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The temporomandibular joint (TMJ) is the area right in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. The temporomandibular joints are very complex and are made up of muscles, tendons, a disc and bones.You have a temperomandibular joint on each side of your jaw (right and left side). Micro trauma is considered internal, such as grinding the teeth (bruxism) and clenching (jaw tightening). TMJ pain can usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles.
Most patients are quite successful with conventional conservative therapy (such as resting the jaw or night guard). We are a full service dental practice that specializes in relaxation and cosmetic dentistry services, dental implants, TMJ disorder treatment, periodontal disease treatment, teeth whitening, porcelain crowns and porcelain veneers, and other restorative dental care. You may remember this article on happiness inspired this list, but I put it aside for a few busy months. Neck (cervical spine) – Years prior to diagnosis, I saw a neurologist for neck problems after two years of shooting pain down my arm. Knees – The first couple of years they never swelled, but they were stiff with frequent stabbing icepick pains. Fever – Since the disease became full-blown about 7 years ago, I get a fever most days of about 2 degrees.
Vocal cords (larynx) – Early in the progression, lost my voice completely for days at a time with no virus or cold symptoms. Blood vessels – Livedo reticularis, permanent for two years on left leg, and periodically in other locations. Eyes – I ignored eye dryness, not recognizing symptoms, again, because more urgent or painful issues took precedence. Cardiovascular – Blood pressure is normally low; however I experience episodes of high blood pressure, usually lasting under one hour.
Shoulders – After the feet, the shoulders were the first with severe flare, and like the feet, they had flared mildly for over 25 years. NOTE: Your comments are an important resource for future readers of this post in the months to come. New article about e-patient communities in the Journal of Participatory Medicine - click to read. Rheumatology Blog Carnival #1: Causes of Rheum Un-AwarenessHear My RA Interview on KISS FM! Comparisons with Chronic Illness What if Rheumatoid Arthritis Patients Wrote a Dear Doctor Letter?
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If the above diagnoses are inconclusive or if a treatment regimen has already been started, a biopsy of the affected skin (i.e. Spray tub and bathroom floor with disinfectant after each use to help prevent reinfection and infection of other household members.
Wash feet, particularly between the toes, with soap and dry thoroughly after bathing or showering. If you have experienced an infection previously, you may want to treat your feet and shoes with over-the-counter drugs. Dry feet well after showering, paying particular attention to the web space between the toes. Try to limit the amount that your feet sweat by wearing open-toed shoes or well-ventilated shoes, such as lightweight mesh running shoes. After any physical activity shower with a soap that has both an antibacterial and anti-fungal agent in it. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw.
Patients may complain that it is difficult to find a  comfortable bite or that the way their teeth fit together has changed.  Chewing on only one side of the jaw can lead to or be a result of TMJ  problems.
This continuous pounding on the temporomandibular joint can change the alignment of the teeth. This trauma can fracture the jawbone, cause dislocation of the TMJ, or cause damage to the cartilage disc of the joint. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding  and clenching their teeth. About 80% of patients with a TMJ disorder complain of headache and about 40% report facial pain, and ear pain. About one half of patients with a TMJ disorder notice ear pain and do not have any signs of ear infection.


Grinding, crunching, clicking, or popping sounds (medical term = crepitus) are common for patients with a TMJ disorder.
If your symptoms persist, your doctor may recommend medications or a night guard to help keep you from grinding your teeth at night. Dentist or doctor will recommend over the counter medications (like Aleve or Motrin), or prescription medications such as Dolobid are a first option to relieve pain. Antidepressants prescribed to be taken at bedtime have been successful in relieving TMJ pain in some patients. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
Injecting botulinum toxin (example Botox) into the jaw muscles may give relief to pain associated with TMJ disorders. For patients who grind their teeth patients may gain from wearing a  firm custom made appliance. For patients whose main symptom is from stress or anxiety they may benefit from a visit to a psychotherapist. The success of treatment depends on how severe the symptoms are and how well you comply with treatment. Marielaina Perrone's advanced training and years of experience translate into greater confidence and convenience for your entire family. Now, I’ve come back to it because it seems valuable to present a more complete picture of one actual disease experience, so far.
The worst part for me is how many of these problems occur every day, and there are NO days when joints, eyes, etc. He obtained abnormal EMG results of “unknown cause.” I’ve been unable to look over my right shoulder for years, and recently reduced range of motion toward the left. I had no idea my vocal cord problems were related to my Rheumatoid disease so at first, I didn’t complain to the doctor. Some mornings, the jaw joints will be too stiff to open and one side or both will be very painful.
Frequent bleeding under skin on hands or feet with painful “bruising” with no injury or impact. I was squinting and using sunglasses constantly, eventually even wearing them indoors in the evening because any amount of light was very uncomfortable. After my first pregnancy, my hips would “go out,” one at a time and I would stumble as it came on. I was never sure which shoulder had the “unknown injury” because the flare always alternated sides. Thanks for visiting this unique site full of information and encouragement to fight Rheumatoid Disease.
When the muscles are relaxed and in balance and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without discomfort or pain.
A problem with either one can lead to stiffness, headaches, ear pain, bite problems ( also called a malocclusion), clicking sounds, or locked jaws.
Teeth grinding as a habit can result in muscle spasm and inflammatory reactions, thus causing the initial pain. Pain in the TMJ can also occur following dental treatment whereby the joint is stretched open for extended periods of time. 50% of those patients will have resolution of their tinnitus after successful treatment of their TMJ disorder.
Your dentist will conduct a careful patient history, dental examination, and take necessary x-rays to determine the cause of your symptoms. This night guard prevents your teeth from coming together in contact, and repositions teeth to decompress the jaw joint. This would allow the patient to become self aware of stress triggers as well learning relaxation techniques to relieve stress. As always, it is best to maintain regular appointments to see your dentist and let them know if there any TMJ issues developing. You’ll find complete dental expertise, utilizing the latest advancements in dentistry, all here under one roof. There were so many baffling events that year and when you can’t feed your baby or wash your own hair, that takes precedence. Each time, I try to gently force the joint to move by forcing first a fingernail and later a finger between my teeth. As with the vocal cords, I had no idea what was happening to me and did not complain to a doctor. The temporomandibular joint functions to move the jaw, especially in biting and chewing, talking, and yawning. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal.


Changes in the normal stimuli or height of the teeth, misalignment of the teeth, and changes in the chewing muscles may cause temporomandibular joint changes.
Teeth grinding and clenching are habits that may be diagnosed in people who complain of pain in the temporomandibular joint or have facial pain that includes the muscles involved in chewing. Massage and heat application following your dental appointment can help relive the discomfort.
These symptoms are usually caused by Eustachian-tube dysfunction (structure responsible for the regulation of pressure in the middle ear). Conventional treatment consists of a diet of soft foods along with warm compresses to settle down the tension of the muscles.
When the neck joints are not swollen, bones move around producing clicking, popping sounds. With ibuprofen and my forced range of motion “therapy” I can eventually open enough to eat. If a patient is experiencing TMJ difficulty the simple act of opening and closing your mouth can cause considerable pain. Opening your mouth allows the rounded ends of the lower jaw (condyles) to glide along the joint socket of the temporal bone. These can include arthritis, trauma to the jaw, or muscle fatigue from clenching or grinding your teeth. Ear specialists are routinely called on to make the definitive diagnosis of a TMJ disorder. It is believed that patients with TMJ syndromes have hyperactivity (muscle spasms) of the muscles responsible for regulating the opening and closing of the Eustachian tube. The popping movement is noticeable 100 x per day and can be triggered by swallowing or slight head movement. Swelling in the front of the knees is occasional and does not always correlate with pain or stiffness.
Except for being larger, hands look similar to when I was diagnosed, with slight deformity.
TMJ disorders most commonly occur in women between the ages of 30 and 50, but can occur in teens after braces, and in both men and women at any age. After the first year of being swollen, the Baker’s cysts began to ache, and they hurt all the time now.
If I walk a lot, causing the inflammation to intensify, the jaw joints begin to hurt (along with all other joints). My wedding ring got tighter and tighter (in spite of weight loss) until it was swollen around it and I had to have it cut off. I had one pea-sized nodule on left elbow for 1 year, but it left during Enbrel (which I was allergic to, so go figure). During those same months, my face and upper torso turned bright red and hot a few times each day.
When the joints are inflamed there is visible swelling along the sides of the cervical spine.
This leads to shooting arm pain, hand numbness, or severe headache, depending on which joint is inflamed. I used to often say, “My hands aren’t affected much” – I still say it; however, whenever I washed my hands, I sighed involuntarily at the relief from the warm water. The first 3 years, I could not hold lightweight iron or soap bottle, but sometimes I now can for a short time.
The shoulders never returned to normal, but only occasionally are as bad as that first night – so that I can’t move my arm even an inch away from my body, even pulling on it. Multiple times, I’ve undergone radio frequency ablation, steroid injections, and epidurals. Very difficult to walk in closed shoes; have purchased 3 pairs of pricey wide athletic shoes that cannot be tolerated.
The Baker’s cysts have been present and often swollen for over three years and have never been examined by a doctor. I noticed a progression in the shoulders when I lie down: First year, when I lay on the left side, it hurt. The past couple of years, I have frequent hoarseness, but only occasional breathing problems.
The next year, if I lay on the shoulder it would hurt and then after a few seconds, my body would visibly drop about an inch as my shoulder slipped out of place.
Eventually, there was no drop, but lying directly on the shoulder, it feels like my arm is ripping off.
Since doctors told me they don’t look swollen, I take photos of both swollen and non-swollen to show the difference.



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