Myofascial Pain…Muscle related pain
Some of the most common symptoms of TMD are muscle pain and jaw dysfunction.
The most common causes of muscular related pain are:
Bruxism:
- For many patients bruxism is mild and requires little treatment. Cases that involve severe grinding and clenching can lead to long term TMD problems such as damage to teeth and gums, breakdown of bones, inflammation and muscular dysfunction. Treatment can include biofeedback, stress management, medication, and the use of a night guard.
Poor Posture:
- Sitting for extended periods of time without moving, or working at a computer can lead to tightening of neck muscles and developing sore points in the back of the neck and shoulders. These are commonly called trigger points and can lead to referred pain to other areas of the jaw and face. Forward head posture may lead to shortening of the back and neck muscles. Treatment may include trigger point massage, physical therapy and learning ergonomics (how to avoid work habits which create excessive amounts of static work and how to reduce the amount of unnecessary muscular force they are applying to their bodies).
Injury:
- Muscle pain occurs when there is a direct trauma or over-exertion to the muscle that may result in tears in the muscle fibers. TMD muscle pain in the jaw can be the result of clenching, grinding which in turn can cause the muscles that are used to support the joint to go into spasms. Treatment is usually focused on getting the muscles to relax.
Orofacial Pain (Nerve Pain)
Trigeminal Neuralgia (T.N.)
- The pain from T.N. affects lifestyle as it can be triggered by common activities such as eating, talking, shaving and brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds can aggravate the condition in many patients. The attacks are said by those affected to feel like stabbing electric shock, burning, pressing, crushing, exploding or shooting pain. These episodes of intense facial pain may last from a few seconds to several minutes or hours. The trigeminal nerve has 3 branches. One branch supplies nerves to the eye area, one to the cheekbones and upper teeth, and the third to the lower teeth and jaw. There is not a general consensus on what causes T.N. The first line of treatment is generally medication for pain as well as antidepressants and anticonvulsants.
Atypical Odontalgia
- This type of nerve pain is generally triggered by a dental injury to the root canal of the teeth or the gums. It may progress to chronic persistent pain. Dental treatments generally do not help even when the tooth is removed the pain may persist and also may move to an adjacent tooth.It is important to note that these types of pain do not respond to dental procedures and should be avoided until a complete history and exam is done of the muscles and nerve functions of the head, neck and face. CT Scans, MRI’s or simple x-rays will help in deciding what treatment is indicated.
Stress Related Orofacial Pain
- It is not uncommon for muscle tension to increase at times when stress levels are high. With TMJ Disorder the tension may trigger clenching and grinding which in turn results in jaw pain. It can be a very vicious cycle. If initial treatment of TMD is not successful anxiety may increase. Anxiety turns into depression, and depression increases the pain by lowering defenses to fight against it. Generally the initial pain is targeted, and reducing anxiety and depression is addressed. Anti-anxiety medications may be prescribed.
Joint Related Pain
Osteoarthritis
- A degenerative condition of the temporomandibular joint. A slow process that generally has no pain associated with it in the early stages. There may be grating sounds in the joint during movement. CT scans are used to verify changes withing the joint.
Inflammatory Disorders
- The joint can be affected by trauma or infection. You may feel tenderness when pressing on the joint and/or pain on opening. Inflammation can also be the result of arthritis. Treatment may include heat, ice, anti-inflammatory medications and antibiotics.
Healthcare professionals and patients alike often call ALL facial pain “TMJ disorder,” when in fact, there are many causes of this type of pain that may not even be jaw related.
As you can see from reading this list, facial pain comes in many types and can have many causes. If you’re suffering from pain, it is important that you get a definitive diagnosis so that you’re able to move forward with the type of treatment that is best for your particular type of pain.