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Educational Brochures on Chronic Overlapping Pain Conditions

This brochure addresses what are Chronic Overlapping Pain Conditions (COPCs), how COPCs are diagnosed, the complexity of the chronic pain experience, and how to work with your health care provider to develop a treatment plan. It is available by postal ma

Study Highlights TMD Evidence and Current Practice Gaps

The TMJ Association has long championed the need for strong evidence-based demonstrations of the safety and efficacy of TMD diagnostics and treatments. Sad to say, as the following journal article indicates, even among a network of research-oriented practices, dental providers are still resorting to such TMD treatments as occlusal adjustments in which teeth are irreversibly moved, ground down, or in other ways altered, a treatment for which there is no scientific evidence of efficacy.

Beware of Ticks and Lyme Disease

We are currently in the peak season for Lyme disease. Each year at this time we highlight this topic because we have heard from a number of patients over the years who were misdiagnosed and underwent unnecessary TMD treatments when they actually had Lyme

#*!"@!**! ... May Help Your Pain... and Improve Strength!

Our headline is adopting the comic strip convention of using symbols to denote swear words because we are intrigued by a report that swearing may have some health benefits.

Predictors of Opioid Efficacy for Chronic Pain Patients

Opioids are increasingly used for treatment of chronic pain. However, they are only effective in a subset of patients and have multiple side effects. Thus, studies using biomarkers for response are highly warranted.

Janelle's Story

  • May 13, 2015

I had probably been dealing with TMD for two years before I first took action in the Fall of 2008. It started out as severe ear pain that I noticed most when I ran outside. I thought it might be caused by the wind, so I would wrap my ears with an athletic band and wear headphones. Finally, the pain was so intense and persistent that I decided to visit an Ear, Nose, and Throat (ENT) specialist. When the ENT reported nothing abnormal in my ears, I think he could tell how confused and disappointed I was. Fortunately, he did something different. He pressed two gloved fingers firmly on the insides of my cheeks. When I yelped out in pain, he explained that the issue was actually my temporomandibular joint, or TMJ, and that TMJ pain often presents as ear pain. He then informed me that he could not treat me and referred me to my dentist.

The Long, Winding Road of Information and Treatment

My dentist suggested applying heat to my face, and when I explained that I had already been doing so, he advised alternating hot and cold packs. He also told me to relax and that the condition, which he called bruxism, was due to stress. He advised me to take the maximum dosages of over-the-counter (OTC) pain relievers—something I would hear repeatedly for the next several years.

After about a month, my pain greatly diminished even though I wasn’t taking OTC drugs; heat only alleviated the pain for about an hour, and cold was ineffective. Two more years passed before my next painful episode, but this time it came with hives as well as foot pain and discoloration. I was referred to a rheumatologist who told me that my symptoms were caused by stress. He recommended anti-anxiety pills (which I couldn’t afford) and told me to take any and every OTC I could buy.

Traveling with TMD

Summer came and I tried to relax as much as possible. In June, my new husband and I were traveling to Romania for a second wedding ceremony with his family. It was all I could do to find a wedding dress as my pain progressed to the point that I could not chew anything at all. Though my husband’s family was gracious and understanding, we quickly discovered that Romania does not have many pureed or chew-free foods. During the wedding, everyone seemed touched that tears streamed down my face. Little did they know that it was pain that was causing them.

My first glimmer of hope occurred the following day. One of the wedding guests worked for a dentist and gave me an arthritis medication called Piroxicam. The pain and swelling went down, and for short periods I was able to eat semi-solid food.

Back to the Dentist

My pain returned and I began to lose weight, so I visited my dentist again after returning home. He suggested Botox. Putting aside the expense of the procedure, my dentist seemed more focused on improving my appearance, rather than reducing my pain. I decided against it after my research concluded that Botox has no known efficacy for relieving bruxism or TMD. He did prescribe a muscle relaxant, which gave me some relief, and made me a nighttime bite guard. I was able to perform well on my final exams in school; however, these treatments were not a long-term solution.

Rays of Hope

A few weeks before midterms, my pain returned. My dentist suggested taking X-rays to see if I had a bad tooth. There was no way it was a bad tooth after all this time, so I knew he had run out of ideas.

My husband and mom, unable to see me in so much pain, spent an entire day calling different dentists, orthodontists, and oral surgeons. Finally, we reached a dentist self-described as a TMJ specialist. At the consultation, he explained that my TMJ socket was probably dislocated. He planned to do X-rays and put in a daytime appliance. While I was still very skeptical, I realized that this dentist was my last hope to graduate on time, or at all. I had X-rays, which concluded that my left jaw joint was compressed. Though I had read on The TMJ Association’s website (as well as in other resources) that TMJ splints rarely work long term, I decided to try the daytime oral appliance. My top and bottom teeth have not touched one another since.

I finished the semester strong, graduating Summa cum Laude. During my last year of school, I had become increasingly involved with the TMJA. The complexity of my TMD led me to the TMJA first for information. As part of a final project for school, I had to partner with and file a grant application for a small non-profit organization. I chose the TMJA. Though it has taken longer than expected, I am anticipating submitting a final grant proposal on behalf of the TMJA by the end of this year.

Though I am not pain-free and remain nervous for the future, finding a cure has become a critical goal for me. To this end, I'm committed to helping The TMJ Association. With the new job I started, I am eligible for gift-matching from my company; so if I make a donation, it'll be doubled. Since maintaining a healthy diet is difficult for many TMD sufferers (myself included!), I have also been working with TMJA and a dietician at Froedert Hospital in Milwaukee to produce a nutrition brochure. I have felt empowered working towards more understanding of TMJ disorders and encourage other patients to take control of their condition in a way that makes the most sense for them.

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