Tmj

Those of you who’ve been on this board for a while know that - like many of us - I have been chasing down a number of theories as to what may be triggering my symptoms. So far they’ve turned our to be a lot of “red herrings” - chronic sinusitus, ETD, SCDS, sleep apnea, etc. I was actually counting the surgical procedures I’ve had in the last three years to try to resolve this and the total came to 5 (one of which was BIG surgery and involved opening my skull). Before all this started I’d go years without seeing a doctor. Well anyway, for the first time I’ve got a doctor who claims to know exactly what is going on. They did some testing in December and took detailed X-rays today and he says it’s a “clean cut” TMJ problem. My condyles (part of the lower jaw bone) are riding too far back and compressing my inner ear whenever I bring my teeth together. He’s making me two dental appliances (one to wear at night and the other during the day). He is very confident that this will “decompress” the inner ear and resolve my problems. I am somewhat less confident, having chased so many theories over the last three years, but I have to say that this really fits some of my symptoms very well. Things like how the tinnitus always pulses whenever I clench my teeth, etc. I find myself starting to really get hopeful here and man that feels good after all this time. Anyway I get fitted with the first of the two “appliances” next Monday. I’ll keep you all posted on how it goes.

Chaz

Hi Chaz,

Have you tried a migraine prevenative to see if it clears everything up? Hannah, who is on this board only occasionally, was given the same TMJ dx and it was totally off the mark. She simply had migraine like most of us do. She messed around with it for months on end and ended up with more bite problems in the end from having to wear the splint. It was propranolol that immediately ended the dizziness for her.

Best … Scott 8)

Hi Chaz

I have all my fingers crossed for you! I do hope it works. Please keep up updated on how you get on.

Scott - I have no idea if they are correct, but a branch of Craniofacial dentists (dentists in the American Society of Craniofacial pain) believe that an incorrect jaw alignment causes migraine (which in turn causes ‘classic’ migraines, dizziness, nausea, headaches, fatigue etc). Therefore, they are saying that while the migraine symptoms can be stopped by a prophylactic medication, it can also be treated at the root cause: by realigning the jaw.

migraineheadachepain.com/index.html
headaches.com/

I am going through the same quandry at the moment, whether to believe that this could be correct and whether it would work. The reason I believe there COULD BE something in it is that I had some treatment late last year from a dentist who said I could pay him if and when I got better. For first two weeks following wearing the device I felt much better. Then the dentist adjusted it and my symptoms came back. It then became apparent that he was ‘just guessing’ as to the position of the splint and I became disillusioned as it didn’t work anymore. On Thursday I am going to see another dentist in London who specialises in this to get his opinion. I have always had jaw problems and a lot of my problems (tinnitus, ear fullness, head pains) are in the same side as my grating and clicking jaw.

Believe me, I am very cynical now about anyone who says they can cure me and I totally see what you are saying about prophylactic medication. I really appreciate hearing about other people’s experiences and opinions because it gives a more balanced opinion. However, I have tried a large number of drugs in the last year and am struggling to tolerate anything or finding something that works. I am beyond frustrated and feel like my life is trickling away before my eyes. If this specialist is convincing enough that he feels he can make me better, I will consider giving it a go as I would always wonder what could have been if I didn’t. I’m probably just being naive to believe there may be something in it, but its hard not to.

Becky

I have been checked for TMJ two or three times when I was going through all of my doctor searching, and again recently when I started having some severe tooth pain. I don’t have TMJ, but I grind the bejeebers out of my teeth to the point that I have cracked most of my teeth and iratated one of the nerves in my jaw. I will buy into most theories about TMJ or bruxing being a cause of migraines because I can follow the muscles from my jaw up into my skull by following the muscle tension and pain that starts at the back of my jaw.

Brian

Scott,
Oh yes, I’ve tried migraine preventatives. Propranolol did nothing for me except make me totally unable to exercise. I’m currently on Verapamil and my symptoms are much better than they were a year a go. However, before all this started I was a professional pilot and if I’m ever going to resume my career “much better” is not going to cut it. To be medically certified to return to flight status the dizziness must be completely resolved. I am therfore, very motivated to find the root cause of all this and I have a lot of trouble believing that I just “spontaneously” developed a migrainous condition at age 40 with no previous history of this kind of thing. In my opinion there MUST be something triggering it. I was very skeptical of the whole TMJ thing. Many doctors are skeptical of it as well, but these are the same doctors who have provided 7 different mis-diagnosises in the last couple of years. I’ve come to the conclusion that when (not if) we get this all figured out it’s most likely to be something that is “off the radar” of the doctors I’ve been seeing. If it were “on their radar” they’d have fixed me by now. Incidentally, as Becky pointed out, the diagnosises migraine and TMJ are not mutually exclusive. There is substantial evidence of an association between TMJ and classic migraine. I’m approaching this, not so much from the stand point of trying to overturn the MAV diagnosis, but that I want to eliminate a factor which may be contributing to the development of migrainous inflamation in my inner ear.

Best

Chaz

Hi Guys,

This is all very interesting about the jaw stuff. I just don’t know what to make of it. I still don’t know if it is the cause of the migraines or not. It certainly could be.

Interestingly I also have a bruxism problem. And my migraines began when I really started to grind 10 years ago. There’s definitely a correlation there. I wear a splint at night to save me from destroying my teeth but it hasn’t resolved the migraine.

A few months ago I contacted a woman who said she could cure me of bruxism … she wanted $180 per session (said I would need 3 sessions) which I thought was outrageous price-wise and thought I might be dealing with a quack so didn’t bother.

I’m due to see my dentist soon for a check up. I might chase this up further.

Scott 8)

edit: I was just talking to a colleague of mine who knows a physio guru on TMJ. The woman did her Masters on it. I’m going to pay her a visit I think and find out once and for all what the deal is with TMJ, clenching etc and migraine. Check her out below!

— Begin quote from ____

Penny Elliott
M.H.Sc.(Orthopaedic Manipulative Therapy) B. App.Sc (Phty) MAPA
Physiotherapist

Penny is an associate of the Physiotherapy Posture and Fitness Clinic and combines her clinical work with lecturing and taking classes. Penny has recently completed her Masters in Orthopaedic Manipulative Therapy.

With a personal background in dance, Penny’s interest has evolved in movement analysis and postural assessment. She uses this expertise in designing individual exercise programs, regardless of your fitness level.

Penny has worked with a variety of sports people at Sydney University’s Sports Clinic including the Sydney University Rugby team, Olympic level rowers, runners and triathletes. She continues to conduct her ever popular postural fitness class at the university.

Penny’s other areas of interest include lower limb analysis and biomechanical assessment, which has arisen from her work making orthotics with a well known Sydney podiatry group.

As well, [size=120]teaching posture at the University of Sydney’s School of Dentistry has sparked her interest in treating TMJ (temporomandibular disorders), or jaw pain.[/size]

Penny’s hands on and exercise based approach to treatment means that patients can really understand their problem and take an active part in managing their own health and fitness.

When not in clinic, Penny will be found in all manner of activities to keep fit including dancing, swimming, jogging, yoga - and, her interest of the moment, Kung Fu.

— End quote

I just made an appt to see her on the 24th of Jan. First consult is for one hour and $125. I’ll post whatever new info I can get from her.

Scott - Yes please post any information you find out!

If you do go to a dentist, please bear in mind that not all believe in this theory, in fact a lot are very sceptical. The ones who believe that migriane is caused by jaw problems are usually in the American Society for Cranio Facial pain. My ‘regular’ dentist told me that migraines are not linked to the jaw at all and said there was nothing wrong with my jaw, despite the fact it opens in an S shape and grates and clicks extremely loudly.

I’ve had to rearrange my appointment with the specialist dentist in London because I have the flu. I am now going on 21st Jan. I will also keep you all updated.

Becky

Hi. I can add a little bit of info regarding TMJ and the migraine connect from my own experience. I have seen a top neuro-doc who specializes in migraines and balance disorders and am currently being treated by him. In my case, the TMJ added to my issues with balance and migraines. This is because in the medical community, they are aware of the facial/cranial pain connection which can trigger problems with people. In my case, because I have a very sensitive inner ear and balance system (figured out 20 years ago from testing after problems after a cruise), the TMJ basically caused my central nervous system to go nuts. I had a list of something like 15 symptoms by the time I got to see the neuro-doc (many of which are those that MAV cause). After more tests, looking at my history, etc, he determined that 1. the CNS was overstimulated and 2. I likely also suffer from MAV. I should note that I do not have any inner ear injury or disease. He told me that with people with sensitive inner ear systems, either born that way like me or from injury/disease, you are more susceptible to balance problems. If you already suffer from migraines, it makes it worse. My MAV stared after the TMJ problems; prior I only had “regular” migraines from time to time. So what I am saying is that TMJ pain can affect MAV or balance problems, but it not the cause per se if you know what I mean. ANY facial/cranial pain or injury can set it off. I could have been hit in the head with a baseball and experience the same problems. I am currently being treated for the CNS with Klonopin. That helped greatly; it was a secondary drug for the migraines and now, I have experincing MAV for which I will likely have to take a different medication for.

Anyway, hope this made sense and helps clarify some things about TMJ. Best, Bonnie

problems after a cruise?

— Begin quote from “MikaelHS”

problems after a cruise?

— End quote

Yes, I went on a cruise (large ship) and while on it, experienced very bad dizziness, brain fog, etc. No one else experienced it from the minor rocking of the boat. Upon return, for over a month I had very bad brain fog, wooziness, etc.

Hi Bonnie,

I didn’t realise you were here for some reason even though I knew you were over at the healthboard. Now, if we can just get Violet over here, that would be fantastic. She’s another really great critical thinker.

Thanks for your post on TMJ. I think what you have said sounds most accurate to me – that “TMJ pain can affect MAV or balance problems, but is not the cause per se … ANY facial/cranial pain or injury can set it off.” No doubt there are some who began clenching first (increased life anxiety), developed TMJ which then triggered migraine.

The real hassle with MAV is that it creates all of these comorbid conditions such as anxiety, clenching (and thus TMJ) etc. And these conditions then make the CNS more and more sensitised which in turn jacks up migraine. It’s all a miserable positive feedback loop. It really makes sense that stopping the clench, fixing the TMJ, and killing anxiety is the way to desensitise and stop the migraine process, or at least reduce it way down.

Scott 8)

Hi Scott,

Yes, I decided to come over here too, as I saw that others including yourself were posting here as well. Regarding the TMJ, it’s problematic. For me, it messed wtih my CNS. I am getting treatment for the TMJ (and I say treatment, not cure) which has worked quite well. At first I wore a specially made lower mouth splint 24/7, then slowly per doc’s instructions, weaned myself off of it and only wear at night (for the rest of my life.) However, I still have some minor soreness and jaw issues (and must be very careful how and what I eat re: chewing) and it times it can flare up and be painful, which in turn then sets off my wooziness. The neuro-doc said this is typical - any disturbance (pain, injury, disease) to the facial cranial area can then cause CNS or migriane-related issues. It usually goes away with or without meds. However, the weird thing for me now is that just recently when I had no pains, no high stress, or any other triggers, the MAV seems to have kicked in. Up until now, it really hadn’t or at the least, was more CNS-related. So I don’t know why that has happened other than the fact that the doc diagnosed me with likely MAV at the same time as the CNS problems and prescribed Klonopin to help with the CNS - meaning it was a secondary drug for the migraine and by a fluke, I didn’t have it then but now I do. It varies from person to person as you know, but there is definitely a direct connection between facial/cranial pain/injury/disease and how it affects your brain and CNS.

Great to see you here - and on the other site. I’ve enjoyed reading and learning from your posts as well. I’m a little new to all of this, so you may see some newbie-type ore repeated questions along the line, as I am trying to figure out what, if any, med I should now go on. And of course, learn about symtpoms and get/share support with folk. Hope all is well in Sydney! See you soon! Best, Bonnie

Hey all. Just wanted to post an update. I was fitted with the first of the two TMJ “appliances” on Monday. This is a bite splint which I wear 24/7. It’s a bit annoying but certainly not painful. I can talk reasonably well while wearing it (better the more I practice). The sensation of “compression” in my left ear canal that the doctor showed me (put your pinky in your ear and bring your teeth together) is definitely dramatically reduced. The first couple days with the device have been pretty much typical for me with respect to the other symptoms. That is to say: no vertigo, mild feeling of inbalance that generally seems to get worse as the day goes on, pretty much constant tinnitus, sensation of pressure in my left ear when I wake up in the morning, etc. Going on the theory that my symptoms are comming from inflamation of the ear because the condyle was compressing it, it’s logical to expect that it’ll take some time for the inflammation to abate and the symptoms to start to improve. In other words it probably too soon to tell if this is going to work. I’ll keep you posted.

Becky, any updates on your treatment? I’m rooting for you.

Chuck

Hi Chaz

Its good to hear you have got your device fitted ok and are getting used to it. I didn’t see any improvement with my symptoms for a few days so I’ve got my fingers crossed for you!

I am going to see the dentist next week (I didn’t go to my original appointment because I had the flu) so I’ll let you know how I get on.

Keep us posted.

Becky