I was diagnosed with TMJ when I was eighteen years old, and except for occasional soreness in the jaw hinge, haven't thought about it much since. I know that if I open my mouth wide, it opens with a click but it doesn't really bother me.
Then, about a week ago, I started having a sore right ear, occasional muffled and ringing sounds, the need to pop my ears, pressure, etc. It slowly progressed, and then two nights ago, I couldn't sleep because the pain was so severe all of a sudden. It was pretty much constant. It hurts worst in my tragus (that little fleshy bump that sticks out from where your cheek meets your ear, and which some people get pierced), the bottom of the inside of my ear, my neck right under my ear, the roof of my mouth, and the side of my tongue. It's very sharp and intense. I don't have vertigo now, though that is a recurring problem for me.
The resident said it was an ear infection, but when the attending came in, he said it was actually TMJ, a bad flare of it. I am wondering if maybe I should see a dentist to make sure it's not a tooth abscess or something, though. Do my symptoms sound like TMJ to you?
More importantly, if it is TMJ, could it explain my chronic migraines? They are ALWAYS on the same side as this ear pain, the right side, and they come up from the right side of the back of my neck and around to my right eye and cheek. They are usually very unpleasant but not unbearable, though I had the worst one of my life a few weeks ago and ended up in the ER, vomiting and dizzy. Meds for the most part don't prevent the headaches. Maybe if I do have TMJ and I deal with it (how do people "deal" with it, anyway?), the headaches could get better?
My dad had TMJ but no one in my family has ever had a migraine, if that means anything.
Thanks for the advice. Oh, and I also suffer from Ehlers-Danlos, which is a condition that makes me super flexible and therefore prone to joint injuries/pain/arthritis. Thanks!
Wow, it appears there are a lot of new people to this board who are experiencing ear pain. I know that was what led me to the board as well.
I had ear stuffiness, ear pain and eventually hearing loss that they couldn't find a physical cause for. After seeing a range of specialists, I finally realized it was probably TMJ. It took me a couple tries, but I finally found a wonderful TMJ trained Functional Orthodontist who has been able to help me.
If you haven't found it, there is a good sticky at the top of this board that lists out various TMJD symptoms. Migraines can certainly be part a symptom.
The thing I've found about TMJD is that we are dealing with a series of muscle spasms triggered by the jaw being out of position. Getting those muscles out of spasm needs to be a goal. In addition to working with my orthodontist, I worked with a well trained PT, my ENT, my chiropractor and some occassional massages (as I could afford them). I found it took the combination of treatments to really help and that if we try just one it usually doesn't help a lot.
When my pain was intensly bad, I would take a short low dosage script of muscle relaxers. Using a properly fitted lower mandibular repositioning splint, getting trigger point releases, having my neck, shoulder and back worked on, working on my alignment, etc... all helped towards loosening those muscles.
THere is a great book that explains all of this called The TMJ Healing Plan by Cynthia Peterson. It is fairly short, very thorough and explains things in ways we can understand to help us heal head and neck pains.
My issues aren't as severe as yours, but I have some joint hypermobility. I firmly believe that it contributed to my TMJ disc slipping and my issues. I've noticed that as I've gotten older my body isn't compensating as well for the hypermobility and I've started to have more and more joint issues. In the last few years, I've had surgeries on my shoulder (first diagnosed with hypermobility with this one) and wirst, developed TMJD and had aches and pains from other joints that I'd never had before. I haven't found any solutions to this so far other than seeing different specialists for each joint issue.
Thank you for the response. I am still perversely hoping it's a tooth abscess because that would be a quicker fix than TMJ, but that's a shot in the dark. I'll know more after I see the dentist later today.I am awake now from the pain. I saw your list of illnesses and you should ask your doctor about Ehlers-Danlos. E.g., ED causes your feet to slowly spread and become flat and then you get plantar fasciitis, which I also have, chronically and horribly. The frequent joint injuries, aches and even sometimes dislocations lead to "early arthritis." I'm 30 and I already have arthritis. Because ED is a connective tissue disorder, severe cases include heart abnormalities. And it's genetic.
Anyway, given all that, it makes sense that I'd have problems with my jaw, but I really don't need another pain problem! What is this about splints? I don't want to wear one other people can see, so unless they've come up with a magical invisible one, I'm not gonna be very happy. Maybe this will just resolve on its own?
I didn't see any Iowa TMJ doctors when I searched that thread at the top. I live in the Iowa City area, which is near Cedar Rapids. How can I find a TMJ doc to consult?
I wore my lower mandibular splint for 26 months. Nobody ever noticed it. For the first few days I had it, my speech was a bit off, but I adjusted quickly. Seriously, nobody knew I had it on. Mine covered all of my lower teeth and was made of clear acrylic. It had "bumps" on the top that coordinated with my upper teeth. In order for me to settle my bite, I had to bring my lower jaw forward and a bit right. After a few months, that was my "normal". I wore the splint longer than normal since I chose to go with braces for my Phase II and I had to come up with the money first. Personally, I would have been just fine wearing it longer if I had needed to because it was that effective for me.
The only thing that made my splint "noticable" was that there were a few foods that I had trouble chewing because the acrylic wasn't as sharp as my natural teeth. Chewing flat lettuce and biting through things like pickle skins was difficult for me. I also had to cut up some foods a bit instead of biting through them directly. I ended up just avoiding some foods or eating them only when I was home so I could take my time working through the problem foods. I think I was the one who noticed all this most of the time though. I ws just more conscious of it.
I have no doubt that I have some sort of connective tissue disorder. It just doesn't seem to be severe enough to be classified with a specific diagnosis. I'm so thankful that I don't have dislocations like you do. I just end up with ongoing subluxations. I actually have an appointment tomorrow with a surgeon to get a 3rd opinion on my chronic wrist issue on my dominant hand. I feel for you that you are dealing with this at such a young age. I was in my mid 30's when I started with the joint symptoms. I have been told that there is a high liklihood that I'll develop arthritis in my TMJ at some point. That is part of why I'm being aggressive in treating it. I want to hold that arthritis off as long as I can.
Finding a TMJ specialist can be a challenge. You might try searching for a Functional Orthodontist with additional TMJ training or a Neuromuscular Dentist in your area. You can call and ask questions about how much TMJ training the orthodontist has before making your decision. I'd recommend trying that before seeking out a surgeon.
I didn't realize splints could be worn inside the mouth! That is cool, and I'd be willing to give that a try. I saw the dentist this morning, and there's no abscess, but I do have a "pulp stone" in one of my upper right molars, near where the pain is. It's like a kidney stone but in the pulp of the tooth and I need ANOTHER stupid root canal to fix it. I have to go to the dentistry college in the area for the root canal, and I realized that I think they have TMJ specialists there, so that'll be my first attempt. The dentist suspected that I do have TMJ, like the doctor thought, and that the pulp stone is contributing to, but not causing, the pain. With Aleve the pain has become more manageable but I worry it'll come back. I'm going to try to read more on the boards to figure out what this Phase I and Phase II stuff is.
I didn't realize splints could be worn inside the mouth! That is cool, and I'd be willing to give that a try. I saw the dentist this morning, and there's no abscess, but I do have a "pulp stone" in one of my upper right molars, near where the pain is. It's like a kidney stone but in the pulp of the tooth and I need my 6th stupid root canal to fix it. I have to go to the dentistry college in the area for the root canal, and I realized that I think they have TMJ specialists there, so that'll be my first attempt. The dentist suspected that I do have TMJ, like the doctor thought, and that the pulp stone is contributing to, but not causing, the pain. With Aleve the pain has become more manageable but I worry it'll come back. I'm going to try to read more on the boards to figure out what this Phase I and Phase II stuff is.
Good luck with your surgeon appt!
The following user gives a hug of support to kloser2fine: MountainReader (09-11-2012)