People with fibromyalgia syndrome (FMS) tend to be more predisposed to muscular disorders than people without the syndrome. One such disorder is temporomandibular joint disorder, known as TMJD or just TMJ. Why jaw pain is more common in FMS victims is not fully understood. However, it may be that if TMJ occurs first it may contribute to the development of central sensitization, a key component of FMS and chronic fatigue syndrome (CFS). On the other hand, if FMS occurs first, then TMJ may be related to the accompanying lax connective tissue that is associated with FMS. The fact that people with FMS tend to feel pain more acutely means they also suffer more pain with TMJ.
What is TMJ and What Causes It?
There are a variety of possible causes for TMJ, including arthritis, jaw injury, or muscle fatigue from clenching or grinding the teeth. The temporomandibular joint works on a combination of hinge action and sliding motions. The parts of the bones that come in contact with each other in interaction are covered with cartilage and are separated by a small shock-absorbing disk, which keeps the movement smooth. The factors that set the stage for TMJ to occur include:
· The disk erodes or moves out of proper alignment
· Arthritis has damaged the joint's cartilage
· Joint damage that is the result of a blow or forceful impact
· Fatigue of the muscles that stabilize the joint. This happens with clenching and grinding.
Gaining Relief from TMJ Pain and Discomfort
If the symptoms of TMJ are present, then a visit to the dentist is important. There are a number of ways to gain relief from TMJ pain and the dentist or doctor can help educate the fibro sufferer as to what might work best. If home treatment doesn't relieve the pain, then referral to a specialist in TMJ disorders will be the next step. If the dentist or doctor thinks the problem may be with the teeth, then x-rays will be taken and a CT scan or MRI may be done to further investigate the position and condition of the bones in the jaw.
In some situations TMJ pain goes away on its own, without any specific treatment. However, if the symptoms persist, then there are some things the doctor or dentist may prescribe to help with the discomfort.
Medications may be prescribed, such as:
· Painkillers - OTC painkillers like ibuprophen may be suggested, however, if they don't work the doctor may prescribe something stronger
· Tricyclic antidepressants taken at bedtime help some people with TMJ pain
· Muscle relaxants may be recommended for a few days
· Corticosteroid injections into the joint space may provide relief from pain and inflammation of the joint
· Botulinum toxin (Botox) injections into the jaw muscles may relieve TMJ pain making chewing easier
Therapies that have been found to be effective include:
· Bite guard - especially useful if there is a lot of grinding and clenching of the teeth at night. A bite guard prevents the teeth from meshing together.
· Cognitive behavioral therapy helps an individual with FMS manage stress and anxiety by becoming aware of negative behaviors that exacerbate the problem. Changes to behavior can be made through learning specific techniques to relax and manage stress.
· Biofeedback is another way to control muscle tension and involuntary body processes. This kind of therapy can help those with FMS who have TMJ to stop unconsciously stiffening their jaw muscles. A technique called electromyography (EMG) is used specifically to measure muscle tension. A study in 2006 found that TMJ patients who did six weeks of EMG biofeedback lowered their pain levels significantly more than those who received only dental care for the disorder.
· Massage therapy can release muscle tension in the jaw as well as lower stress that contributes to TMJ pain. It can be done by the individual at home as a self-care therapy and works well with the application of warm compresses.
· Acupuncture, aimed at opening the flow of energy through the body has been proven to cause an increase in the release of endorphins, the body's natural pain relievers. Although results may vary from person to person, a study in Sweden published in 2008, found that the majority of TMJ patients who had received acupuncture treatments up to 20 years prior were still enjoying the benefits.
Home and Lifestyle Do-It-Yourself Fibromylagia TMJ Ideas
Some suggestions in terms of lifestyle and home remedies include avoiding overuse of jaw muscles. In order to minimize the stress on the jaw muscles:
· Eat soft foods
· Cut food into small pieces
· Avoid eating sticky or chewy foods
· Avoid chewing gum
· Avoid opening the mouth too wide when yawning
A few alternative methods of dealing with stress that can be very beneficial to people with FMS who have TMJ include relaxation techniques to reduce jaw clenching or teeth grinding. They may also help alleviate other symptoms of TMJ:
· Deep breathing
· Progressive muscle relaxation
· Guided imagery
You can lean about these various methods in classes at a local community center or through books and DVDs.
TMJD is an uncomfortable condition, but with consistent self-care, it is possible to calm the pain and get the relief that is needed.