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odog 03-10-2003 10:44 PM

Cervical Spine, TMJ - more tests or surgery?

I will try Physical thearpy. If it works great. If it doesn't what other tests or surgeries should I consider?

The situation is as follows -
7/2002 - TMJ symptoms - headache, jaw pain, teeth, neck (throat, front, back)
8/2002 - X-ray confirms - degenerative joint disease
osteoarthritis in back

9/2002 - TMJ doc - Says have degenrative TMJ joints
causing pain.

10/2002 - Second opinion TMJ dentist that just specializes in TMJ diagnosis - say's no TMJ but tension and stress. Recommends - Cranio Sacral Therapy
Decide to get MRI of TMJ.

10/2002 - TMJ doc does MRI - Mandibular condyle remodeled so its pointed in apperance. Meniscal appartus mildly anteriorly subluexed. Eary reduction during anterior translation of the mandibular condyle.
Recommends - Arthroscopic surgery on joint (medicate, clear out adhessions, etc.)

12/2002 - Try a month of drugs (Anti-Inflamatory, muscle relaxers.) - Helps TMJ joint pain and some spasms.

1/2003 - More anxiety neck throat issues (spasm, pain). Regular Dr. say's TMJ Dr. "Wants a new boat"
Forget surgery. Regular Dr. talks like it might be cardic issue (Had a Thallium Stress test 4/2002, results normal and good. Tot. Chol. 179, HDL 47, Tri 127, LDL 106 Tot Chol/HDL - 3.8). I hope not cardic but had brother and dad who ate bad and smoked and had heart attacks 5-10 years younger than I am now. I don't smoke or eat bad). Have some acid reflux problems but relative minor. Regular Dr. gives me NitroGlycerin and Anti-Depressant (Remeron). Nitro pill helps spasm but cause TMJ joints to "burn - like fire" after taking a pill. Regular Dr. not sure why nitro burning. If I go back to Dr. might get sent to cardiologist for angiogram workup, but hard to believe it is plugged up artries.

2/2003 - Neck/Throat pain still big issue. Go around holding neck all the time especially in stressful situations. Have a cervical spine x-ray. Result - C2,3 osteophyte sinus processes posteriorly. Disc degeneration with space narrowing C5,6,7. Disc vacuum phenomenon C6,7. Alignment of the cervical vertebrade is maintained. Mild bony foraminal narrowin on the left & right at C4,5,6,7. Conclusion: Disc degeneration at C4,5,6,7 with associated bony foraminal narrowing.

3/2003 - Trying physical thearpy.

TMJ joints areas ache when in direct cold weather or stressful situations along with spasm and pain in throat around carotid artery on right side especially.
Back feels like I would like to make it pop in the mid back to relieve tension.

winged phantom 03-11-2003 07:27 AM

I know nothing about the TMJ issues. But since the C-spine X-ray showed degenerative changes, be sure to get a C-spine (cervical-spine; neck) MRI. And don't you dare get your neck cracked or adjusted!

As far as the esophageal spasms, try my posting under Digestive Disorders: [url=""][/url]

Last year I was relying on nitro to help them, too, until I found a much better way. I hope this can help you, too. Or anyone else on the boards, for that matter!

Good luck with the MRI. I hope it doesn't show too much wrong. But if it does, I'm right there with you: I'm getting a three level fusion at C4-5, 5-6, 6-7.


CoffeeGirl 03-11-2003 12:14 PM

Please please treat the TMJ conservatively. I KNOW it hurts... been there, done that and am still doing it... but the more time someone does something invasive into the TM area, the less likely things will improve and will often, in fact, worsen.

I had the arthrocentesis. It did nothing. I've had the surgeries. It's not helped the pain. Now I have cervical spine problems after years and years of TMJD.

If I could advise someone just "starting out" with TMJD, I'd say be conservative, avoid surgery if at all possible. There truly is not a lot of knowledge among MD's out there re: TMJD. Not much is known and so there is a log of hocus pocus and experiementation...much of it is well intentioned but the research isn't there to back much of it.

I don't mean to be discouraging. For me, TMJD pain is a fact of life. The best thing I've done is gone to a pain clinic. I'm now taking Topamax for my jaw and neck.

Email me if you want.

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