Hi all, I've joined this forum for a while but this is the first time I'm posting. I've been having TMJ issues for about 2 years now. Mainly muscle spasms at the right TMJ/face/head/neck area. The discomfort is 24/7 from when I wake up till I go to sleep, and the level ranges between 2-8. Tried all sorts of treatments and nothing has worked.
I have a question for those who have experience with the Neuromuscular Orthotic.
I understand that this orthotic would reposition the jaw into a more comfortable position, usually by moving the lower jaw a bit down and forward. But let's say in this situation: the right TMJ has a problem, the left TMJ is fine. When you reposition the jaw so that the right TMJ goes into a better position, wouldn't this make the left TMJ OUT of position?
I'm asking because I saw a neuromuscular dentist 3 weeks ago. I'm still waiting for my orthotic to arrive from the lab, but the dentist made me a temporary one, and I've been wearing it about 20 hours a day (can't eat or speak with it on because it's bulky). However, after 2 weeks+, I'm starting to feel a bit of facial pain and muscle tension on my left side (the good side). It's very slight but still it is very worrying. I wouldn't want to have TWO bad TMJs!
So to those who have had the Neuromuscular Dentistry way, did you ever experience things getting worse on the good side with the orthotic?
The following user gives a hug of support to MissyJ:
I'm not too far ahead of you. Face, neck muscles spasm joint pain- all constant. 3 weeks in the NM orthotic after a few in the soft splint. I got a touch of pain on the good side but it went away. The idea is that both joints find the natural position(with the soft splint or tensing and the NM splint), so it will cause some muscle disturbance initially but your muscles will adapt quickly.
In my case and probably yours too the joint is in bad shape and that causes the long term pain, both joint and muscle, on the bad side.
I wish I had some encouraging news but after 3 weeks I'm not much different. Maybe a little less intensity but thats it. Hopefully you get recovery faster. I'm thinking I'm staying in pain for many months.
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I've had a TMJD diagnosis for a couple years now. Muscle spasms were causing me all kinds of problems for a very long time.
I'm curious about what testing you had to know you only have TMJD on one side. Is it just because the pain is on that side? In my case, the pain/muscle spasms are all on the right side. Ironically, testing shows my left side is actually in worse condition. It took a series of tests to confirm this.
I've been in multiple splints over the years. Some actually made my TMJD symptoms much much worse. My actual lower mandibular repositioning splint has actually been the most effective. I actually supplemented my splint therapy with visits to my physical therapist for orofacial/neck therapy and trigger point releases. My orthodontist also did trigger point releases and ultrasound on my tmj and neck areas. When things were at their worst, my ENT would also prescribe some low dose muscle relaxers. When the muscles are constantly in spasm, it takes a long time and a lot of work to get them to loosen. In my case it took about 6 months into repositioning splint therapy until my muscles were "happy" and allowed my bite to relax enough to be comfortable in the new position.
The goal of your treatment is to get your entire bite into order. There are times when things might feel worse before they get better. I really wouldn't worry yet about the pain on your left side yet. Make sure you let your orthodontist know about your pain when you go back for your splint though.
I will say that as I've progressed in treatment I've had periods of time where things have been great and other times when the spasms still flare. I just need to know what works for me to address those flares. That took trial and error, money for treatment (which I don't always have and has resulted in my treatment progressing slowly at times), multiple modalities of treatment.
jbuilder2 and MountainReader, thank you for your replies. Tears uncontrollably rolled down from my eyes when I read them beucase you guys can actually relate to what I'm saying. I feel so so so alone in this nightmare. I wish I could hug you guys now.
jbuilder2, I've heard that you need to wear the orthotic for a minimum of 3 months, so hang in there! We're into treatment around the same time so it'll be great to compare stories with each other. May I know what was the cause of your TMJD? Mine was cuased by my chronic clenching in my sleep. And how long have you had symptoms for? Mine's been about 2 years.
MountainReader, over the last 1.5 years I've had a couple of ENT exams, 2 brain MRIs, multiple dental x-rays, and everything came out normal! However, there were two things that indicated something was not right :
1. Upper cervical x-ray which indicated a loss of lordosis (I've lost the natural curve in the neck). The x-ray was ordered by the chiropractor.
2. K7 EMG testing which indicated the muscles on the right side of my head/face/neck were much more tensed compared to the left side. This was done by the current NM dentist that I'm seeing.
So besides these two things, I'm mostly indicating the TMJD on my right side based on the pain/spasms/discomfort that I'm feeling.
I've felt facial pain and muscle tension in the left before (mostly around the ear, base of skull, and across cheek but never in the joint itself, or as bad as the right side), but they went away after I did neck adjustments with my chiropractor, which was really helpful. But in the last one week I can feel they are slowly coming back, so I was just worried what if my temp orthotic was making my right better but messing up my left. I'm going for a neck adjustment later and hopefully it'll get rid of the discomfort in the left side!
MountainReader, what was the cause of your TMJD? Have you finished Phase 1 treatment? How many months in total did you wear the orthotic for (or the repositioning splint)? So when you say after 6 months, your muscles were finally 'happy' do you mean all the pain and spasms went away? What level of pain are you feeling now? (On a scale of 0 -10). I would love to hear more of your experience.
Oh dear I asked you guys about the causes of your TMJD and I just realised it's already been answered in another thread called Why did we all develop TMJ problems? I'll add my own story into that thread too.
As you can see from many of my past posts, I'm not great at answering without writing a while book. I'll try to keep it short here.
I'm now about a week shy of being 8 months into Phase II treatment. I started my Phase I treatment with a repositioning splint in June 2010. After about 6 months, my muscles had loosened enough that the spasms weren't as bad and I was doing well with the repositioning splint. While I've never gone extended periods without any spasms at all, my ear finally popped (after over a year being stuffed), my ear pain went away and the bad spasms diminished. I reached a point where some days I didn't have any pain and when I did it was typically mild. I couldn't afford my Phase II treatment at the time so I just continued with my Phase I splint only until I was ready. My orthodontist did a 3D scan with my splint in to see how my tmj alignment was before I went to Phase II.
Currently, I have periods of time where the spasms are pretty well gone, then I will have something that triggers them again. Sometimes adjustments to my braces will temporarily flare things, but that usually works its way out. Right now, I'm dealing with some serious spasming, but it stems from another health problem. I had surgery on my arm. Long story short, it triggered bicep and shoulder tendonitis which has triggered my neck and tmj on that side into spasms. It is pretty slow getting it back under control because my wrist therapy is going to take a while longer. I did get an ultrasound treatment at my orthodontist a couple weeks ago to help.
I am very happy with my progress though.
Really, when I was at the point you are in the orofacial trigger point releases on my masseter and pterygoid were lifesavers. Extremely painful, but totally worth it.
My TMJD PT did alot of work on my neck and shoulder areas first during every treatment. Two TMJ specialists I went to also diagnosed me with cervicalgia and myofacial pain. They seem to go hand-in-hand.
Thank you for sharing! I've read some of your other posts and now have a better idea of your experience. I'm so happy to hear that you're progressing well! I also have been diagnosed with myofascial pain, and the jaw spasms really drive me crazy. I can't wait to feel better, but from your story (and others), I know this is going to be a long journey, and I have to be very patient. I hope you're recovering well from your arm surgery!
The following user gives a hug of support to MissyJ:
So I finally saw my NM dentist again this week and got my actual orthotic. I thought it would be somewhat the same as the temporary one but I was surprised it was quite different. So I've been wearing it for about 4 days now, and the facial pain on the left cheek is now gone, thank god. There's still a very slight tension in below the skull and neck area, but it doens't bother me too much. Of course my major concern is still the right side but I will need to give it time.
Anyway, so I asked him the question about the orthotic. By repositioning the jaw, wouldn't it 'realign the bad side' but then 'mess up the good side'? So his answer to this was that: The jaw can move in 6 ways (up, down, left, right, front, and back), so to reposition the jaw into a more comfortable place, it's not as easy as just 'drop down and pull forward'. Makes more sense to me now.
Just wanted to clear that up incase anyone else had the same question.