Does this sound like TMJ?

by Kenny White
(Springfield, MO)

The TMJ is located just in front of the tragus of the ear.

The TMJ is located just in front of the tragus of the ear.

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I went to my doctor yesterday and he diagnosed TMJ, but I'm not so sure. Symptoms are ear pain on the left side, and severe pain on the left side when swallowing. Thought I had an ear infection, but he says that ears and throat look fine and said it is likely TMJ. He prescribed a muscle relaxer and a steroid, and told me to search the internet for TMJ exercises. Any suggestions?




Hello Kenny,
Do you feel well? Mumps can mimic this, but then you are sick and not just sore. It affects the parotid gland and swallowing is certainly painful.

The hallmark of a TMJ syndrome is tenderness of the one or both jaw joints, often with clicking or popping sounds when chewing, yawning, kissing, and so on.

Place both index fingers just in front of the tragus of the ears and slowly open and close. Are they tender, and do the TMJs pop or click?

If so then try the exercises at Chiropractic Help, and hopefully they will be adequate.

Let me know what transpires.

Dr Barrie Lewis


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My 10 year old may have TMJ syndrome.

by Dewalla Smith
(Texas)

Anatomy of the TMJ

Anatomy of the TMJ


My daughter has been having ear aches for sometime. Some have been infections. We went to a ear, nose and throat specialist yesterday. When we told him her symptoms, earaches, headache, and cold air bothering her ears. He informed us that Mya may be suffering from TMJ. Her ears were fine. The doctor touched her jaw and had her open and close it and the pain hit. She has been having headaches for years. What should we do, contact the dentist? Thank you!




Hello Dewalla,
Yes, I think your dentist would be a good start. She's very young to be having TMJ pain; it more usually starts after having dental work, especially wisdom teeth extraction, under anaesthetic.

So the question is whether this is really TMJ pain, or referred pain from the ears.

Then I would recommend an opinion from a chiropractor who is experienced in working with the jaw joints. Phone your local chiropractic association, and see if you can get a few names.

Is there any suggestion that she grinds her teeth at night? That's called bruxism and is a large complicating factor.

This is a little bizarre, but yes, it certainly can happen. Let me know how you get on.

Dr Barrie Lewis




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TMJ trigger

The sensory nucleus of the trigeminal nerve is in the neck.

The sensory nucleus of the trigeminal nerve is in the neck.

I have noticed that when I speak with my head turned to the left; this triggers TMJ pain on my right side. So, I have avoided speaking with my head turned that way. Unfortunately this has caused a lot more problems, neck pain, a very unnatural feeling of turning my head to the left and anxiety and fear of even speaking with my head turned.

Any advice?





Good evening,
That's an interesting and unusual question. To be quite honest, I'm not sure, without a thorough examination.

My initial thoughts are that, you presumably then always turn your whole body to the left so that you can speak directly to someone; but that obviously hasn't fixed the problem.

Also, turning your head to the left shouldn't directly affect the jaw joint, although the neurology is complex, so I wouldn't entirely rule that out.

So the question is whether this is primarily a neck problem, or a condition of the TMJ, or both. The sensory nucleus of the nerve supply the jaw joint is in the neck, so the pain is often also felt in the neck.

If you press just in front of the tragus of the ear, do you get tenderness in the jaw joint; open and close. Any popping or clicking sounds?

If you turn your head, right and left, up and down, sideways, do you get neck pain?

Headaches and facial pain?

These are all important questions to think about, but over and above that there's nothing like a thorough clinical examination. See if you can find a chiropractor in your neck of the woods who also treats the TMJ.

I'm sorry not to have contributed more.

Dr Barrie Lewis




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TMJ disfunction back after root canal infection

by Kathy
(Delavan, IL )

Could having an injection to numb a molar #19 to have a root canal have aggravated my tmjd to come back again? I have been in no pain since 2000 and not wearing my night guard to sleep with all these years and now suddenly after the root canal I am experiencing jaw pain again. They did have to go back 2 months later and redo the root canal because there was infection pus that came out when he was in it and on the xrays it is also into the gum and bone area. How could that happen? I have been in pain since October when the first root canal procedure was performed.





Hello Kathy,
Even under the best of conditions, there is risk of nosocomial, or hospital acquired, infection. And when you had the root canal, it was probably because of infection in the first place.

The infection itself is unlikely to have set off your TMJD, but opening the jaw for a prolonged period, perhaps over opening, could certainly be the problem.

It's all history now, and nothing is going to change that; trust your dentist to deal with the infection and see someone skilled in the jaw joint to help you.

And you do your part; remember that sugar promotes bacterial infection and plenty of citrus help fight that infection. See our lime nutrition page for details.

Good luck.

Dr Barrie Lewis



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I have TMJ

by Tiara Cafferty
(USA)

Hi, is it very nice to talk to a professional. I have had all of these symptoms. I went to a TMJ specialist and we went through a big process of fixing my jaw. I have been wearing a TMJ splint for 4 months, and my jaw is completely fixed. Although, the other side of my jaw has been popping. It doesn't hurt it just keeps popping. so we moved my jaw a little further forward and after 3 weeks, it stopped popping and I was completely back to normal! What helped was having me sit a little further up when I go to bed. Then I went to my friend's house for a week and I had to sleep on the ground I wasn't really thinking and I went to bed with my head on a small pillow and when I woke up my jaw started popping. It was the side that didn't hurt. Then I went to my orthodontics and my head far back and when I got up my jaw didn't pop but only for a minute. My whole point is, should I sleep with my head more up or down to help stop my popping?




Hello Tiara,
You also have to consider the rest of your body. Sleeping too high, or low, is likely to affect your neck.

I don't believe there's a right or wrong answer to your question, just what works for you.

I suspect your jaw joint is going to continue popping periodically whatever you do. A yawn, bite an apple and it's likely to start again.

The point is, if it's not painful, you can be well pleased; don't get too excited about the odd pop.

Dr Barrie Lewis


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Vestibular Migraine & TMJ

by Alexandra
(Miami, FL)

Hello Chiropractic Help,
I am a 23 year old female who was diagnosed with a Vestibular Migraine. I get a lot of headaches throughout the week and with those headaches I get symptoms of disequilibrium, a little ringing in the ear, and stiffness in the jaw.

I've had this already for three years and I've gotten multiple MRI's, MRA's and CT scans and everything comes out normal. When I came across this page and reading about TMJ I remembered when I would get really bad jaw pains that would last for hours. It has made me wonder if these vestibular migraines may have all started from the TMJ. I would like to know where I can see a good chiropractor that can help me with my situation.

Thanks,
Alexandra




Hello Alexandra,
As you've discovered, you're living in a minefield. The great difficulty in all this is to discover what is the primary, underlying cause of all these bizarre symptoms.

Could it be something in your jaw joint, or teeth, or sinuses that is triggering the trigeminal nerve? Or, is it a problem within the ear ear, mostly likely the tiny organs that control once sense of balance. It's directly connected to the eyes. Or is it chocolate, red wine or smelly cheese that's setting it all off. Or, perhaps it's a subluxation in your upper neck, where the sensory nucleus of the trigeminal nucleus is found, triggering pain in the muscles of the face and jaw joint.

Most often, it's you, the patient, who has to work it all out. It's all chicken and egg, and you are the best person, through careful observation to find out what is the primary trigger. There may be more than one, just to add even more difficulties.

Start by doing two little tests, one is easy, and one difficult.

1. Place your index fingers on the jaw joints, just in front of the tragus of the ear. Are they tender? Is one much more tender than the other. Slowly open your mouth and evaluate if they open simultaneously together. Press on the temporalis and masseter muscles. Do they seem inordinately tender and do they cause shooting pain? Place your index finger, pulp outwards, inside your cheek, slide right back to the pterygoid pocket close to the wisdom teeth, and palpate the later pterygoid muscle. Is it very tender on one side? That's the easy one.

2. Have your partner carefully check your eyes when you have an attack of dizziness. Do the pupils zig zag from side to side or in a circle? Lie on a cushion, and put your head and neck into extension, and turn quickly first to one side, back to the centre, and then to the other. Does it make you giddy, and ask your friend if your eyes start to make darting movements? The may last only a few seconds. Look up nystagmus in Google.

3. Turn your head right and left, tilt your head, look up and down. Any inordinate pain? Press on the joints right at the top of your neck, just below the occiput of the skull. Does it seem more tender than it should?

4. Try provoking the symptoms with different foods.

5. Sinuses and grinding of teeth, a bad cavity?

In short, be your own detective.

I hope this contributes. It's difficult, I know.

Dr Barrie Lewis


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