TEMPOROMANDIBULAR JOINT SYNDROME OR TMJ SYNDROME
Temporomandibular joint syndrome (or TMJ syndrome to give its most common name) is a condition associated with the jaw muscles which control chewing. The hinge joint between the skull and the lower jaw bone is a common site of pain.
Those with symptoms of TMJ syndrome commonly complain of headache or facial pain. In many cases, they have been labelled as having an”atypical facial pain’ or arthritis of the jaw joint.
Atypical facial pain simply means that the condition is not typical of the recognised physical causes of facial pain such as trigeminal neuralgia or sinusitis. But, with most, there is no evidence of arthritis in the jaw joint.
Rather they commonly and unknowingly clench their jaws and grind their teeth at night. The condition is usually seen as a consequence of day-to-day tension causing extreme muscle tension in the muscles which control chewing.
The TMJ syndrome also commonly causes pain in the ear, the side of the head, and the side of the neck on which the jaw joint is affected. This condition is sometimes confused with the severe pain that occurs in tic douloureux or trigeminal neuralgia.
Other less known effects of the TMJ syndrome include nasal stuffiness, burning of the tongue and mouth and hearing difficulties. These latter can range from clunking and grating sounds in the ears to the relative losses in hearing in the absence of any discernible hearing problem or ear wax buildup.
Many of those seen at the general pain clinic and at the specialised pain clinics at some dental hospitals which deal with mouth and face pain have previously been treated poorly, with unnecessary multiple dental procedures, ear, nose and throat procedures and sometimes neurosurgical operations.
Treatments The simplest form of treatment is the proper application of a dental night splint. This simple plastic device is inserted between the upper and lower jaws and is worn at night, and at times during the day, to prevent grinding of the teeth.
At times, muscle relaxant medications are prescribed and, for those in whom depression is thought to be playing a leading role, antidepressant medication is also prescribed. Among the more com¬monly prescribed medications for this condition are Mersyndol and Norgesic, both of which contain combinations of muscle relaxants and pain killers.
Heat treatment, such as microwave therapy, and relaxation treatment such as hypnosis or biofeedback are sometimes of benefit for this condition.
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