Treating Jaw Pain
Elimination Of Jaw Pain, “TMJ”,“TMD”, and Related Conditions
In many cases, people suffering from jaw pain and/or headaches are told that they have “TMJ”. However, “TMJ” is short for “Temporomandibular Joint” which is the technical name for the jaw joint in front of the ear. Could you imagine what you would think if you consulted your physician for pain in your arm, and were told, “You have elbow.” You’d probably be shocked because “elbow” is not a diagnosis. It’s the name of a joint just like “TMJ” is the name of a joint.
The term “TMD” or “Tempormandibular Dysfunction” is not much more meaningful. Using the previous comparison, would an orthopedist diagnose a condition as “elbow dysfunction”? In each case, a specific diagnosis must be made. Whether the problem is in the head, the face, the arm, or most any other joint, the diagnosis can include arthritis of various types, tendonitis, ligament sprains, tumors, etc. Specific to the TM joint, the ligaments which hold the disc in place may be stretched causing the disc to be displaced and locked outside the normal position permanently or temporarily. Curiously most (but certainly not all) people who suffer from “TMJ” have a muscle or ligament dysfunction which is the primary source of pain with the TM joint dysfunction being far less important or even insignificant. Now you can see why less than one percent of our patients require joint surgery yet over 90% report that pain is gone when we discharge them from treatment. This includes numerous patients who came to us for a second opinion after being told that their only hope was surgery — yet none was needed.
The TM joint is the most complicated joint in the body. First of all, the right and left joints are connected to each other by a rigid bone called the mandible or lower jaw. Consequently, any movement, swelling, or disc displacement on one side affects the opposite side. Surprising as it may seem, we have seen many patients who had significant injuries and advanced arthritis on one side but only felt pain on the opposite side.
Secondly, each of the two joints is composed of two separate joints. The lower joint consists of the condyle or ball at the top of the lower jaw, and a disc which is held in place by small threads called ligaments. Rotation of the condyle inside of the disc allows for opening of the mouth partway – to approximately the width of a finger. To open fully, the combined disc and condyle slide forward out of the socket.
The most common reason which one can hear “clicking” or “popping” sounds coming from the TM joints is a result of stretching of the ligaments which normally hold the disc in place. The condyle is incorrectly sandwiched between the opening for the ear and the disc (which is no longer on top of the condyle where it belongs). When a person with this condition opens his or her mouth, the condyle pops back into its correct position. When the mouth is closed, the disc moves in front of the condyle once again. This is diagnosed as “Anterior Displacement of the Temporomandibular Joint Disc with Reduction” because the disc “reduces” or goes back into place.
In certain cases, the ligaments which hold the disc in place stretch even further thereby making it impossible for the condyle to get under the disc. In this case, the disc is jammed or stuck in front of the condyles. The person is unable to open his or her mouth wider than the width of a finger (approximately 1 inch). This is diagnosed as “Anterior Displacement of the Temporomandibular Joint Disc without Reduction”.
As you can imagine, some patients can diagnose their own “anterior displacement with reduction” because of the clicks or pops which the joint produces. However, this is not always true. In certain cases clicks which are detectable with MRIs and sonograms are silent to the patient themselves. In addition, limited mouth opening (for example, to the width of a finger or 27 millimeters) can be due to “anterior displacement without reduction” but can also result from muscle spasm and other conditions which occasionally include tumors. Obviously, proper treatment requires a correct diagnosis.
Fortunately, the comments from physicians and patients included on this web site suggest that we have the knowledge, experience, and concern not only to make the right diagnosis, but to properly treat our patients and return them to a pain free, functional condition. Further advances in medicine have made it possible for us to treat these conditions without surgery in the vast majority of cases (click here for information regarding treatment). However, time remains a significant factor. Consequently, the earlier treatment is complete after the onset of symptoms the better.
For Family and Friends
Hundreds of times each year patients tell us that their family and friends simply don’t understand how they can be in so much pain and yet look completely normal. In 1991, a new patient added this perspective to his medical history. It may be useful for you to show this to your loved ones:
“I am 32 years old. Over the past years, I have had open heart surgery to close an atrio-septal defect. This required cutting my ribs, pulling them apart, and then wiring them back together. The wires subsequently broke when I fell out of a tree, at which time I also broke a rib and my back in three places, and displaced several discs in my spine. I was told that one of the bones in my back will never heal. In addition, I have agonizing cluster headaches and passed kidney stones, which is an excruciatingly painful experience.
I used to assume that TMJ problems were minor, unimportant afflictions. However, now that I have injured my temporomandibular joints, the head pain, ear pain, face pain, and throat pain which I am experiencing are far more severe than any of the above pains which I have had. In fact, this is the first time in my life that I have showed up at a doctor’s office on an emergency basis asking for relief from the pain.” – Steven
This also makes the point:
“I had kidney and pancreas transplants, but nothing caused as
much excruciating pain as my headaches and my face pain. The treatment here
gradually reduced the pain and now it’s all gone.
Please click here for information regarding other sources of pain in the face and jaw.
“When I had eye and jaw pain, I had to come home and just lie on the couch. I couldn’t play with my kids, do the laundry, or take care of normal things that needed to be done. Now I can function as the mother of a two year old. The eye pain and jaw pain are gone.” – Johnna S.
To see more statements from patients who were treated for Jaw Pain, “TMJ”, and “TMD”,
please click here.