Life can be Miserable with the Pain of Jaw Imbalances
The severe headaches started about 10 years ago and plagued her constantly. She woke up with them and went to bed with them, but the myriad of medical specialists she had seen could find no cure.
"I got to the point I really didn't want to live," says Connie Williams, a registered nurse.
"I practically lived on Excedrin," she says. "I took about 300 a month because the pain was so excruciating."
Her story is not uncommon among people suffering from Temporomandibular Joint (TMJ) Syndrome. Severe headaches, commonly accompanied by several other symptoms including neck- and backaches, ringing or stuffiness in the ears and "clicking" jaws often herald the existence of a problem, which is commonly overlooked or misdiagnosed.
Trying to determine the cause of their "migraines," TMJ Syndrome sufferers go from one medical specialist to another - often ending up at a psychologist or psychiatrist. But the problem is not all "in their heads;" it's in their muscles. And it often takes a dentist or orthodontist to discover this.
The pain they experience is a result of stress - not only emotional or psychological stress but physiological stress caused by jaw imbalance or malocclusion. Rather than adapting to the misalignment of the jaw, the surrounding muscles strain to bring the jaw back into proper position, and the constant strain creates muscular spasm.
All the pain killers and other pain-relief techniques that sufferers try merely mask the problem - if they work at all - instead of correcting it. Much too often, sufferers just give up trying to cure the pain and decide they must simply bear it.
"It's just something you learn to live with," says Jane, a 40-year-old professional working wife and mother of three, who wished to remain unidentified. She suffered with headaches four to five days a week for ten years.
"I'd have an earache with them," she says. "My teeth would hurt. Sometimes I'd even get a backache."
At first the headaches would go away after taking some medicine, she says, but then they grew progressively worse. Jane sought professional help and went through all sorts of medical tests including a CAT scan but to no avail. "Nothing ever showed that there was any physical problem," she says.
Her decision that she must bear the pain is a common one among headache sufferers.
"These people commonly report that they 'have to live with this,' and they do remarkably well," says Dr. Gerald W. Spencer, a Sedalia orthodontist who treats many TMJ Syndrome sufferers. "The body is an incredible adaptation machine."
The TMJ Syndrome has been dubbed "the great impostor" because it imitates many other medical problems. For this reason, doctors are often unable to diagnose it, and patients spend unsuccessful years trying to treat it. "Most of these people have been going through the mill," Spencer says.
Whether someone bears up under the extreme muscular stress and adapts or experiences a lot of pain depends upon the individual and the individual's lifestyle. Any additional stress caused by the person on top of what the muscles are bearing can create pain.
Stressful emotional situations such as depression or anxiety can cause headaches without the TMJ stress, so it's not surprising that these are enough to trigger pain when the TMJ is already stressed. Some not so obvious, but common, causes of physiological stress are poor postural habits such as propping the jaw upon hands, cupping the phone to the shoulder with the chin, or chewing on pipes or pens.
In addition to changing these stressful situations and behavior, the jaw must be brought back into alignment. This is often a simple procedure, requiring a plastic splint and orthodontia. In Mrs. Williams' case, treatment consists of three steps:
After making sure her headaches were not caused by any other problems that should be treated by a different medical specialist, Spencer fit Mrs. Williams in January with an upper appliance that kept her mouth from totally closing. She wore it for three to four months and adapted to it so quickly that Spencer moved her on to the next step, she says.
Now Mrs. Williams wears a removable plate, which fills her whole mouth and keeps her jaw in alignment by pulling the bottom jaw forward. This relieves pressure and gets rid of the pain.
"In the last four months since I've started treatment," she says, "my headaches have gone."
The next step in her treatment will be braces on her teeth, she says.
Jane started treatment in February and also experienced immediate results. Wearing only a simple splint, she now has headaches only about once every six weeks. "It's changed my life, needless to say."
Some pain may linger for a while after the jaw is moved back into proper alignment. It's as if a muscle is composed of a lot of rubber bands, Spencer explains. When the muscle is contracted, the "rubber bands" are all stretched. But after the muscle is relaxed, one "rubber band" stays contracted. This causes pain, which is often referred to other parts of the body.
In these cases it's necessary to locate the "trigger" point - where the muscle is knotted up - and release it either with ultrasound, injecting it with anesthetic or some other technique, Spencer says.
The study and diagnosis of TMJ Syndrome is a relatively new field, of which many physicians and dental specialists are just now becoming aware. This accounts for the rapidly increasing number of patients seeking this treatment.
Spencer, who has practiced in Sedalia for seven years, says he has 40 TMJ Syndrome patients in active treatment right now. He estimates as much as 70 percent of the population has TMJ problems. "Its national average would designate that 10 percent of the population is suffering (from TMJ Syndrome pain)," he says.
Because Temporomandibular Joint Syndrome mimics other physical problems, many people spend a lot of time and money - often futilely - to treat the symptoms rather than the problem causing them.
The Sedalia (Mo.) Democrat, July 8, 1984