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Old 08-06-2008, 07:22 AM   #1
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Muscle Spasms caused by Anterior Displacement with Reduction

Hey Folks

An MRI revealed that my right TMJ is anteriorly displaced but still reducing. It is anteriorly displaced when closed but reduced into the correct position with opened. I have always had a full range of motion and no real 'pain' per se. The real problem is constant muscle spasms on the right side. Does anyone think this could be the source of my problems? I am really sick of this and think I may eventually pursue some kind of surgical procedure down the road. However, because I have a full range of motion, I suspect people will not want to operate on me. Has anyone had similar experiences w/ jaw joint issues that do not cause motion problems but just cause muscle spasms? Thanks again.

-MS

 
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Old 08-06-2008, 01:27 PM   #2
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

I am getting facial spasms that involve my tongue and midline area just beneath my nose - yet a second or 2 before I get them I can feel pain building in other areas of my body just before the spasm occurs and from what drs that have reviewed my MRIs have told me, I do not have any displacement issues - when my spasms first started almost every dr told me it was not related to "tmj" per se - so my feeling is that is what is going on with you as well. My current dr and chiro feel an anterior bridge I had replaced torqued the implants it was attached to and the force of this over time resulted in a structural conflict within the cranio-facial and cervical areas. Is it possible that you have something along the same lines - that although the displacement is evident - it is not the source of the spasms but could have started the ball rolling or the displacement itself also resulted from something else structually being misaligned?

 
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Old 08-06-2008, 02:23 PM   #3
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

Thelma-Louise - If you do not wear your splint for a long period of time (6 months or so - if you've ever tried) do the muscle spasms in your body decrease? In my situation, the muscle spasms in my body decrease, however, my jaw is always 'searching' around for a happy place and I get tense muscles on the right side with and without the splint. In a sense, the splint pushes the muscle spasms downward and makes my mouth feel kind of okay. I don't doubt I do have some structural problems because my whole neuromuscular system from age 11 on developed around the pop. I hope/think at least half of the issue is do the the right joint (where the pop used to be being out of whack). Only time will tell what will eventually happen... I don't think a neuromuscular dentist would ultimately be able to help me, but I would be curious to see exactly what muscle the spasms begins with from their EMG equipment. I think that have EMG equipment at Tufts and that is one of the reasons I'm looking forward to going there .

 
Old 08-06-2008, 04:08 PM   #4
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

I had a Surface EMG done by a Upper Cervial Chiro (aka NUCCA chiro) so you don't necessarily need to wait for Tufts for that - so if you want call around to some chiros in you area to see if they have it. It provided a colored print out of 4 different charts that show what muscle groups are involved but it was limited to the c-spine and spine - are you hoping Tufts uses it on your facial muscles to determine where the problem is?

I don't wear the splints I have and the splints I have tried in the past seemed to make my symptoms more pronounced - another reason why the drs I have seen feel my problem is more structural than tmj related. When I do wear what I have my jaws start jumping around as well and basically will not find a place to rest - its annoying - but they also have no affect on the spasms. Also when I wear the splints my jaw will pull to one side - which no one has been able to explain why - yet w/o the splints It goes back to center - it has happened the same way with every splint I have worn by various drs - and when the jaw is pulled to that side the widespread pain
becomes intolerable again.

Have you made your arrangments then to go to Tufts - I'm just wondering how that is going.

 
Old 08-06-2008, 05:34 PM   #5
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

I'm still trying to determine if our reactions to the splint are similar. Let me describe the following experience (probably why I'm so disturbed at this moment and am actually traveling to see specialists):

Earlier this year, about 1 year after I'd had orthognathic surgery in 2006, there was still what I observed to be some minor muscle tension left. I still had my hopes high that it had actually been my bite that was the problem and I thought that maybe if I just stopped wearing my soft splint that the problem would go away. (Before orthognathic surgery, it seemed as if I was clenching my teeth uncontrolably. However, after the surgery I completely stopped clenching altogether, but some tension still remained.)

So, in September of 07 I stopped wearing it with my hopes high of being done with this problem for good. The next few months were very strange and often painful. It was as if my body was untorquing itself. My left toe would to numb and I would often get strange jerks. I was also in pain a lot. I was still hopeful that this was just years of the prior muscle tension from my bite 'working' itself out. I also started having memory problems and all kinds of other issues that made me less productive at work. In May of 08, the muscle spasms in my body were completely gone except the right half and a little of the left half of my head. But even with these spasms, I wasn't sleeping well and felt 'sick' during the day.

Hence, I started wearing the soft splint again. Disturbingly, over the course of the next two months, I could feel the muscle spasms gain intensity and slowly spread through my body once again. It has been crazy. As we speak, I can feel a static like feeling in my right foot. My body is still adjusting to the tension in my jaw. However, I made one valuable discovery. In my case, it is far better to have the muscle spasms pushed down into my body and my head jaw operating/feeling okay than vice versa. I will never go w/o the soft splint again. I also realized that a lot of various feeling over the past 5 years, such as my hips feeling tight, or my knee/leg locking or asleep after long periods of time were due to this muscle tension that has transcended my body. This did not happen overnight!

As I said before, I have always been a very tense/energetic person and probably an intense tooth grinder in my youth. I probably had it coming in some for or another (especially w/ the pop). Perhaps TMJ is natural selection's way of taking tense/nervous people out of the gene pool.

It is crazy because last year I was finishing up a Masters degree and was totally productive. It was as if I was so busy that I didn't have time to think about what was going on in my body. I think I slept pretty well too. This year I've been really depressed. I need to put this problem in the corner of my mind once again and be productive.

 
Old 08-06-2008, 05:46 PM   #6
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

No, I haven't contacted Tufts yet. I am goint to go over the MRI's w/ my TMJ dentist here in Oklahoma at the University and tell her I'm going first so she can have all my records sent over (...I'm curious to see her reaction because I don't think she really believes any of my symptoms... she will think I am one neurotic/crazed person).

 
Old 08-07-2008, 09:34 PM   #7
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

Well the road we travelled to get here is a bit different but we have quite a few similarities. I experienced a few facial traumas when younger, braces, modified orthognathic surgery and then anterior implants with bridges. But through out it all I seemed fine and normal. It was replacement bridges done in 2000 which started my problems (facial pain, pain under my tongue, body fatigue, brain fog, excessive salivation, facial tingling,etc) and an attempt in 2004 by the dentist to relieve the intense pressure I was feeling on the bridges in 2004 that triggered the facial spasms. From that point on I developed every imaginable tmj symptom in addition to the facial spasms and my c-spine, spine and pelvis were impacted. Talking or moving my mouth or tongue seemd to induce more facial spasms and the overall body pain became intolerable. I haven't been able to work as a result and I have spent a large fortune over the years giong from dr to dr - I even went to Dr Gelb in NYC - but I too have come across drs that thought I was crazy or suffered with mental anxiety or stress that was manifesting itself physically.

Its interesting that you feel it is better to push your spasms down - I have been told to do just the opposite. I too tried to forcibly control or stop my spasms. However the cranial chiro I now see said this just pushes the torqueing further down the body's structure and makes it harder to "unwind" even with treatment. He feels the spasms are the body's way to self-unwind so the more it is allowed to do this the more the structural conflict will be resolved. When I first started seeing him last year I was getting a good 20 or more spasms an hour - no exaggeration - and now I get 20 a day - so a big improvement there and I am now walking better and have less overall body pain. However when I first started to see him it did seem like the spasms got progressively intense and frequent so I thought his treatment was making it worse - but now I know they were just responding to his treamtent.

I am just curious - this will seem like a strange or unrelated question with reagrds to all of this - but did you ever suffer or experience any injury to a leg or arm - like a sprain or fracture or any other injuries to your body which did not require treatment but needed to heal on its own just the same?

 
Old 08-08-2008, 07:45 AM   #8
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

Thelma-Louise

The only significant injury I can think of is broken right leg at age 16 that required a cast but healed mostly on its own. Sorry to be asking you so many questions, but I'm just fascinated by other people with similar symptoms. When you say 'spasms'.... do you actually mean an event of heightened muscle tension that can be defined in a time interval? When I say 'spasms', I am referring to more constant muscle tension that builds up and travels down my body. The muscle tension/spasm is always present on the right side of my jaw, and through wearing the splint or whatever it builds into a cresendo and eventually effects all the other muscles around it. I have had what one would define as 'spastic torticolis', but I think that was just more of the process of the muscle tension reaching my neck. I knew it would be there for awhile as the muscle of my neck adjusted and soon it was gone.

Just out of curiosity, considering the degree to which you are disabled, would a total joint replacement be something you would be willing to try? I was reading the book "Taking Control of TMJ" which gave a chart of TMJ/TMD symptoms at certain ages and how they get worse over time. Interestingly, it was right in line w/ my symptoms. i.e. clenching and popping and clicking from age 10-20, tight muscles and scoliosis setting in from 20-30. Alarmingly, it lists 'total loss of control of all facial musculature' from age 60 on. I always assumed those advanced symptoms would only occur if one were living in a third world country or some other bad healthcare situation. If you really had a total loss of control of all facial musculature, don't you think Dr.'s would end up trying some kind of major joint replacement surgery and it would be medically necessary for insurance to pay for it? Perhaps not w/ the current understanding of tmj...

Like I said before though, I believe I really had it coming w/ the pop on the right side and clenching. I went through a horrible stage from age 21-23 where it was almost as if I was 'addicted' to clenching my teeth and it seemed uncontrollable. This was directly following a period of emotional stress and anguish. I've heard other people w/ TMD problems report this. I have this feeling that the Anterior Repositioning Appliance that the dentist used from 98-2001 in an attempt to get rid of the pop on the right side has something to do w/ my pronounced symptoms now. I remember him saying he had actually changed my bite with it. It gradually made things a lot worse. Perhaps my cranium/skull was still growing at that stage. I've also heard that having braces on can 'confuse' the neuromuscular system into making the TMJ/TMD problem worse. This is another thing I experienced because I was convinced that the problem was gone in the two years I had braces. As soon as they took them off in May of 2007, I began having more discrete muscular problems again.

Anyhow, I sincerely appreciate your listening and input Thelma-Louise. I have learned so much from all of you on the forum and I hope I can be assistance to you as well in the future.

-MS

 
Old 08-08-2008, 01:14 PM   #9
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Re: Muscle Spasms caused by Anterior Displacement with Reduction

I read something on the web - but can't find it again - but it was a study that had been done that suggested injuries to other parts of the body do not really heal - the body will do what it can to mend itself and recover but the injury remains and the central nervous system will push the body's "energy" elsewhere - as the body adapts to the change the redirected force in the body's energy flow can induce other injuries elsewhere - what was interesting was this study was done by a tmj dentist "in training" and his study group were his patients and 98% of those he treated suffered an injury to the leg (I had a terrible sprained ankle that took weeks to heal when I was about 20 yrs old) and 90% had an injury to the arm. What he was suggesting or his hypothosis was that the injury to the limb although mended, did not fully heal and over time the body considered this to be a weak link to the overall skeletal structure and in doing so pushed its energy to the strongest area - the jaw or mandible - and this in turn may casue stress to the tmj joints and affect muscle functioning in later years.

Ah the spasms - I will do my best to describe them but its quite hard - but you may understand them more based on what you have described - I get a tightening somewhere in my body, ususlly a muscle in the leg or foot, sometimes my arm or a finger, kind of like a muscle contraction, I then feel this tightness move and travel up -it either goes first to the hips and then to my back and neck or it just goes straight to the neck - the actual spasm will occur when it gets to my neck as my tongue tightens it is then thrusted either upward or forward and my left side of my face gets pulled toward the left and my mouth opens very widely toward the left as well and my head makes a circular motion. It only takes a few seconds for all of this to occur but I am acutely aware of the process as it happens. Initially when it started my left foot would pull out and make a circling motion too but that has since stopped happening. I too can often feel what seems to be muscle tightness randomly moving up and down my body (primarily from my legs going up toward my back - but never downward from my back to the legs) - its not just pain radiating but actual muscle contractions occuring along the accupunture merridian. Its one of the reasons I find it hard to sit for long periods or lay down for long period of time - I find them to be unnerving to say the least. Sometimes I kind of feel like a pinball machine and a ball is inside me binging from spot to spot. I have been told what I have may be described as torticolis or oromandibular dystonia (repetitive irregular muscle functioning) as well. I also have myoclonic jerking - my arms and legs jerk when I am in a relaxed position - another thing that can keep me up at night. The funny thing is with all of this going on - my left upper and lower jaws always feel like they are crossed over one another , not lined up with one over the other - yet MRIs do not confirm this - which is also frustrating - that things look normal on film but I can not function normally. Based on MRIs, every dr that has looked at them have said my tm joints are fine - some arthiritc changes or degeneration on the left side and some flattening of the condyle on that side as well but overall the MRI is seemingly normal - so I doubt I would consider joint replacement - but gee I have been wishing someone would find something - anything - since at this point I would probably jump to surgery, hastey as that might be, just to see if it would have any affect since splints and meds do not.

I too have been told the braces changed my neuromuscular make-up and have confused things .

Also I do recall shortly after getting the dental implants in 1994 experiencing a large "pop" at the back of my head one day and I heard and felt what seemed to be a clunking noise around my neck - kind of like a zipper sound- - it scared me but since nothng happened afterward - no other symptoms other than being concerned about what it was - I pretty much forgot about it until all of this started a few yrs ago. Since the implants were placed anteriorly I am wondering if they did affect me similarly to what may have occured with you as a result of you wearing the anterior repositioning appliance.

I spent quite a lot of time in the begining trying to figure out what caused all of this - the truth is, as one dr told me - it doesn't matter. I thought maybe understanding what caused it would help a dr undo it or treat it - but most feel although its good & useful info (bits and peices of a puzzle so to speak), it doesn't really change anything - what needs to be done is figure out where the source of the problem is. how to stop it and then permanently correct it.

Last edited by Thelma-Louise; 08-08-2008 at 01:20 PM.

 
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