We learned the song as kids: “The foot bone’s connected to the leg bone . . .” My how quickly we forget! Even as doctors, we tend to overlook the fact that every part of the body is interconnected with every other part of our body. Misalignments and imbalances in one area can have a cascading effect. Patients suffering from TMJ pain are probably experiencing more than just jaw pain. What they may not realize—and what a doctor not trained in integrative medicine and pain management may not realize—is that their other aches and pains are probably related to an imbalance in the TMJ as well.
The TMD and Body Connection
When patients come to me complaining of TMJ pain, their complaints are far more than just pain or popping in the jaw when they chew. They also usually experience muscle soreness in the shoulders and neck. Many suffer from chronic headaches and even earaches. When I probe further, some of my patients even experience tingling and/or numbness down one or both arms.
Patients are often confused at first by the questions I ask during a consult. They are then shocked when I tell them that their TMD is probably the root cause of all the other ailments they have just described. What patients don’t realize is that a misaligned TMJ affects more than just the jaw and the teeth. It also affects the muscles and nerves, not only in the jaw, but also in the head, neck, and spine. The pressure this misalignment exerts is nearly three times the weight of our heads when the TMJ is in balance!
The Other Way Around
On the other hand, some patients come to me complaining of TMJ pain, but the cause is not actually TMD. After peeking at their medical history, I can usually tell what’s really causing their pain. These patients have no misalignment in the jaw that’s causing the pain. What they do have is a chronic medical condition. Fibromyalgia and similar medical conditions can make chewing, speaking, yawning, and other jaw movements painful. This can cause the same muscle pain and limited mobility as TMD.
Nearly 70 percent of patients with fibromyalgia experience TMJ pain, and more than 35 percent experience popping or clicking as well as limited mobility. This makes it crucial to properly diagnose patients. Although some of the treatments we recommend for TMD could help, it would not provide these patients with long-term relief. Instead, they would be back in my office sooner, rather than later, complaining that their pain has not completely gone away. Or it may have returned or worsened.
Fibromyalgia requires more effective pain management, and an increase in pain thresholds, to alleviate the facial pain patients experience. It’s possible that patients with conditions such as fibromyalgia also have TMD. But more often than not, patients have one or the other. If the patient does have both conditions, doctors must work together to provide solutions for effective pain relief.
Relieving TMD-Associated Pain
As pain management experts, we must provide our patients with pain relief. To do so means treating more than just the symptoms. We must also address the underlying cause. It is our duty develop a comprehensive plan to alleviate not only the pain, but also the potential causes, including TMD, stress, and teeth grinding. This can provide patients with the pain relief they desperately need.
About the Author: Dr. Mickiewicz owns a private practice in Sacramento and lectures across the nation on TMD treatments. He is a diplomate of the American Academy of Pain Management and holds membership in many professional associations for dentistry, sleep medicine, and TMD. In addition, Dr. Mick, as his patients call him, founded Pacific Orofacial Pain Consultants, a team of experts in various disciplines, who tackle the issue of TMD pain and treatment, to help sufferers find relief from chronic pain. To talk with Dr. Mick, call his Sacramento dental office at 916-457-7710.
