Ken (not his real name), in his fifties, had been suffering from intractable, severe headaches for a number of years. He had been to various well-known medical centers and hospitals for this condition. Yet the diagnosis offered could not explain his symptoms. He received prescription pain medication, tranquilizers, sedatives, etc. None of them helped long term. He was even offered psychiatric treatment, which he rejected. Finally, by chance, he heard over the radio that sometimes headaches could be caused by “TMJ.” This acronym stands for temporo-mandibular joint. TMJ refers to the jaw joint located just in front of each ear. When TMJ and related muscles and nerves malfunction, headaches and facial pains can result.
Ken drove from Arizona to our Alhambra office to seek help for this condition. When he arrived, his wife confided to us that Ken nearly committed suicide because of the hopelessness of his situation. Ken was referred to a neurologist and an ear, nose and throat physician to rule out any medical condition that can contribute to his pain symptoms. Abnormal medical conditions were ruled out.
Dental examination indicated that he had a “bad bite” (malocclusion); that he habitually clenches his teeth day and night and frequently cradles the telephone between his ear and his shoulder. He had severe tenderness in his jaw joints, in the chewing muscles and even some of the posterior molars on which he habitually grinds. His jaws click loudly when his jaws move. He could hardly open his mouth more than the width of two of his fingers because of pain from the TMJ’s.
Tomograms (somewhat like CAT scans) were taken of his TMJ’s. These radiographs showed osteoarthritis and other abnormalities in the joints. When he was told the diagnosis was TMJ syndrome, he was greatly relieved. Someone had finally confirmed what he believed all this time. That is, his pain is not only in his head, but is caused by a medical condition. He was told that TMJ syndrome is a condition, which affects millions of people nationally. He is just one of them.
He underwent other tests, one of which measured the spasms in his muscles (EMG) and another recorded the movements of his jaws. TENS treatment, which relaxed the muscles of the jaws, significantly relieved the pain. Based on the data from all the tests, an intra-oral device that is shaped like an orthodontic retainer was made for him. This device, called an orthotic, was given to him. He was instructed to wear it twenty-four hours a day, except for when he eats. Within a week practically all the pain was relieved. In subsequent visits his personality changed to one who is extroverted, sociable and energetic. His wife said he again became the person she fell in love with many years ago before this problem arose.
Ken wore the appliance for about a year. Slowly he was able to be “weaned” off the device and yet stay relatively pain free. Ken has not needed to come back for follow up visits for quite a few years now. He is still doing well. The above story illustrates how many people unknowingly suffered from severe headaches, which may be related to TMJ disorders.
.
