticing the return of the hypertonacity in my SCM, levators,UT, and rhomboids.  Last summer I gave up working out all together (other than stretches), my doctor put me on flexeril, which did very little for 6 months.  In December she sent me to physical therapy (severe loss of range of motion in side to side neck movements, and severe loss of motor functioning in my hands with new burning/numbness).  PT performed chiropractic manipulations from the thoracic region up to my c-spine, a minimal (maybe 2-3 minutes max) amount of muscle manipulation (the area directly to either side of my spine, thoracic up to c-spine), and traction 3x a week for 6 weeks.  He also gave me some shoulder stabilizing exercises which did provide great and quick relief to a quickly rounding posture.  I continue those at home.  The PT provided temporary relief of the symptoms in my hands/arms but the neck/jaw/upper back symptoms remained, and any week that I was not able to get

all 3 sessions (Christmas and New Years the office closed), my symptoms came back within 3-4 days.  2 weeks after the end of PT, I was back to my original limitations and pain.

Last week my primary sent me for X-ray (TMJ specific) and a new C-spine MRI.  She also ordered a TMJ specific MRI but that has not yet been scheduled.  Waiting for the doc to call for my follow up post radiologist report.  A good friend of mine is a radiologist in CA, so I sent him a copy of my films, and anecdotally (as a friend and I realize it’s not considered the best practice) he noted what appears to be a significant herniation at C-3/4 on the MRI.  The x-rays were not of very good quality and he suggested I may need new films, but he said it was clear that my disc is no longer recognizable in the TMJ joints, there is significant condyle (sp) degredation and evidence of adhesions.

In addition, I have been treated at the same dentist office by 2 dentists since 2008 and have always asked about my jaw issues, and noted that the only way the dentist could even work on my back teeth was for me to manually dislocate my jaw to open it wide enough.  My dentist has been replacing amalgam fillings with composite to ensure better strength of those teeth that formed cavities in my childhood (havent’ had a cavity since 1982).  At one point, my original dentist stated she wanted me to see a maxillo facial surgeon before completing my work, the last of which was to replace the crown I destroyed in 06 (yes, I dealt with the searing sensitivity of a ‘nub’ for 5 years..I can tolerate a significant amount of pain, and I have always been VERY particular with my dental care).  She left the practice before finishing the work, and my new dentist avoided the subject on several occasions when I mentioned the referral.  He said ‘we don’t refer unless things are bad’…to which I let him know my history of symptoms, self treatment, and injury from ‘unknown cause’.  His reaction ‘yeah, wow that IS kind of bad”.  End of discussion.  He encouraged me to have the last crown placed, despite my voicing concerns that it would increase TMJ grinding, but he said it wouldn’t be a problem if he gave the crown a low profile.  He was absolutely wrong.  I have had to go back for 2 sessions of dental work where the crown surface was lowered, and the two teeth surrounding the crown, and one on the top jaw have also needed reduced as they are not under greater pressure with the new crown placement.

The only consistency in 30 years has been the night bruxism.  The rest of my spine is happy and healthy, and symptoms have progressively radiated from the TMJ area down my head, neck and arms.

I apologize for the mini-novel, and if you can give any guidance I will be extremely grateful.  I’m at the end of my wits as to why practitioners continually ignored that something was at the root of my symptoms as the symptoms have been significant.  I now am wondering what can possibly be done if 3/4 is severely herniated as I already have 3 vertabra fused in my C spine?!?  I don’t want to become disabled or severely limited, and if that’s the case I’m beyond frustrated that none of my practitioners ‘stepped up’ to give this proper attention.  Any suggestion made by a practitioner has been followed to a T, but those have been rare.  As of late, I started seeing a new primary and she is very interested in helping me come to the root of my symptoms, thank goodness.

I feel I am articulate (sorry, I know verbose fits this note as well) intelligent, patient, motivated, very healthy, active, self-aware, avoid any and all medications unless necessary, and find preventative care (such as healthful living, stress reduction, massage, chiropractic, etc) to be the best way to lead a healthy life.

So, how can I share this succinctly with practitioners as we go forward in the process of discovering a cause and hopefully finding solutions for the cause vs. remedying damaging  and continual symptoms?  I don’t want to sound whiny or self-involved, but after 30 years of this, and at least 10 years of being handed off to someone else or some other practitioner….only to utilize their every resource and still have issues (hello, TMJ disorder anyone?) I’ve lived through more pain, limitation and frustration than a person should expect in this day and age with our advanced medical system.

Thank you so very much for your time.  I appreciate any advice.  Confidentiality and discretion is also appreciated

Dr. Burt’s Answer:

Got your message via AskDrBurt a question. Long history of problems that have been avoided, ignored or misdiagnosed in the past. My main concern is the surgery that was performed on your cervical spine. Post surgical scar tissue formation is the main cause of excessive pain in your cervical spine. No Post Surgical rehabilitation was performed, such s physical therapy. I do not understand how come your surgeon said:”The surgery will fix the problem.”  WOW. Limited ROM is making things even worse in your neck. Intervertebral discs stop getting their nutrition the moment the two adjacent vertebraes stop moving – process called imbibition. Solution – life long manual cervical distraction and maintaining whatever is left of a cervical lordosis. I have couple of products on my blog that would be of a great benefit to you. If you are interested I could send you direct links and you can evaluate them.

TMJ – TMJ is very closely related to a cervical spine. There is a close neurological relationship between TMJ and Cervical Vertebral Joints. The question is – did your jaw healed properly after it was fractured? If yes, then there is still some hope in correcting by special cranial work (S.O.T. technique – Sacro Occipital Technique) It is very hard for me to provide more recommendations as I would actually need to see, examine, evaluate and make my own diagnosis with areas of concern. Doctors of Chiropractic look at the health related problems from the causation point of view and not symptoms point of view. Find the cause and the problem will be fixed. Feel free to ask any additional questions. Perhaps by helping to find the proper solution to your problem is going to be the first step, second would be to find the proper health care practitioners.

PS: Would you like me to post your health history and the problems that you had with previous doctors on my blog?  can keep your name confidential if you like, so no one will know who you are. This will open a door to many other health care providers reading your story and possibly commenting and adding valuable advice to your health related problem.

Talk to you later

Reader’s Response:

Wow, thank you so much for your prompt response!  I couldn’t agree more with your statement that fixing the cause usually resolves the symptoms, and that is my main mission now.

Unfortunately, the jaw was never re-evaluated after the initial fracture/dislocation at age 10.  If I had to estimate, I would say ‘no’ as that’s precisely when the popping, locking, grinding sounds upon movement began.

Considering I only have the axis, atlas, 3 and 4 discs left in my c-spine (not sure I got the anatomy properly identified with those terms) I have always done as much to keep range of motion functional post surgery.  2×3 times a day I use a heat pack (dry rice wrapped in flannel) stretching under warm shower, and PT generated cervical stretches (I also use a stretching strap, theracane, pro-stretch for calves and mini-tough tennis ball to roll the balls of my feet, and a foam roller for myofascia release), and now spend most of my time at a standing desk, as only standing and flat supine laying down do not cause significant pain/numbness….if it can help, and it’s not surgical or drugs, I’m willing to try it.  Please do send me links to the products you mentioned and I will determine if they are within my budget.  Unfortunately I’ve not been able to work much due to the pain and the limited amount of time I can spend seated during travel, ugh!

Another concern….should I be wary of the x-rays recently taken…as the tech had me lie in a prone position and placed my head on what was like a slightly inclined podium on the x-ray table?  How could joint position possibly be properly evaluated since I have a hard time with ROM on rotation, and the pressure point ended up right ON the TMJ area?  Tech had to take 5 attempts on the left side, 8 on the right.  In addition the MRI tech decided against the deliberately ordered contrast for the MRI, and there appears to be a black blurred area around my fusion and above due to the titanium.  I would certainly have traveled to a larger metropolitan area if I had the funds available, but as an entrepreneur I’m without health insurance at present.    I KNOW things will get better, I KNOW this will pass.

I suppose it can’t be too terribly invasive to post my information after removing identity…please feel free to edit anything as you see fit if it will make it more relevant to other practitioners.

I understand you cannot evaluate beyond the anecdotal information but I cannot tell you how absolutely grateful I am for your consideration and suggestions.

Again, thank you from the bottom of my heart for your reply, suggestions and care.  If there is anything I can do to promote your business, your blog (through my blog) or your products please do not hesitate to share that process with me.  I will oblige and remain extremely grateful.

Attached the x-ray taken a few weeks after the fusion 09 June 2008.  What lordosis, ha!?!  Sorry that IS humor albeit sarcasm…if we can’t laugh at ourselves…… ;0)

Very Gratefully,

Reader wished to keep his identity anonymous.

Dr. Burt’s Answer:

Hello again,

I agree with you 100% that your X-Ray tech just radiated you for nothing. Spine is a weight bearing structure and responds to weight bearing stresses. You could see better what is going with the spine when you shoot X-Rays in a standing position. Full spine X-Ray is an optimal if possible. Lower back problems are related to your neck problems. Every single subluxation and curve in a cervical, thoracic and lumbar spine must be taken into consideration in order to achieve the best results possible. I would not expose myself a second time to an additional dose of radiation at this point and time. The is still a small presence of cervical lordosis which is a positive sign. There is nothing that can be done at this point and time with your lower cervical spine. Sorry to say, but too much damage has been done by your orthopedic surgeon. The goal at this point is to keep the vertebraes and IVD (Intervertebral discs) from degenerating farther. If I would be you I would get these two products: #1. Bodyline BDL127 The Neck Decompressor and #2 Posture Pro Corp. POS107 Deluxe Full Spine Posture Pump Model 4100

Neck Decompressor will keep your IVD healthy and Posture Pump will help to keep cervical and lumbar lordosis in order. I use these products on myself and the members of family.

When the blog post will go live you can continue the conversation via DISQUS, thus many other doctors can add value to your condition.

PS: If you are a health care practitioner and got to the end of this blog post feel free to add any recommendations for this patient. Thank you.