tmj???

[sassiegyrl]

Hello,  I have been having terrible pain behind my left hear and extremely light sensitivity for the past 6 months. I saw an ENT last week. He said that I had no ear infection but it is probably tmj. He mentioned to stop chewing gum and to take 3 ibuprophin for pain.
Other symptoms I have are anxiety, sinus problems, My jaw pops, clench my teeth and I do grind my teeth at night even as a teen. I probably have more to list. What doctor should I see for additional help????

Thanks

[consus]

Hi, could you provide more information on you condition?
How would you decribe the pain, with 0 being no pain and 10 being the worst pain of you life?
What causes the onset, and how often do you get this pain?
Is it a burning, aching pain, or a sharp, stabbing pain?
Does the pain radiate to anywhere, or just behind the left ear?
It it worse on waking, or during the day?

The above poster did a good job covering some of the treatments for chronic TMJ pain.  She's correct in saying its a crap shoot, often when no treatment works really well, a lot of "ok" treatments are used.  I would avoid any orthodontic/surgical work until you figure out a little more about whats going on.  Sometimes TMJ pain will subside over tiime, but if you are in pain do seek treatment.
Heres a few things you should do:
-see your dentist about getting a night guard to protect you teeth from grinding
-see a medical professional about your symptoms, if you ccan answer some of my questions above, it might narrow it down a bit
-avoid wide jaw openings and gapes, try to not to do lateral movement of your jaw beyond what you need to for daily function
-anxiety is linked to TMJ disorders, see about management of this with your Dr.
-if you have a history of migraine headaches, they are often one sided, and have photophobia associated see your Dr.

Two warning signs:
-if you have narrowed vision in the eye on the side of the headache/joint pain, and a vein that "stands out," go see you Dr. immediately
-if these are headaches that come on like a thunderclap, hurt worse than anything, and go away and return multiple times (in clusters), you should see your physician

Hope this helps, get well soon

[lindahand]

I would get some sort of panoramic xray done to determine if there is any damage in the joints. They have really good digital xrays that are phenominal at seeing the jaw joints. They also use less radiation than a typical xray.

I would be careful not to exceed the recommended dose of ibuprofen. It can cause stomach problem - happened to me. If this continues I would go to the doctor and ask for a buffered drug. I also found Aleve (Naproxen) works better than ibuprofen and lasts all day. Although I found Rub A535 Capsaicin Arthritis cream applied behind the ears works better than either and has no known side effects. Capsaicin with extended use actually decreases Substance P which is known to increase pain. So the more you use it the more likely you are to experience greater pain relief. Capsaicin is hot peppers so don't put it in front of your ear because you may get it in your eyes.

It is a bit of a crap shoot as to what doctor is the best. An oral maxilliofacial surgeon looks after the physical aspects of jaw joint disorders. So if there is something structural that needs fixing these are the guys to see. They are not all created equal. Ask if they do jaw joint replacements. If they do it is a good sign. Some oral surgeons just do wisdom teeth, don't want to waste your money seeing one of them.

The other doctor you can see is an orthodontist. Sometimes if your bite is off it can cause the grinding you talk about. They can also create a bite splint (retainer) for you. I would not be without mine as it really helps with the pain. A dentist can make these as well. The cost is between $300 - $600 in Canada. Likely cheaper in the US. Well worth the bucks.

My oral surgeon referred me to my orthodontist (That was 15 years ago now). Terry and Walter worked together to consult on my case. I had my jaw joints completely rebuilt and they did an excellent job. I went from severe pain on disability to being able to return to work with only minimal pain.

Another professional you can see is a physiotherapist (I think they are called physical therapists in the US). They will work on the muscles and functioning. Again they are not all considered equal. It is important to ask if they do any post jaw joint surgery work. Most physiotherapist will say they work on jaw joints, but the really good ones do post surgery work.

If you can do things like guided imagery, diaphramic breathing, progressive muscle relaxation and even yogo it will help with the pain and anxiety.And don't neglect the cardio exercise because it creates pain fighting endorphines. I know how hard it is to do when you are in pain. Your natural instinct is to quit moving.

I know from experience, the anxiety will increase the pain and clenching. It may be worth seeing a psychologist to see if you can't learn some skills to help overcome the anxiety. The Phobia and Anxiety Workbook is a good book as well.

Hope this helps. I know it is a little long. In a verbous mood today I guess.