for TMJ Doc

[bbuster]

I'm hoping you will respond to this as it seems you have a lot of expertise.... scotma has replied and I also appreciate his feedback... I have multiple sounds on what I consider my "bad side" ONLY  on closing (NOT on opening). Also my jaw deviates significantly on opening and the other way when closing. On opening, the deviation returns to midline on full open. I can open my mouth wide, but I do feel discomfort in the joints. Lots of moving face pain/under jaws/in front of ears, etc. Something interesting - I have NO PAIN when sleeping or upon awakening, but then an hour or so later, the pain begins. Also lots of neck and upper back muscle pain. Would you respond to his - I sure would appreciate it... thanks.........

[TMJDoc]

If you have limited mouth opening as well as side to side movement you are probably not functioning on your discs properly.  A 'displaced' disc is usually the cause of tinnitus and ear pain (but not the only ones).  I'm of the opinion that patients who are 'off' their discs clench and grind more as a result.  If this is the case that you are off your disc(s), facial exercises are futal.  A TMJ specialist who knows how to get you functioning on your discs is your best option.  The TMD 'community' is divided on treat patients to get back on or readapt to their discs and treating them off of the disc and working on the symptoms.  I'm of the former philosphy even though it is more challenging to do and probably takes longer and may require bite changes to stabilize the TMJ.  But the results are less pain and less likely to regression.  Personally I try to restore the correct anatomic relationships that have most likely changed for the worse.  Your symptoms are very common for displaced discs so I hope you can find someone to help.  Check the American Academy of Craniofacial Pain website referral area.  Good luck.

[jt1967]

I feel desperate.  I don't have health insurance, and have seen two doctors in the past (one, a regular MD; and the other, a TMJ specialist whose assistant is a physical therapist trained to help recovering  stroke victims who limited control in their facial muscles).  My problem had started a few years ago, but it was so minor that I didn't think anything of it.   It began with occasional  ringing in my ears, and discomfort in my neck at night when going to sleep.  I noticed this pain more so lying on my left side than on my right side. It got much worse about 7 months ago: constant tinnitus, very stiff jaw (like it feels rusted).  I was under a lot of stress at the time and chewing, grinding my teeth heavily for several months.   My condition has improved since then, but I seriously want to know what to do to improve my condition so the ringing and jaw stiffness can subside entirely (hopefully).  I notice I have slight clicking noise in my left joint (no popping).  I stopped the facial exercises about two months ago gave me because of the conflicting info with the first doctor.  I'm so confused.  I want to get better, and hopefully recover fully, but don't know how.  

[bbuster]

Thanks for your feedback - some days are not bad, other are really bad to point that I think it's more than mechanical or structurel.........scary. The two sounds in the tmj that are made when closing are audible and can be easily felt and heard when a finger is placed in the ear canal.... anyway, thanks again for your insight............

[TMJDoc]

What you are describing is a disc displacement with reduction, ie, you go on and off of the articular disc in your TMjoint.  They are discplaced forward (anterior) and usually medially (to the inside) to some degree as well.  The shape of the disc and the point to go on and off during opening and closing determines the amount of noise you notice and the amount of deviation in you jaw movements.  You may not experience pain at night because you fortunately 'rest' you jaw at night--most don't.  Poor 'alignment' of the TMJ usually leads to neck and upper back muscular dysfunction as well.  You need to find a qualified TMJ specialist that can evaluate your situation and use effective orthotic treatment to get you functioning on your discs (we call it recapturing--although that doesn't always happen) again.  It can be done by an experienced clinician and is very effective in relief of pain and can limit or stop future osteo-arthritis in the TMJ.  Hope that this info helps.