TMJ & Facial Pain
Temporomandibular disorders, commonly known as “TMJ” include a number of clinical problems that involve the masticatory musculature, the Temporomandibular joint (TMJ) and associated structures, or both.
Orofacial pain can exist due to disease or as part of neurovascular, neuropathic or psychogenic disorders.
1. Temporomandibular joint articular disorders are specifically in the joint. They include disc displacements with and without reduction, deviation in form, dislocation, subluxation, inflammatory conditions, osteoarthritides and ankylotic changes.
2. Muscle Disorders may involve the masticatory musculature as well as other skeletal muscles of the head and neck. Subgroup classifications include myofascial pain, myositis, myospasm, protective muscle splinting and muscle contracture.
3. Cervical and spinal disorders related to vertebral rotations and instability, disc herniations, ligamentous Injuries and nerve impingements involving the cervical and brachial plexi of nerves.
4. Neurological pain disorders including neurovascular disorders such as migraine and cluster headaches, mixed type headaches.
5. Neuropathic pain disorders including various neuralgias and deafferentation syndromes commonly related to the teeth, face and jaws.
6. Psychogenic pain disorders such as somatoform disorders, anxiety and depression, mood disturbances commonly found with chronic pain disorders.
Some of the common symptoms experienced by “TMJ” patients include:
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Headaches.
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Face pain, tightness, stiffness.
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Neck pain, stiffness, noise on movement.
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Arm pain ,weakness, tingling and numbness of fingers.
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Ear pain, stuffiness
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T.M.Joint pain, joint sounds (clicking, popping, grating), locking.
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Changes in bite, inability to chew, painful mastication, pain in teeth.
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Neurological pain disorders including neurovascular disorders such as migraine and cluster headaches, mixed type headaches, arteritis and other vascular disorders.
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Neuropathic pain disorders including various neuralgias and deafferentation syndromes commonly related to the teeth, face and jaws.
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Psychogenic pain disorders such as somatoform disorders, anxiety and depression, mood disturbances, and other DSM IV diagnoses commonly found with chronic pain disorders.
There are many reasons for these problems to occur and in some cases to persist:
Predisposing factors (that increase the risk) may include missing teeth, hyperfunction or altered function, and certain stress disorders affecting ability to cope.
Initiating factors (that cause the onset) may include trauma to the masticatory or head and neck structures or moderate to severe parafunctional activity, sudden changes in maxillo-mandibular relationships, sudden intense physical or psychological stress and medical conditions leading to structural breakdown.
Perpetuating factors (interfering with body’s ability to heal) may include nutritional, environmental, postural, occlusal and psychosocial factors. Loss of muscle tone due to lack of exercise or loss of function leading to permanent disability are the major reasons that patients do not recover without treatment.
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