How do you tell what symptoms are from TMJ or TN I know the electrical shocks are TN but I am not sure about all of the other Atypical pain is it TN or TMJ ? What symptoms are common for TMJ and is it on both side of face or just one. I am a little confused about Atypical Pain I have is it TMJ or is it Atypical TN? Can anyone describe to me what their TMJ pain is like?
I've been trying to find the answer to this question, too.
My first facial pains were TMJ related. I haven't had the electrical shocks with TMJ but definitely nerve pain in V2 and V3 that affects every tooth, tooth roots, gums, palate, tongue, bottom lip, and chin. The pain is constant, 24/7 and I was told that this was TMJ pain that was worsened because the TMJ prosthesis was implanted crooked and pressing on facial structures. But if you just have straight TMJ pain with no prosthesis or other pieces of metal, etc. in your body, the question I have is does it affect your neck, base of your head, shoulders, give you headaches, difficulty concentrating, etc.?
You can have TMJ pain bilaterally. It is usually because of the condyle is out of positioning causing a whole cascade of events involving pain. Sometimes the disc has slipped out of positioning and you may be having bone of bone touching on one side or both sides causing pain. This can sometimes be fixed by an "easy" procedure called an arthroscopy to pull the disk back into place so it won't be bone on bone anymore. This may eliminate any popping and clicking noises and protect the upper and lower jaw bones. . That disc or meniscus is important. Mine got out of place on one side, bone on bone, and one side started to look crooked because the doc said since the disc had "deteriorated" , it was causing my chin to deviate to one side. Turned out the disc was in my face, it just needed to be moved back into place and sewn into place.Before you have anything done, you may want to contact and become a member of the TMJ Association. I think it's www.tmj.org. My personal advice is do not get a prosthesis unless you have cancer or have been in a horrid car wreck. I had one TMJ surgery that I never should have had ( was "scared into it by one of the top docs in the US"). But I'm no doctor, so always have it evaluated by reputable oral maxillofacial surgeons. Not many OMFS do TMJ surgery anymore because insurance doesn't cover it most of the time. There is a small circle of surgeons and they look after each other's back, if you know what I mean. That has been my experience. Contact me at ■■■■■■■■■■■■■■■■■■■■■■■ if you ever need to talk about TMJ/TN and which docs have had the best outcomes. The TMJ.org is not allowed to say but the members can.
Have you worn splints? Are you grinding teeth? You may want to consider wearing splints at night that your dentist or orthodontist can make after making teeth impressions. If your symptoms get better,, you'll know that most of your pain may be TN related vs. TMJ. Also, neuromuscular therapists can help with TMJ pain. Make sure they know what they are doing. Ask questions of your dentists or orthodontists as to who is good at facial pain massage therapy in your area.
Take care.
Tinkerbell
the question I have is does it affect your neck, base of your head, shoulders, give you headaches, difficulty concentrating, etc.? Yes Plus I get pain a sudden pain on the small outside part of the ear that is closetst to your face and then runs down my jaw to chin on both side plus it aches and burns sometimes in same area
I do not grind teeth but I do clinch my teeth
Tinkerbell said:
My first facial pains were TMJ related. I haven't had the electrical shocks with TMJ but definitely nerve pain in V2 and V3 that affects every tooth, tooth roots, gums, palate, tongue, bottom lip, and chin. The pain is constant, 24/7 and I was told that this was TMJ pain that was worsened because the TMJ prosthesis was implanted crooked and pressing on facial structures. But if you just have straight TMJ pain with no prosthesis or other pieces of metal, etc. in your body, the question I have is does it affect your neck, base of your head, shoulders, give you headaches, difficulty concentrating, etc.?
You can have TMJ pain bilaterally. It is usually because of the condyle is out of positioning causing a whole cascade of events involving pain. Sometimes the disc has slipped out of positioning and you may be having bone of bone touching on one side or both sides causing pain. This can sometimes be fixed by an "easy" procedure called an arthroscopy to pull the disk back into place so it won't be bone on bone anymore. This may eliminate any popping and clicking noises and protect the upper and lower jaw bones. . That disc or meniscus is important. Mine got out of place on one side, bone on bone, and one side started to look crooked because the doc said since the disc had "deteriorated" , it was causing my chin to deviate to one side. Turned out the disc was in my face, it just needed to be moved back into place and sewn into place.Before you have anything done, you may want to contact and become a member of the TMJ Association. I think it's www.tmj.org. My personal advice is do not get a prosthesis unless you have cancer or have been in a horrid car wreck. I had one TMJ surgery that I never should have had ( was "scared into it by one of the top docs in the US"). But I'm no doctor, so always have it evaluated by reputable oral maxillofacial surgeons. Not many OMFS do TMJ surgery anymore because insurance doesn't cover it most of the time. There is a small circle of surgeons and they look after each other's back, if you know what I mean. That has been my experience. Contact me at tracyburttata@gmail.com if you ever need to talk about TMJ/TN and which docs have had the best outcomes. The TMJ.org is not allowed to say but the members can.
Have you worn splints? Are you grinding teeth? You may want to consider wearing splints at night that your dentist or orthodontist can make after making teeth impressions. If your symptoms get better,, you'll know that most of your pain may be TN related vs. TMJ. Also, neuromuscular therapists can help with TMJ pain. Make sure they know what they are doing. Ask questions of your dentists or orthodontists as to who is good at facial pain massage therapy in your area.
Take care.
Tinkerbell
Hi,
Yes, TMJ Disorder can give you pain in your neck, shoulders, and back and headaches are quite common. This is because misalignment or disbalance anywhere in the head or body affects all the rest of your body too, or so they say. Difficulty concentrating is a consequence of the pain and strain in your face/head, I think. www.tmjhope.org is another good site to visit, lots of useful info there!
Take care,
Oldriska
Take care,
Oli
TMJ disorder is very broadly defined -- s0 much so that some people (including me) suspect that the lack of precision in its definition has something to do with the financial self interest of dentists who treat the disorder.
That being said, from years of reading in this area of medical literature, I've arrived at some informed but not authoritative opinions that I'll share. Remember that I'm not a medical doctor. There are several ways to narrow a TMJ diagnosis and distinguish it from other alternative interpretations of the same symptoms. If the joint is "clicking" or has ever locked in place, then TMJ Disorder is pretty much indicated. X-ray identification of debris in the joint is also a fairly reliable indicator. But beyond those two, it's time to get careful.
Normally if you're grinding your teeth enough to cause joint problems,there should be a wear pattern on the teeth. If there's no wear pattern, then very likely you are NOT grinding and there's no confirmation of Bruxism or TMJ. Pain in your neck or shoulders almost has to be "referred" pain or related to a problem in alignment of the cervical spine. If that pain responds to non-violent chiropractic adjustment, then it is NOT TMJ. Pain in your forehead is likewise not likely to be TMJ-related. There's no neural pathway for referral from the TMJ structures. If a dentist tells you that your bite is misaligned, then require him to walk you through the physical evidence that it is, step by step. If he can't do that, then find another dentist before you let a misinformed practitioner cause you more trouble.
The term "atypical pain" should also be used with care. Atypical Face Pain is not a legitimate medical entity with a defined course of treatment. It just means "face pain of obscure origins that isn't like classic TN".
For those who are interested, I have a rather lengthy article from a dental practitioner, on a case study where TN was mis-diagnosed as TMJ. Send me email at ■■■■■■■■■■■■■■■■■■■ and I can return it to you by attachment. It's copyrighted so I can't post it here.
Regards, Red
Can TMJ cause pain severe enough to cause one the throw up and consider going to the ER? Does it cause severe ear and face and head pain?
Last weekend, I had the WORST flare up of my entire experience with this ear/jaw/face pain after an acupuncture treatment. I felt that my face and head were being crushed from the inside, I couldn't lay on my pillow because it hurt so excruciatingly, i was puking uncontrollably, and my husband was driving me to the ER when suddenly the pain dropped from a 10+ to a barely tolerable 7. I told him to turn around and take me back home. When he did, I was able to rest - for a while, then the migraine from hell came with more puking and extreme suffering. All Saturday and Sunday were lost in sheer pain.
NOW....the neurologist I went to (just once) quickly diagnosed me with Glossopharyngeal (sp) neuralgia.
But, could TMJd cause this pain as well, if left untreated for a year??
Achingear, As noted above, I personally believe that TMJ is over-prescribed by dental professionals who have a financial self-interest in treating it. Diagnostic criteria for TMJ are very imprecise. However, I do not often hear of cases of either TN or TMJ that involve vomiting. My intuition would be to suggest that you be evaluated for Cluster Headache.
Regards, Red
If you are not happy with your Neurologist go for a second opinion if you do not think your doctor is listening to you ro does not have the knowledge to treat you find out how many patients he as treated with TN and GPN Second opinions never hurt they may just let you know what your doctor is diagnosing with is right or wrong.
Good luck I hope you get answers to your pain and God Bless you I hope you will have a pain free day
achingear said:
Can TMJ cause pain severe enough to cause one the throw up and consider going to the ER? Does it cause severe ear and face and head pain?
Last weekend, I had the WORST flare up of my entire experience with this ear/jaw/face pain after an acupuncture treatment. I felt that my face and head were being crushed from the inside, I couldn't lay on my pillow because it hurt so excruciatingly, i was puking uncontrollably, and my husband was driving me to the ER when suddenly the pain dropped from a 10+ to a barely tolerable 7. I told him to turn around and take me back home. When he did, I was able to rest - for a while, then the migraine from hell came with more puking and extreme suffering. All Saturday and Sunday were lost in sheer pain.
NOW....the neurologist I went to (just once) quickly diagnosed me with Glossopharyngeal (sp) neuralgia.
But, could TMJd cause this pain as well, if left untreated for a year??
Also, go to the TMJ Association. They have alot of great articles and stay on top of what's going on with the FDA, Medical Devices (devices used in TMJ problems/treatment, etc.). I have TMJ and atypical TN that was caused by TMJ surgery! Beware. Many who developed the devices they implant (prostheses, etc.) and get "royalties" from implanting them. I used to have horrid headaches that were TMJ related but after I had a hysterectomy, my headaches subsided! LOL! But I don't advice that...I needed the hysterectomy but my headaches got so much better one I got my uterus and ovaries out (I take bioidentical hormones in low dose now) but after I had TMJ surgery because my jaw was going crooked, it made my pain worse...not headache pain but it gave me trigeminal pain...chronic in V2 and V3 in the face, in every tooth, gums, lips, chin, etc. Find a really good oral maxillofacial surgeon who knows about TMJ/TMD and make sure they do not get any kick backs from implanting devices (as sure as you can be). They can do a CT scan or panoramic xray, cone beam 3 D CT scan, (and some MRIs) and tell if your disc is in the proper position between the upper and lower jaw joints, etc. Are you grinding teeth (can be a cause)? Have you had orthodontics (can be a cause)? Have you had any car accidents that could have gotten your neck/head in an off balance position? They can do exploratory surgery to see if you have anything wrong with your joint before anything "major" is done (arthroscope, arthroplasty, etc.) How is your bite? Just questions to ask yourself but do not have any seemingly unnecessary surgery. Yes, bad headaches can elicit vomiting and then we feel better for awhile! Gross but true. Tinkerbell
I don't have anything crazy going on with my jaw, actually - the bite's not off, there's not incredible popping or anything just this unexplainable pain that comes and goes as it pleases. My dentist absolutely refuses to do a nightguard for me even though it's obvious that I grind and clench. I think she's just covering her butt, because the pain started after my visit there last year for that filling. She wants me to see the TMJ/orofacial specialist. BUT I found another dentist that is going to make me a nightguard on Monday. This dentist said it is stupid to jump the gun and rush to a specialist without out trying a simple conservative measure first. And, on Monday I had my first appt with an upper cervical Chiropractor. I didn't have a crazy reaction physically to the treatment (yay!!!) and I'm seeing him again tomorrow. He did a ton of xrays and said that, as I suspected, my neck and head are twisted out of alignment pretty bad on the left (the opposite side that I'm having the pain) and scrunching everything up into the right side of my head, essentially. Although, he said it much better than that. So, I'm hopeful that whether it's TMJ or TN or GN or a combo that some of what I'm doing will eventually start to help. Fingers crossed. I cannot live like this, in fear of suddenly rushing to the ER in the worst pain of my life, any longer.
I have an extreme open bite, but refuse to have surgery for it. My face pain specialist agreed it would be a bad idea. I also have an issue with my condyles being out of place; being bone on bone on one side. My specialist advised against the splints. I want to do the splints, if they'll help. Maybe my doctor thought I wanted them to help my TNP/ATN, which isn't the case, but is why he said no? I plan to ask him next time I see him.
Do you think the splints are a good idea? My doctor didn't seem to think they did anything bad, but nothing good either, and basically thought it would be a waste of $5k. Thoughts anyone? Tinkerbell?
How did your other Chiropractor appt go I was thinking about going also I think I I hava a little of TMJ TN and GPN but I can tell my back and neck are out of alignment I used to see a chiropractor a long time ago it helped my TMJ but know i have bone deteriation in my c4-c7 and do not know if it would be a good idea to go to chiropractor again
achingear said:
I don't have anything crazy going on with my jaw, actually - the bite's not off, there's not incredible popping or anything just this unexplainable pain that comes and goes as it pleases. My dentist absolutely refuses to do a nightguard for me even though it's obvious that I grind and clench. I think she's just covering her butt, because the pain started after my visit there last year for that filling. She wants me to see the TMJ/orofacial specialist. BUT I found another dentist that is going to make me a nightguard on Monday. This dentist said it is stupid to jump the gun and rush to a specialist without out trying a simple conservative measure first. And, on Monday I had my first appt with an upper cervical Chiropractor. I didn't have a crazy reaction physically to the treatment (yay!!!) and I'm seeing him again tomorrow. He did a ton of xrays and said that, as I suspected, my neck and head are twisted out of alignment pretty bad on the left (the opposite side that I'm having the pain) and scrunching everything up into the right side of my head, essentially. Although, he said it much better than that. So, I'm hopeful that whether it's TMJ or TN or GN or a combo that some of what I'm doing will eventually start to help. Fingers crossed. I cannot live like this, in fear of suddenly rushing to the ER in the worst pain of my life, any longer.
Chiropractic for the cervical area isn't going to help with real TMJ pain, I'm afraid. Not if the pain is associated with actual deterioration or debris in the joint. And the evidence for chiropracticis more than a little inconsistent with Type I TN pain too.
Regards, Red
Went to the eye doctor, who is also a practicing MD, today, and one thing led to another conversation-wise. I mentioned to her that I was thankful that there wasn't anything significantly wrong with my eyes (unlike what her assistant told me, erroneously) because I have had so many health issues this year.
She asked, and I told her what was going on. Long story short: she mused if this could have been the result of shingles, and pointed out that anyone who had chickenpox as a child is susceptible to getting shingles and that not all cases of shingles result in a rash/scabs but that the virus can remain internal, unseen. But that the skin around the area will be extremely sensitive to touch, it can be misdiagnosed as migraines, cluster headaches or even neuralgia (even tho if left untreated it can cause neuralgia).
Can I ask my doctor to prescribe me an antiviral - just in case?? Is this a likely cause of what's going on?
If you have shingles, your bloodwork will be positive for the Herpes Zoster virus. You are generally wise not to treat with anti-virals unless you have confirmed the virus is present and active. FYI, of all the meds used with PHN, the best record for forcing the virus back into remission and suppressing the pain is Neurontin (Gabapentin) over a period of weeks, combined with an antiviral (Acyclovir?) for a few days.
Regards, Red
Do you know if I can request that my regular doc do bloodwork to test me for Herpes Zoster, or can I go to a walk-in?? Also, if this is the result of PHN, what is the track record of it being controlled and subsiding? Or is this an indefinite problem??
Few doctors will support a walk-in, though some may be willing to work you in on short notice, or refer you to a local emergency care center for the blood test. Generally, PHN pain may take up to a few weeks to subside under treatment, though the virus may not be detectable in your blood stream after the anti-viral med kicks in in just a few days. Shingles can recur, and in some patients does. The pattern of pain may vary from out-break to out-break, and the outbreaks can be years apart. There is now an inoculation for Shingles, though. Your general practitioner can advise you on what to expect, and administer the vaccine.
Regards, Red
I’ve heard that diagnosing shingles is complicated when no rash is present; is it possible that this is often mis-diagnosed as something else and left untreated?? Also, i’ve been experiencing this pain off an on for about a year now. If I even do have zoster sine herpeticum, is it too late to treat it with the anti-virals or could it still be effective?
I hate the idea of talking to my MD about this. At times she can be very stubborn, flippant and minimizes my pain.
If there is no rash present but you still have pain in areas other than your face, then you need to be evaluated for other neurological or auto-immune disorders. These include MS, Fibromyalgia, and Lupus. If there is no indication of active Herpes Zoster in your blood work, then it's likely you actually DON'T have Shingles or Post Herpetic Neuralgia. Anti-virals are most effective if used early on. Realize in this discussion, however, that I am not a medical doctor. I've been reading the literature on face pain for about 17 years, but there's a lot I don't know with any confidence.
Regards, Red