Chronic Pain

Temporomandibular Joint Disorder

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The temporomandibular joint joins the lower jaw to the skull; it is located in the front of each ear. The temporomandibular joint acts as a hinge and allows the jaw to open and close and move from side to side enabling the ability to chew and talk.

Temporomandibular joint disorder causes pain in the jaw as well as the nerves and muscles surrounding the jaw. Temporomandibular joint disorder is often called TMJ, referring to the joint. TMJ is generally caused by dislocation, arthritis, jaw trauma, teeth grinding, deformities, genetics, or a combination of these. Oftentimes, the exact cause of TMJ is not established.

Symptoms of TMJ include, but are not limited to, a popping noise or sensation when the mouth is opened and/or closed; headache; pain in the jaw; difficulty moving the jaw; locking of the jaw; pain in or around the ear(s); swelling and/or tenderness in the face, neck, or shoulders; dizziness; and ringing in the ear(s). For some people, symptoms are limited to one side of the face; while for others, both sides of the face are affected. For many people, TMJ is mild; however, TMJ is debilitating for others.

If not treated properly, TMJ can get worse and can possibly lead to permanent injury. A visit with a healthcare professional for a proper diagnosis and treatment plan is important. Diagnosis can be made via X-rays, CT scans, MRIs, and physical exams. Physical exams consist of pushing on the jaw to locate the exact area of the pain, checking for swelling, listening to the jaw as it opens and closes, and observing the range of motion as the jaw is moved. A small camera inserted into a tube may also be used to look at the joint and determine a diagnosis.

Many treatment options are available for TMJ. Naproxen or ibuprofen can be taken to assist with TMJ inflammation. Alternating ice and heat may also help relieve symptoms. Eating soft foods is good for those suffering from TMJ as the jaw is allowed a rest from vigorous chewing. Other remedies consist of keeping the tongue between the teeth, wearing mouth guards to prevent teeth grinding, undergoing dental work, working with a stress therapist to assist in reducing jaw tension, and working with a speech therapist to aid in the correct movement of the jaw. Also, Corticosteroid injections into the joint can help relieve pain. If further treatment is required, a TENS unit may help. A TENS unit uses a low level of electricity at the pain site to help relieve pain by relaxing the muscles. Various surgical procedures can be performed as a last resort if all other treatment methods are unsuccessful. Arthrocentesis is a procedure that uses small needles to irrigate the joints. Modified condylotomy can correct dislocation. Open joint surgery to replace or repair the joint can also be performed; however, it contains risks, and all other treatment options should be considered before making a decision about surgery.

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