Some of you are aware that I’ve been struggling with incredible pain this week – so much so that I literally lost a day on my writing spreadsheet!
So, what is TMJ?
TMJ actually stands for temporomandibular joint.
The term actually refers to the joint where your jaw hinges – just in front of your ear. TMD is the correct term for the dysfunction or disorder where the TMJ causes you excruciating pain!
However, I rapidly discovered that when referring to the disorder, I had to be less exacting as many people simply call it TMJ.
Here is a diagram of the joint and the muscles attaching to it. There is also a little disc which can get worn or dislodged.
(Image from WebMD used for educational purposes – see the rest of the slide show.)
According to the National Institute of Dental and Craniofacial Research (part of the National Institute of Health), there are three main kinds of TMJ dysfunction, and you can have more than one kind at a time.
Researchers generally agree that the conditions fall into three main categories:
1. Myofascial pain involves discomfort or pain in the muscles that control jaw function.
2. Internal derangement of the joint involves a displaced disc, dislocated jaw, or injury to the condyle.
3. Arthritis refers to a group of degenerative/inflammatory joint disorders that can affect the temporomandibular joint.
What causes TMJ?
Apparently more than 10 million Americans (of 360 million residents) suffer from some form of TMJ and it affects women much more frequently than men, despite the fact that injury to the jaw is one way of causing it. Yet, there are many other factors including genetics, arthritis, teeth grinding (bruxism) or simply stress. (No, it’s not caused by talking too much!)
I could tell you one of the main things which caused mine, but it’s not for polite conversation and has something to do with a domineering ex-husband’s personal demands. Yet, this was the first time I noticed difficulty with my jaw function, including clicking, popping and occasionally simply not being able to open my mouth very wide.
Stress is a major cause because even if you’re not actively grinding your teeth, simply clenching the jaw muscles can cause damage to the jaw or over-tightening of all those muscles that attach to it. These muscles go all the way into your forehead and can cause a tension headache for the duration of your bout with TMJ.
What are the symptoms of TMJ?
According to the Mayo Clinic:
Signs and symptoms of TMJ disorders may include:
• Pain or tenderness of your jaw
• Pain in one or both of the temporomandibular joints
• Aching pain in and around your ear
• Difficulty chewing or pain while chewing
• Aching facial pain
• Locking of the joint, making it difficult to open or close your mouth
The reality is much more excruciating!
My symptoms:
Years and years ago: clicking, popping and difficulty opening the jaw. (At this point, there was no pain with it.)
Months ago: occasional pain of the jaw. Upon palpating it, I found that the pain was not near my gums at all (so, not tooth pain,) but in my cheeks, and the muscle attachments to the lower jaw. I also had numbness to the right side of my lips. (Hot/Cold/Sweet sensitivity – common in tooth decay – was not an issue, so I concluded it was not anything to do with a tooth that I’d been avoiding work on.)
This week: severe pain in all the muscles involved in the TMJ. Muscular pain all the way up to my head (i.e. constant headache) and all the way down into my neck and shoulders. Pressure in my ear, like it wants to develop an infection. Inability to chew – even canned tuna caused an increase in pain. Discomfort when talking, smiling, laughing. Even some difficulty swallowing anything larger than 200mg of ibuprofen.
Check out Katie’s story to see more about the level of pain that is felt with this problem. I literally started crying as I read it because it’s exactly what I’ve been feeling! (You can read part of her story without registering, but I decided to register since this is a problem I’m suffering from.)
What really caught my attention from her story was the fact that going to the dentist can make things worse!!! Simply from aggravating the problem muscles. It’s something I will have to mention when I go in to the dentist this week.
Treatment of TMJ
According to the Mayo Clinic website, there are a few standard treatments for TMJ.
- Pain relievers and anti-inflammatories such as ibuprofen. Prescription pain relievers are also available.
- Tricyclic antidepressants.
- Muscle relaxants – ibuprofen helps on this, I’m well aware. I guess the others are prescriptions though maybe some muscle rubs function this way. This isn’t an area I know a lot about.
- Mouth guards – these protect the teeth, perhaps, but from what I’ve read, they have limited effect on pain as it’s not helping you relax. (Extra important if you have bruxism which can be connected to sleep apnea!)
- Physical therapy – exercises, moist heat and ice. Exercises are great for minor pain or between episodes, but I couldn’t do any of these exercises when I was in severe pain. Moist heat helped me a lot. Cold made it worse.
- Counseling – I guess as long as it’s centered on stress reduction, it might be helpful. Many, however, seem to treat TMJ as a “behavior” that you can control rather than a medical condition.
- Injections – corticosteroid shots into the joint may be helpful. There are other treatments such as botox and ozone which are not well-substantiated and not generally recommended.
- Surgical procedures
(I have heard some thought that cranial osteopathy might help – especially if the TMJ is caused by alignment or disc issues.)
What helped me
- Ibuprofen – maximum daily dose for about three days. (I had to google it.)
- Acetaminophen/paracetamol helped a little for the breakthrough pain.
- Cat’s Claw – an herbal anti-inflammatory
- Oregon Grape Root extract – just happened to have it on hand and it turned out to be very beneficial
- Licorice root tea – to keep away any strep mutans (the tooth decay bacteria) floating around.
- Calcium-magnesium supplements – to help nourish the muscles.
- Scalding hot wet washcloths pressed against the muscles and very hot baths.
- Lemongrass oil (I put about half a dozen drops in a small baby-food jar of olive and coconut oil) massaged into my shoulder, neck and more gently on my cheek.
- Hot drinks – I drank copious amounts of tea, hot chocolate, anything hot. While the mug was still hot, I would roll it across my cheek muscles to help soothe them
- Relaxation – some of the TMJ was caused by stress in my jaw, clenching my teeth. Every time I found myself clenching, I would deliberately relax the muscles. Only a small amount of relief, but most importantly, it helps to undo what caused it to begin with.
- Sleep hypnosis and similar videos – These had a minor impact to be completely fair. Partly because my ear was so sensitive at this point that even listening to music hurt! Putting an earbud in my ear also hurt because of swelling there.
- Different sleep positions - The worst night, I gave up trying to sleep at all and sat on the couch – strangely, I was able to drift off in the position. Thankfully, that morning, the pain suddenly let up. It wasn’t gone, but it was no longer the defining part of my day.
Note: at one point, after the slight swelling around the ear and getting water in my ear from the hot bath, I was starting to worry that my ear was heading for infection. (Some of the wax was discolored.)
So, I used some drops of hydrogen peroxide in my ear. I left it there until the fizzing stopped (or I couldn’t stand it any longer.) This breaks up the ear wax and allows it to come out. Very important!
Caution: not everyone can use this treatment and it should not be used if there’s actual injury to the ear. As always, Google is your friend.
Other factors in my case of TMJ
It is important to figure out what caused your TMJ as it will have an impact on your treatment plan. I had two events lead to this crisis. One was a very stressful week including a “friend” threatening my family. (She is no longer our friend – though it’s not that simple because her husband is a good man.) The other was the loss of a filling in my wisdom tooth. This caused my jaw to close differently with a sharp point left by a stupid dentist 25 years ago. I was able to handle that one by itself, but not with the “friend issue as well.”
Of course, this being America (land of the free – if you can pay) and us being low-income, I couldn’t just go in and demand things get fixed – NOW – even once I worked out was going on. No, I had to fill out forms and make an appointment – for a week later! (At this point, I’d already been in pain and on a mostly-liquid diet for a week.)
Because I could not see a dentist immediately to deal with that tooth, I now have the suspicion that it’s broken and partly loose as well as starting to abscess. (I can keep that draining with a salt rub, so I’m not overly worried about that right now – it’s causing very little pain.)
But now, because there’s a minor infection going on, I highly expect that Tuesday’s appointment is going to result in me being sent home with antibiotics and a new appointment in another week for an extraction. (Root canals are bad news anyway, so this is probably the only sensible option now.)
Additional treatments for the abscess:
- Sea salt – fine salt rubbed directly onto the swelling of the abscess. (Can be mixed with clove oil, raw honey, garlic oil, cinnamon, things like that for the antibiotic effects.) This helps keep it drained and keeps the danger to a minimum.
- Hepar Sulph Calc. 30X – I have a friend on Facebook who is a homeopath. She recommended this remedy for the abscess. Hourly the first day, bi-hourly the second, then re-evaluate.
Here is what I’m eating right now:
Nothing!
Not quite true. Anything that is liquid or dissolves easily in my mouth.
- Bone broth – I heat up a mugful, stir in an egg yolk or two and drink that. Sometimes, I add some crackers to soften with the soup.
- Cocoa – high in magnesium and potassium if I remember correctly. Adding milk and/or cream to it helps make it even more nourishing.
- Jello – I make my own with fruit tea, honey and good quality gelatin that I get at Natural Grocers. The only bad thing is that it doesn’t dissolve quite so perfectly, and actually sometimes makes me hit my teeth wrong – but then, I do make it extra thick. The gelatin also nourishes the joints and cartilage, so should be actively useful in TMJ, long term.
- Chocolate chips – they dissolve and give pleasure. Need I say more?
- Ice cream – without nuts!!! I found the cold to be unpleasant, so I’ve only eaten a tiny bit of ice cream.
- Pretzels – strangely, they dissolve well in the mouth – especially if they’re slightly stale first. The salt has anti-bacterial properties, so is useful.
Despite the fact that I’m consuming well under 1000 kcal daily right now, I’m not overly hungry. I don’t know if that’s because the bone broth is so nourishing that it fills most of my basic needs or whether my body has (temporarily) adjusted to the fact I can’t eat.
Bright side
At the end of this, I may have lost a few pounds – I do need it. Not the best way, but I’ll take it.
Lori Svensen – A'mara Books & Viking Visual
Banner by @shai-hulud
Nice article...
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I have been dealing with TMJ for about 12 years. It sucks!! At my worst i couldn't open my mouth wide enough to eat a banana.
The mouth guard things made me feel worse. So i use ibuprofen, ice, sometimes heat, and do certain gentle jaw range of motion movements to help and usually avoid overly "chewy" foods.
On a side note, you're a dreamian, if you get a chance check my most recent resteemed post you can learn more about what's happening with steemit Dreamit.
Yeah, totally with you there - and I find the mouth guard comment interesting too. In Katie's story, she talked about diclofenac helping her a lot (she mis-spelled the drug name) - have you tried that? I might see if I can get some when I manage to see a doctor about it - after I get the tooth taken care of, anyway.
I will comment on the other post. Thanks for mentioning it.
Oof, so sorry to hear about this! That’s got to be so frustrating, especially since it’s impacting so many parts of your life! Sending you my thoughts and prayers for a speedy recovery 🙂
Thanks for your prayers. Yes, it's frustrating. It's easier to deal with other aches and pains because you can sort of get on with things. When my hip hurts, I don't walk so much. Muscle cramp, I spread my lemongrass on it (I'd use lavender, but my husband is allergic to it, so safer not to use it now) or take a cal-mag capsule. In either case ibuprofen and cats claw help. This is totally different pain - and long-lasting. Tiring.
Ouch, this doesn't sound like fun at all... It was a really informative post, and quite interesting, I like learning new stuff and most of biology is untouched ground for me!
Although, after reading it, my jaw starts to ache a bit...
I dislike anything to do with medicine, really. But it's important and I've learned so much this past week, I felt it was a great thing to share. Unfortunately, once suffered, TMJ tends to recur.
That's not good news, at least you are figuring out what works for you in helping with the pain.
Thanks for this educative write up. All i know before is just jar pain but never know it has type
You're welcome. I am glad you found it useful. Thank you for stopping by.
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I once had a pain in that area and it was all hell
Very tough, isn't it?
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Prayers for quick recovery dear.
I guess i should be frequenting your blog as always @viking-ventures cos i do learn alot here. Thank you for sharing
Thank you.
I don't often do research posts anymore because my primary focus is on my fiction - and then curation on Steemit. I do anticipate doing a series on domestic violence soon - maybe launch a project I've been wanting to do for years... But, we'll see when that manifests. Somewhere between books, I guess.
Wow this is so well written and researched, I’m so glad you found me so I could find you to read this post because my jaw clicks and I never knew why!! Now I know, I can take steps to sort it out before it gets worse, big thank you!
Awesome! I hope you are able to take measures to learn better ways of dealing with your stress. A clicking jaw might be normal for you - but it also may be a sign that you are putting your stress into your jaw. (I never looked it up all those years ago either.)
So interesting, thank you this post was such a help for me, I hope yours is all sweet now too
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OMG I am so sorry you had to go through these pains! Thank you for this detailed article. Home remedies are awesome, as usual. Stress is bothering me too, neck pain!
Thanks for stopping by and commenting!
I had been worried about the cost of cats' claw, actually - but then, I was comparing it to the cost of ibuprofen. Then, my husband found out the cost of a month of diclofenac (that's what helped in Katie's story) and suddenly, the cats' claw seems so much more reasonable!
One of my best friends also suffer of this. She is always in pain too. Also she is under stress because family and college. I can't never help her with the pain, but she said that she is happy because I always put a smile on her face.
I hope that you can recover! And smile too!
I'm glad she has you as a friend. It is very tiring to be in pain constantly. Mine is not so bad now, but we'll see after I visit the dentist, the act alone can cause a flare-up.
We don't always have the option of having stress, but we can learn better ways to manage it.
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I'm so sorry to hear this @viking-ventures! Years ago, I was involved in a car crash and TMJ was the lasting result. Most of the time, I can subdue it with ibuprofen, and here in Mexico, I can get 600mg tablets which seem to be the perfect amount. Normally, I call these a "jaw headache" and the pills help. Other days, not so much. Oddly enough, when I've taken the ibuprofen, and it starts to take effect, it helps if I do chew or eat something to get my jaw going. I must start to hold it tense or clench without knowing it.
I hope yours right now is bad because it is an infection and can be quickly cleared up.
I can read between the lines just fine; sorry about the root cause of it all too.
Actually, the infection didn't start causing problems until after the TMJ started to calm down. I suspect it was the clenching part of the TMJ that caused the infection if the tooth is broken now... I'll find out tomorrow, I guess.
A little TMJ pain this morning - both in the jaw and shoulder, so I must have clenched a bit overnight.
How often do you take your 600 mg? The maximum daily dose is around 2400 mg (some sources say up to 3000 mg) before you start doing liver damage. I was basically taking 200 mg every two hours (twice as often as the bottle says - but I knew to do more homework, spending a couple years as a pharmacy tech.) Definitely loosening the muscles is crucial.
Oh, that's weird @viking-ventures. I too will be curious what you find out tomorrow.
I only take it now when it bothers me. This morning it is a bit, but I had a very restless sleep, so I'm sure that has something to do with it. I can go for days and sometimes weeks without having to take anything. My accident happened about 25 years ago though.
I think that's why when mine bothers me, I take the ibuprofen and the force myself to eat/chew something. It really helps.
Had the wisdom tooth out just now. I was right that it was loose - though it wasn't broken.
So how are things today @viking-ventures?
Slight sore where the tooth was. Slight TMJ pain. Still getting used to a lost tooth - it feels like I'm mourning, actually. It's weird. I guess it's because I'd never lost an adult tooth until now - still had all my wisdom teeth, it feels like a bit of a failure.
Hoping to reduce ibuprofen again tomorrow. It's time to be off it again.
Thanks for asking!
You're welcome @viking-ventures! And yeah, that's a little weird 😎
Best wishes on your recovery! I had jaw surgery back in 2006. It helped but my jaw will never function ideally. Thankfully, I haven't had extreme pain. I definitely believe in homeopathic approaches, including acupuncture and essential oils. I hope you continue to feel relief.
Oh wow. Yeah, I will try just about everything before I do the surgery thing. My suspicion is that osteopathy is probably the way to go for long term relief, but I've got to deal with the whole tooth thing first. Dentist tomorrow (and I hate/distrust dentists!)
Good luck!!!