Neuromuscular Symptoms of TMJ

The majority of TMJ symptoms originate from stress and tension in the surrounding muscles. This is caused by their relationship to your body’s bone structure. When it comes to relieving your pain and undergoing a successful treatment, it is important to understand all of the ins and outs of your diagnosis, including the neuromuscualr symptoms of TMJ.

Some common neurologic and muscular symptoms experienced by patients who have underlying TMJ problems include:

1. Anesthetic Failure

The trigeminal nerve is often in a state of dysfunction and irritation in the majority of TMJ and head pain patients. The trigeminal nerve is responsible for carrying sensation from your teeth, gums, tongue, lips, face, jaws, ears, nose, eyes, etc… to your brain. This nerve travels through and around the TMJ area. When this area is under compression, or the TMJoint is damaged, this nerve goes into dysfunction and it is hard to calm it down. That is the reason that many people have experienced episodes at a dental office when a tooth wouldn’t get numb after several injections. Many of these patients don’t even know that they have an underlying TMJ problem because nothing may be hurting around the joint area.

Review our Self Diagnosis Checklist to determine if you may have such an issue.

One of the biggest problems that many dentists experience is with patients who have jaw compression problems. Many of these patients do NOT effectively numb for dental treatment on lower teeth. These same patients can also experience an unusual number of complications following treatment. The muscular dysfunction and/or joint damage can cause compression of the fascia, nerves, and muscle fibers and this limits the efficiency of the anesthesia.

There also seems to be a lot of lactic acid buildup in the muscles, which neutralizes the anesthetic and renders it useless. Some of our patients have such tight and overworked muscles that it is sometimes very hard to pass the needle through them to achieve anesthesia. Now you know why many of your dental visits may have been so disastrous.

2. Phantom Toothache

Many patients experience 'phantom’ toothache. Normally, nothing is found on the x-rays and examination, yet the patient insists that a tooth must be pulled or root canaled.

The intense pressure and stress that an individual tooth experiences from jaw compression is tremendous. The root of each tooth is coated with shock-absorbing ligaments that become strained and bruised. This is very distressing to the teeth and they respond by being temperature sensitive and aching. They are trying to tell you that something is wrong, even though an x-ray of that tooth will look normal.

Push on any of your teeth with one of your fingers for about 20 minutes. Let go, and you’ll see how that tooth begins to ache. This is exactly what happens when intense clenching occurs.

The trigeminal nerve can also cause the 'appearance' of a toothache simply by carrying wrong messages to the brain. Many times, it is the muscle tension sensation or joint damage that is mistaken for a toothache. This nerve carries the same nerve impulses from teeth and other structures and sometimes it cannot differentiate between a muscle or joint or tooth problem.

3. Neck Pain

Some patients have headaches that originate primarily from the back of their necks. The most common reason is due to neck dysfunction or possibly the result of a whiplash injury. Jaw compression and TMJ problems can also cause hyperactivity in neck muscles. The lower jaw normally moves over 7,000 times per day. Patients who clench will use the muscles of the lower jaw over 20,000 times per day. This hyperactivity will also cause the neck muscles to activate, especially in patients who have overbites and worn teeth. Furthermore, this worsens for people who sleep on their backs at night because the lower jaw slides backwards placing more stress on the neck vertebrae and muscles.

Any activity of the jaw muscles can put tremendous strain on the neck muscles resulting in the headache felt at the back of the neck and radiating up the back of the skull.

The shift in blood flow from the external carotid also causes an increase in blood flow to the occipital blood vessels in the back of your neck. This shift of blood flow is like a flooded river breaking its banks. It wreaks havoc to the local community!

For more information about neck problems, click here!

4. Sensitive or Ringing Ears

How come our ears feel so weird? Put your little finger in your ear while opening and closing your mouth. Now, move your jaw from side to side. You can feel a lot of action in there! The over-activity of your jaw makes your ear canal sensitive.

Excess wax can be produced, as the body tries to protect itself. The ear has two important muscles: the tensor tympani (it attaches to the ear drum, and stabilizes it from the excess vibration caused by loud sounds) and the tensor levi palatini (it attaches to the Eustachian tube, and helps to open and close the tube, thereby equalizing pressure within the inner ear…it is what 'unplugs' your ears as you chew gum in an airplane).

Over activity of these muscles can sometimes cause a ringing sensation, called tinnitus. It is not unusual for the patient with compression problems to complain of ringing in their ears, or vertigo. The tensor tympani and tensor levi palatini are tensed whenever the jaw-closing muscles are tensed. For more information about ear problems, click here.

5. The Sinus Headache

The lateral pterygoid muscle attaches at one end to the top end of the jawbone. The other end attaches to the walls of the nasal passages. Frequently, when a lateral pterygoid muscle becomes dysfunctional, it will cause pressure and pain in and around the nasal passages and sinuses. This is what is called a sinus headache.

The patient may get sinus pressure, or a runny nose. A visit to the sinus specialist, for a special x-ray, reveals nothing particularly wrong with their sinuses. Antibiotic therapy rarely resolves the condition.

The patient is convinced, however, that there is definitely a problem with the sinuses. The patient maintains this conviction by observing that they do get some relief from sinus headache medications. What they fail to realize is that sinus headache remedies are simply pain medications with added decongestants.

Sleep apnea can also cause sinus problems. For more information about sleep apnea click here.

6. Ocular Migraine Pain

There is a little muscle called the Sphenomandibularis, which attaches just behind the eye, and is responsible for the 'ocular' migraine. It’s all part of the same overactive jaw muscle complex. It is also innervated by the trigeminal nerve. Now you know why your new glasses and five visits to the ophthalmologist did not accomplish very much.

7. Accidents and Trauma

Physical trauma to the neck can cause headaches. It is crucial to receive the proper medical evaluation from a team of physicians who can ascertain possible disk or vertebral abnormalities. If no fractures or disk problems are found, then a diagnosis of muscular tension can be concluded.

The cervical sympathetic ganglia (a group of neurons from the sympathetic nervous system within the neck) has been shown to cause and maintain jaw and neck muscle contraction. Again, the muscles try to protect the underlying body parts. If the dysfunction is not treated properly, the pain and headaches may continue indefinitely. If there is underlying disk or vertebral damage, treatment must still be aimed at muscular relaxation in order to promote adequate and proper healing.

Traumatic Brain Injuries can also increase clenching and eventually lead to TMJ damage and worsening pain symptoms. Proper treatment must be implemented before the damage ensues.

TMJ dysfunction can have an exponential effect on your health. To learn more about the neuromuscular symptoms of TMJ, contact us today!

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