"You don't
have to live with headache pain." (Middlesex County
Healthcare Professionals), Ira Klemons, D.D.S., Ph.D.
Dr. Ira Klemons, director
of The Center for Head and Facial Pain located in South
Amboy, New Jersey, reports that numerous patients had virtually
given up hope before they found help. "Many of our
patients who thought that their headaches were due to brain
tumors, were thrilled to have complete relief after treatment
of what actually turned out to be a muscular injury which
had been causing their pain," says Dr. Klemons who
has treated thousands of chronic pain sufferers from across
the United States and abroad for over 20 years.
By far, the most common
causes of headaches are muscle spasm and irritation of related
structures. "It is not uncommon for headache sufferers
to be told that there is nothing wrong neurologically and
that all tests, including MRI's are normal, regardless of
the fact that pain is a frequent problem," says Dr.
Janet R. Crain, a co-director of the Center. Most of the
Center's patients find that pain is relieved through conservative,
non-surgical procedures. "We have documented that 90%
of our patients find that their pain is 'gone' or 'almost
gone' at the completion of treatment," says Dr. Klemons.
Lucy Berry, "Painful
jaw disorder: a constant headache until doctor's cure."
(The Messenger, Madison, North Carolina). Note: To date,
twenty-eight patients from North Carolina have traveled
to Dr. Klemons' office in New Jersey, after failing to obtain
relief locally. Numerous other patients have come from across
the United States and abroad.
Mother and daughter, Janis
and Sherri Hurd, thank Klemons for stopping a pain they
thought incurable. Sherri began having severe headaches
when she was 5. Following a treatment combining diet, exercise
and a special orthopedic device that repositions the jaw
bone and fits invisibly behind her bottom teeth, Sherri,
now 21, is pain free. The routine 1,100 mile round-trips
to his Family Dental Practice in Woodbridge, N.J., for six
months, they say, was worth the 10-hour drive.
Roughly 30 percent of the
population in this country suffer from headaches at least
once a week, said Klemons. Most are women between 20 and
40 years of age. Eight times as many of his TMJ patients
are women than men.
Just by accident, Janis
Hurd found an article on TMJ in Women's Day in the restroom
of her office building. She told her sister, Debbie Tilley,
a beauty shop operator, about Dr. Klemons. Tilley started
having headaches three years ago. She went to see her dentist,
thinking that she had an abscessed tooth. He told her to
see a neurologist. Her condition kept getting worse. She
blacked out at her office. She even tried biofeedback methods
that help a patient deal with the constant pain. Nothing
worked.
After she read the article
on TMJ and saw Dr. Klemons' name, she wrote to him. In 1981,
he fitted her with a permanent orthopedic appliance. Her
problem was more severe than most. Another patient, N.C.
License Examiner, Gay Welch of Madison, also suffered for
many years with TMJ, without knowing it. Last March she
saw Klemons. In December he fitted her with a lightweight
metal and clear acrylic orthopedic appliance that looks
like a retainer dental patients wear after braces. "I'm
a different person. I am me again," Mrs. Welch said.
Ira Klemons, D.D.S., Ph.D.,
"TMJ syndrome causes pain." (The Advocate). Temporomandibular
joint disorder, or TMJ syndrome, can cause chronic, severe
head and facial pain: pain so. severe that often a victim
cannot get out of bed for days. The syndrome is not new–the
first surgery on the temporomandibular joint was performed
in 1858 and the first known , article about these disorders
was written in 1934–but it is a complex problem that
is still frequently misdiagnosed.
Most head and facial pain
involves contraction and spasm of muscles of the head, face
and neck. The spasms produce pain in the head, face, neck,
in or around the eyes; ears and throat, as well as difficulty
swallowing, blurring vision and dizziness. The most common
symptom is a chronic, severe headache. The TMJs, 'temporomandibular'
joints, are located in front of the ear on each side of
the head. When the TM joint is injured, many ligaments,
tendons, muscles, nerves, blood vessels, discs and fascia
are injured simultaneously. An injury to the TM joint does
not always involve pain at the site of the joint itself.
The pain may be located at almost any part of the head or
face.
Most TMJ dysfunctions are
due to trauma. When TMJ problems are suspected, muscles
and joints are evaluated through x-ray and physical examination.
Tests to evaluate TMJ disorder might include tomography,
EMG, thermography, Doppler sonogram, or arthroscopy.
Most patients find that
pain is relieved through physical-medicine procedures–orthopedic
appliances, electronic devices to stimulate blood flow and
healing and .joint mobilization techniques. Some patients
require injection of trigger points, tendons or ligaments.
In those cases where the pain does not abate, or recurs,
radio frequency cautery procedures, in which the.pain-producing
structure is denervated, may be considered.
The majority of TMJ disorder
patients, however, do not require surgical intervention.
And nearly all of them find relief from the chronic, debilitating
pain they've been suffering from for years.
Ira Klemons, D.D.S., Ph.D.,
"Volunteers." (Journal of the New Jersey Dental
Association). Dr.lra Klemons recently journeyed far from
his Sayreville, NJ practice, limited to head and facial
pain and TMJ disorder, to go to the Himalayan Mountains
to treat needy Tibetan villagers. Although their makeshift
clinic consisted of an operating table made from wooden
planks, and instruments which were sterilized in big pots
of boiling water, Dr. Klemons and the two trained Tibetans
who guided him were welcomed by the villagers, who had heard
in advance that men were coming to help the people in pain.
Working from sunrise to
dusk, Dr. Klemons and his assistants often saw over 100
patients a day. Interestingly, few had ever heard of the
United States, and none had ever seen a Western doctor or
a Caucasian.
Although he has practiced
in Appalachia and in some of the United States' most depressed
urban slums, Dr. Klemons reports that he has never seen
so many unhealthy people as in the Himalayas. "It is
hard to understand how these people live for so long with
such pain," Dr. Klemons says.
"It is quite clear
that curative medicine (treating those who are already sick)
will never provide the answer to these villagers' health
problems. Wherever we went, we trained villagers in proper
nutrition and in preventive medical and dental care, but
these practices require changes in customs which have existed
for thousands of years."
Ira Klemons, D.D.S., Ph.D.,
"Whiplash can injure jaw joint." (New Jersey Law
Journal). Severe head pain is a common and long-term consequence
of the injury typically referred to as "whiplash."
The overall effect on an individual, his family and his
employment can be devastating. Besides the physical suffering
to which a patient is subjected for long periods, many patients
suffer emotional stress, caused by their long but unsuccessful
search for help. Until recently, the accurate diagnosis
of Temporomandibular Joint (TMJ), or jaw joint, and related
injuries was elusive, due to the inability to base the diagnosis
on objective findings, rather than subjective complaints.
Most TM joint dysfunctions
are due to trauma. In many cases, however, the onset of
pain occurs so long after the accident that the patient
does not relate the pain to the earlier injury. Shortly,
you will see how initial awareness of symptoms can be delayed
for months or years.
Injuries fall into three
categories: I. Direct Impact; II. Ripping; and III. Latent
Onset Due to Alterations in Posture.
Remember, referral for evaluation
should not be based on the presence or absence of "clicks,"
or on whether the injury victim specifically complains of
"joint pain." Patients complaining of any one
of the following symptoms should be referred for evaluation
as soon after injury as possible: headaches in any part
of the head; pains of the eyes, ears, face, jaw and neck;
blurred vision; swallowing difficulties; chronic sore throat;
dizziness; ringing in the ears. (Patients suffering from
cervical injuries, should also be evaluated by specialists
competent in related fields, e.g. physiatry, neurology,
orthopedics, chiropractic, etc.)
Although it is recognized
that injuries to the temporomandibular joint and its related
structures are permanent, the vast majority of sufferers
can be helped to reduce their pain experience. Ira Klemons,
D.D.S., Ph.D., "Successful Treatment of Tinnitus in
Patients with TMJ dysfunction." (Tinnitus Today - The
Journal of the American Tinnitus Association)
The condition commonly referred
to as "TMD" - temporomandibular joint disorder
- is a complex dysfunction of muscles, ligaments, and joints
in the head, face and neck. (The temporomandibular joint,
or "TMJ", is the joint in front of the ear which
allows us to speak, chew, swallow, kiss, smile, and exhibit
normal facial expressions.) TMD is typically caused by injuries
that result from falls, automobile accidents, trauma at
birth, etc. It is very common for the onset of symptoms
to be delayed for months or years. the delay of onset occurs,
in part, because these tissues progressively degenerate.
Close to half of the patients
who have TMJ dysfunction have tinnitus as one of their symptoms,
and in these patients, success rates in eliminating these
sounds approach 90%. Recent research has found that TMD
therapy improves tinnitus in 46-96% of patients who have
TMD and coexisting tinnitus. A survey of patients taken
two years after TMD therapy suggests that improvement is
sustained over time.
The diagnosis of TMD requires
evaluation by a dentist or physician with advanced training
and experience in treating head and facial pain. Diagnosis
begins by taking a detailed history of the patient's (sometimes
extensive) list of complaints. Symptoms can include headaches;
pain in the face, eye, neck, or ear; blurred vision that
comes and goes; hearing loss that comes and goes; frequent
sore throats; dizziness; ringing in the ears; pressure or
blocked sensation in the ears; difficulty swallowing; burning
tongue; and tingling or numb sensations of the arms and
hands. A physical examination of the muscles of the head,
face, neck and shoulders is done using manual palpation
to rule out "trigger points" and muscle spasms
that can transfer pain to other areas. Range of motion tests,
x-rays, sonograms, and painless EMG's can also help in reaching
an accurate diagnosis.
Treatment commonly employs
painless procedures which help stimulate muscles and joints
to function normally, decrease spasm, remove toxic waste
products, and increase blood flow and nutrition to the affected
areas. Therapies such as low current electric stimulation
to reduce muscle spasm and stimulate healing, ultrasound
for deep tissue heating, hydrocollator for moist heat, and
cryotherapy (cold therapy) are used with a variety of removable
orthopedic appliances aimed to correct the position of the
condyle, or "ball" of the lower jaw within its
socket. In addition, joint mobilization procedures, physical
manipulation, and other procedures might be employed. Eighty-four
percent of our last 1200 TMD patients who also had tinnitus
reported that their ear sounds were "gone" or
"almost gone" after treatment.
Treatment time and costs
vary according to the extent of dysfunction, the simultaneous
presence of related problems such as neck injury or thyroid
disorders, patient compliance, and the patient's age. Unfortunately,
for reasons not yet explained, we have found a decreased
success rate for elimination of tinnitus in patients over
60 years of age.
Many patients are given
only home care instructions at a single visit, while others
require an average of 4-6 months of care. Still others require
much lengthier treatment and, in a small number of cases,
even surgery. Approximately 1% of our patients require TMJ
surgery and approximately 3% require radiofrequency thermoneurolysis
-a surgical procedure that uses high frequency electrical
energy to modify or eliminate pain impulses from injured
structures. This technique in particular offers enormous
promise for eliminating pain and tinnitus where other conservative
procedures have failed to bring relief.
Wright and Bifano cite a
study in which the relationship between tinnitus and TMD
therapy resulted in the following: of 267 TMD patients who
were evaluated, 101 reported co-existing tinnitus. Ninety-three
of those agreed to participate in the study. Of the 93 subjects
who were treated for TMD, 52 said that their tinnitus had
resolved, 29 reported experiencing significant improvement,
and 13 reported minimal or no improvement. No one reported
experiencing a worsening of the condition. It's been noted
that patients who have tinnitus without any other symptoms
are relatively unlikely to experience improvement with treatment
of this type.
Over the last few decades,
we have come a long way in diagnosing and treating TMJ disorders
and the accompanying symptoms such as tinnitus. No doubt
future research will provide greater knowledge regarding
the relationship between tinnitus and temporomandibular
joint dysfunction and consequently even higher success rates
than are available at the present time.
Studies have shown that
close to half of the people suffering with tinnitus have
a dysfunction of the muscles and joints of the head and
face, commonly referred to as "TMJ." The Temporomandibular
Joint (TMJ) is the joint in front of the ear which allows
us to speak, chew, swallow, kiss, smile and exhibit normal
facial expressions. Almost half of the patients who have
TMJ dysfunctions have tinnitus as one of their symptoms
and in these patients, success rates in eliminating these
ear sounds approach 90%.
In certain cases, tinnitus
may be a result of spasm of a tiny muscle (called the stapedius)
in the middle ear. This spasm may cause a slight vibration
which is heard within the ear as a ringing, buzzing or hissing
sound. In addition, dysfunction of other muscles, such as
the tensor veli palati, may prevent the Eustachian tube
(an air passage connecting the middle ear to the throat)
from functioning normally, causing fullness and pressure
behind the ear drum.
Conditions commonly referred
to as "TMJ," "TMD," "TM Joint Dysfunction
Syndrome," etc., are complex dysfunctions of muscles,
ligaments and joints involving the head, face and neck.
These conditions are typically caused by injuries such as
falls, automobile accidents, trauma at birth, etc. It is
very common for onset of symptoms to be delayed for months
or years, thereby leading the individual to believe that
the symptoms merely started on their own.
For many patients, tinnitus
is accompanied by other symptoms such as:
- Headaches
- Face pain
- Eye pain
- Earaches
- Dizziness
- Pressure in the ears
- Clicking noises or pain
when opening or closing the mouth
- Difficulty swallowing
- Burning tongue
- Frequent sore throats
We have found that patients
who have tinnitus as one of their symptoms, experience an
elimination of their ear sounds following treatment in the
vast majority of cases. However, patients who have tinnitus
without any other symptoms, are relatively unlikely to experience
improvement with treatment of the type discussed below.
Since approximately half of the people who experience tinnitus
also have other symptoms, a major proportion of tinnitus
sufferers can eliminate the source of their frustration.
Many assume that stress
is the cause of these conditions. However, stress makes
virtually any dysfunction worse. If a person has a heart
problem, under stress, they are more likely to have a heart
attack. Similarly, a person with a stomach ulcer, dysfunction
of the muscles of the head or even a broken leg, are likely
to feel worse stomach pain, headaches or leg pain respectively,
as a result of stress. Certainly, this does not mean that
stress was the cause of these conditions.
Treatment commonly employs
procedures which help stimulate muscles and joints to function
normally, decrease spasm, remove toxic waste products, and
increase blood flow and nutrition to the affected areas.
In rare cases, surgery to the affected tissues (not involving
the ears) may be employed.
Over the last few decades,
we have come a long way in diagnosing and treating temporomandibular
joint dysfunctions, and accompanying symptoms such as tinnitus.
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