Advice regarding treatment, including hyaluronic acid.
I thought I'd best seek some advice as I'm due to meet my surgeon this week to discuss my treatment. I've had a dental and jaw problem since I was little - as a child I had my back teeth removed as my mouth was too small and as a teenager I had to have braces. Progressively my jaw got tighter and started to click and pop but it was never bad (not to the extent that it stopped me from doing anything).
Two years ago I was diagnosed with a genetic disorder that required a colectomy. Unfortunately during the intubation my jaw was dislodged and whilst recovering from surgery my jaw symptoms worsened. My treatment and symptoms since mid-2011 has been thus:
1) Topical ibuprofen for joint. I have to use NSAIDs as I'm on a Proton-Pump Inhibitor.
2) One morning my jaw locked closed. It took a couple of hours to loosen and my doctor gave me a strong dose of Diazepam as a relaxant.
3) Referred to Dental Hospital. Was put on a course of Diclofenac which was contra-indicated by the PPI.
4) Jaw was x-rayed and I was given a splint to use at night. Made the pain worse, jaw became locked open and closed more frequently. At this point it became difficult to do things normally. Very bad headaches and neck pain.
5) Had an MRI and was prescribed, in turn, cocodamol, amitryptyline and nortrypyline. These also reacted with the PPI and made me lethargic.
6) Had athrocentesis in June - successfully washed out debris, released left disc (which was stuck forwards) and released right disc (stuck backwards and turned in). Some degradation to discs. All was wonderful for two weeks.
7) After two weeks reverted to 'normal', i.e. popping, clicking, limited opening, etc. Referred for CT Scan.
During the post-op consultation (when I was referred for a CT scan), my surgeon suggested that I embark on a course of hyaluronic acid injections. I gather that very few places use this method for TMJ treatment and my local hospital is the only one in the UK doing so. Does anybody have any experience and advice regarding this? I'd like to know about the efficacy of the injections - do they provide a lasting solution or do they require repeat treatment?
The other option discussed at the time of my referral for a CT scan was joint replacement. I'm uncertain as to what this would entail at the moment but would be interested in people's opinions.
This is increasingly unbearable. I go to bed with a headache, I wake up with a headache. I ache in my neck and shoulders. I tire easily. It's hit and miss whether or not I'll be able to open and close my mouth each day. Thanks for listening and for any advice you can offer.