Jacksonville Beach, FL: Proper diagnosis and treatment helps TMJ sufferers.
Most people have heard the term TMJ and associate it with jaw pain. But for those who suffer with TMJ (temporomandibular joint)it can mean a lifetime of headaches, bouts of severe pain, teeth grinding, muscular soreness, limited jaw movement, depression and drugs to help with the symptoms.
As a Chiropractic Physician, who has treated many TMJ sufferers in Jacksonville Beach, Florida, the new and more descriptive term is temporomandibular disorders, or TMD. This is important because there are a number of causes for TMJ pain. These causes can range from trauma to poor leveling of your teeth after dental work, disc displacement, or when the pads between the joints shift their position, arthritic changes, stress, joint misalignment, and neck problems can all contribute to TMD.
Because it has different etiologies or combinations of, it is consequently very difficult to diagnose and treat. Due to the difficulty of diagnosis and poor treatment outcomes, many physicians shy away from attempting to treat this condition and many insurance companies refuse to pay for treatment.
One reason for the poor response to treatment is that many in the health care arena claim to treat TMD, but in reality only treat one related condition. For example, a massage therapist claims to treat TMD, but in reality only treats the muscle tightness associated with the disorder when the cause of the muscle tightness could be due to disc displacement, which would require a consult with an oral surgeon.
Another example could be the prescription of a splint, such as a bite plate or mouth guard, by a dentist to treat the symptoms of teeth grinding, when actually the joint is misaligned or there is a problem in the patient’s cervical spine causing pain and associated muscle spasm, which leads to teeth grinding. In this case, a chiropractic physician with experience treating TMD could gently manipulate the jaw and have a complete resolution of symptoms, including teeth grinding.
Because of this single-minded approach, many people undergo unnecessary treatment, including surgery. Therefore, sufferers should seek many opinions and consider a team approach. It is unlikely that one person can be proficient in all aspects of nonsurgical treatment. The multi-disciplinary approach brings together the different specialties to provide for all aspects of non-surgical management of the patient with TMD.
TMD is a very complicated disorder, and because of the wide range of causes, accurate diagnosis is paramount if treatment is to be successful. In addition, TMD mimics other medical problems such as cancer, which can be life-threatening.
As a rule of thumb, failure to respond to treatment within four to six weeks requires reevaluation of the diagnosis. Treatment itself is divided into non-surgical (Phase 1 treatment) and surgical (Phase 2 treatment). The biggest, and I believe most important difference between Phase 1 and Phase 2 care, is that Phase 2 care is irreversible.
Most patients respond well to non-surgical management, which has a 70-80 percent reported success rate. Phase 1 treatment usually starts with a soft diet to decrease the load on the joint and rest tight muscles.
Other treatments, listed here in progressive order from least invasive to invasive include: relaxation training, physical therapy, stretching exercises and massage, chiropractic manipulation, occlusal splints, dental correction, medication including non-steroidal anti-inflammatories, steroid injections, and arthroscopy.
Phase 2 treatment has a high rate of failure. Because of the high failure rate, patients who report partial relief of symptoms and can accept limited success are encouraged to continue with supportive non-surgical treatment while being monitored for any progression of the disorder. Patients in which limited success is unacceptable and who have clearly defined joint pathology a surgical Phase 2 alternative may be indicated.
Once again, TMD, for many is a serious condition. But with proper diagnosis and a team approach, treatment can be highly successful in restoring sufferers to a normal life.
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As natural health care provider and chiropractic physician in Jacksonville Beach Fl, I see my job as educating, coaching, and nurturing my patients to better health and wellness.
Yours In Health,
Dr. John Davenport