I got TMJ-like symptoms from neck and shoulder pain!

[bbsadmin]

I thought I'd post my recent tale of woe, in case it helps others.

As you all may know, I (the owner of this site) had braces for 3 years. They've been off for about 5 years. I have NEVER had any TMJ-type problems in my entire life until recently.

My neck and shoulders started aching, and the problem became chronic. It was mainly on the left side. This has happened before, but this time it just wouldn't go away. After about 2 months of this, suddenly one day when I was eating something soft and not very chewy, I got a sharp pain at the TM joint on the left side of my face. OUCH! One more bite - YIKES, OUCH! I consciously relaxed my jaw and it went away after about 15 minutes. I forgot all about it until about a week later when it happened again. And that time, it stuck around. It got to the point where I just wasn't opening my mouth very far. I wore my Hawley retainer more often, because it prevented me from biting all the way down in my sleep. That helped. But still, the problem persisted and I was getting worried. My joint wasn't popping and my jaw wasn't locking, so I thought it must be muscular.

Then I caught a cold and it turned into a persistent cough. That didn't help.

After doing some research on the web, I found that TMJ-like symptoms can result from neck and shoulder pain and tension. This was the most logical explanation. All of that anatomy is linked, especially as far up as the jaw muscles.

More web research revealed an excellent physical therapist, right in my town, who had helped other people with TMJ problems. I made an appointment.

Well, to make a long story short, my neck and shoulders are pretty screwed up, and he is helping to fix it. After 3 sessions with him, the TMJ-type pain went away. After a couple more sessions, I forgot all about it and was concentrating more on my neck and shoulders.

To help the TMJ-type problem, he not only manipulated my neck, but put latex gloves on, reached into my mouth, and massaged all the muscles on both sides of my jaw. At first it was pretty darned painful on the left. But by the third session, it was much better.

I've never seen a physical therapist do that sort of thing inside a person's mouth! I must say, I was very impressed. And I wanted to post about it here on the board because I know that sometimes we get members who have TMJ problems.

I'm continuing to see him to help relax my neck and shoulders, particularly on the left.

I think I'm also going to continue with him to help strengthen my lower back, which has been a problem for years.

[drrick]

It's not a one way street. Clenching can cause both tm symptoms and neck and shouler pain. I personally have this issue.
Out of curiosity do you get pain behind your eyes too?

[bbsadmin]

Dr. Rick,

No, I don't get pain behind my eyes. I'm not a clencher, as far as I know. Never had any issues with that previously.

-Lynn

[drrick]

Most clenchers dont know they are clenchers (I didnt) since you do it primarily when sleeping. The reason I asked about the eyes is that many (not all) protrusive clenchers get pain behind the eyes as well as the in the neck.

[sadpanda]

I'm a clencher and I get a lot of migraines with pain behind my eyes and recently I've been having some really horrible neck pain that won't go away. I have tmj on the right side, but the neck pain is toward the left. I didn't even think about posting it on here until I discovered this post. I never considered that clenching and/or tmj could cause neck and shoulder pain. Anyway, I'm not sure what I'm asking for...maybe suggestions as to how I can relieve the pain? Thanks.

[drrick]

I have had great success(both persoanlly and with my patients) with this appliance:
http://www.nti-tss.com/

You can ask your doc if he/she makes them or you can look at the "NTI Provider" section of the site to find a doc near you.

I have no connection with the company I just like the appliance.

Many succesful pt treatments including frequent and severe migraine sufferers.

[bbsadmin]

Also, if you can find a physical therapist who is familiar with TMJ, and see them in addition to using a bite guard at night, that might help the problem!

[bbsadmin]

Here is a picture of an NTI device:

NTI.jpg

[lianas]

While it is a wonderful temporary treatment, it is a lousy long-term
treatment. Long-term use will cause two undesirable problems.
First, it will cause an anterior open bite, that is; it will cause the front teeth to separate
causing an unsightly gap. This occurs because there is a constant pressure on the front
teeth from squeezing on the device. This will depress the anterior teeth (intrude them into
the jawbone). The amount of open bite depends on how much pressure one places on the
device and how long one continues to do so. Some patients do not clench on it much so
there may not be a problem, in which case he or she probably does not need it in the first
place.
The second problem with these devices is that while the front teeth are being depressed,
the back teeth over-erupt or protrude from the alveolar bone. This makes balancing the
bite more difficult. A long treatment with a balanced bite splint may have to be used to
get things back to the patient’s normal ‘acquired’ bite before the teeth can be properly
equilibrated with selectivegrinding. www.clenchingsyndrome.com this site is easy to to read, go to books and a guide for tmj the other 2 book have a lot of information to.

[drrick]

That's one opinion (Not mine but thats ok)
This is a highly debated issue.
I am not going to get into it here. Feel free to join the debate over on the occlusion forums of dentaltown.
That is a more appropriate forum for that IMHO. (if you are a doctor of course)

[lianas]

I'm sorry I wasn't trying to offend you I was just trying to show what would happen if someone wore one every night. The book actually says its great temporary treatment. It even shows how to construct one.

As an initial treatment, use it until the
pain goes away then discontinue wearing it.

The object of the anterior splint is to keep the back teeth from touching
when sleeping. Back teeth (bicuspids and molars) cause most of the unbalanced bites that
prevent the jaw from seating correctly, that is, one side’s teeth are taller. If the back teeth
cannot touch when sleeping, the jaw’s condyles will seat correctly, simulating a balanced
jaw. (These splints can stop TMJ pain quickly making them a great temporary treatment.)

In the same way, an anterior deprogrammer reduces the remaining muscle inflammation
by stopping the relentless reduced clenching giving the body enough time to eliminate all
muscle inflammation. Once the inflammation is gone, the patient can be pain free (until a
new episode comes around). If a person has frequent episodes, avoid the medicine and
deprogrammer approach.

[drrick]

you didnt offend me, I just said this is a hugely debated topic and there is much disagreement btwn docs over this(on the verge of fist fights -- seriously) You are entitled to your opinion based on your training, knoweldge and experiences and I am entilted to mine.

The condyles will only 'seat' if they are not in the correct position to begin with. Even then it doesnt always happen for many reasons.

It is very difficult for the posterior teeth to erupt since the appliance is not worn full time.
How many pts here have anterior bite turbos and are still waitng for their posterior teeth to occlude? (and that is with the help of the niti wires) Once you remove it and are eating, swallowing, clenching, etc during the day the posterior teeth 're-submerge' if they erupted at all. This is particularly true on pts who are not dolicocephalic.

A 'perfect' bite wil not supress clenching and you can clench harder on a full guard than a segmental one.

As I said this isnt really a topic for this forum IMO, if you are a doc head on over to DT you can debate this to your hearts content.

[Amanda6]

I have TMJ dysfunction, shoulder and neck pain has been one of my many symptoms. My TMJ dysfunction developed 4 years after I had orthodontics done when I was a child. I am now having orthodontics again to help correct my TMJ dysfunction. It is believed that the orthodontics I had as a child has caused my TMJ dysfunction, as it involved having a set of 4 premolars removed, and the gaps closed with braces. This results in the upper dental arch becoming narrower, and encourages the lower jaw to move back, resulting in the condyles being positioned too far back within the TMJ, so the discs with the joint then become displaced. The orthodontics was not taking TMJ function into consideration.

I am now having Functional Orthodontics to correct my TMJ dysfunction. This involves wearing a 24/7 lower splint for the duration of the orthodontics, having my upper arch widened with an ALF appliance, to enable my lower jaw to move more forward, so that my condyles are in a better position within the TMJs, and my TMJs can function better.