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Temperomandiubular Joint (TMJ) Disorder (or TMJD) is a broad term used to describe a variety of conditions that lead to pain and dysfunction of the jaw. People with TMJD often also experience neck pain and stiffness, headaches, ringing in the ears (tinnitus) or vertigo, and sinus congestion. The temperomandiublar joint is a hinge joint between the temporal bone of the cranium and the mandible (jaw bone).
TMJD can be caused by an acute injury (like a punch in the face or a fall on the ground) or it may come on insidiously. As with all conditions that we care for at Valeo, we like to take a holistic, whole-person approach to healing with TMJD. Craniosacral Therapy is a gentle treatment that works with the cranial and facial bones, as well as the surrounding fascial tissue.
After 2 months of treatment I noticed a drastic improvement and after the third month I was pain free. Lindsey is a very talented Registered Massage Therapist who is always professional and passionate.
His assessment was thorough and he took the time to teach me when I had questions…I highly recommend Brendan to anyone wanting to see how they can experience greater health and wellness. We will be provided with an authorization token (please note: passwords are not shared with us) and will sync your accounts for you.
Subjective tinnitus (ST) is an auditory percept perceived in the absence of any external or internal auditory stimulus.
Indeed, cross-modal interaction of auditory, visual, and somatosensory inputs is obvious because in our dynamic and changing environment we constantly shift our gaze and move our body toward detected relevant auditory objects. The eye movement investigation adhered to the tenets of the Declaration of Helsinki and was approved by the local ethics committee for human experimentation, CPP Ile de France II (No: 07035, Hospital Necker in Paris). Tinnitus was modulated by jaw movements in 13 patients, head movements in seven patients, muscular pressure in eight patients, eye movements in three patients, and global muscular effort in two patients. In summary, the pathophysiological mechanisms underlying the tinnitus percept probably vary among patients.
The stimuli consisted of a white dot that was displayed at different locations on a computer screen filled with a black background as in Figure 1. Horizontal and vertical eye movements were recorded binocularly with the EyeLink II device. The data on three parameters (fixation drift before the start of the saccade, fixation drift after the saccade and saccade disconjugacy) were not normally distributed; however, these data fit normal distribution after log transformation. This section presents the results of ANOVA, evaluating the effects of the Tinnitus Side conditions and Saccade Direction conditions on each of the following parameters: latency and fixation drift before saccades (preparation of the saccade), amplitude and mean velocity (execution of the saccade), fixation drift after saccades, and saccade disconjugacy (binocular coordination). Figure 2 presents the mean latencies and standard errors for each direction of the saccades and side of the tinnitus.
Figure 3 presents the absolute mean fixation drift before saccades start and standard errors for each direction of the saccades and side of the tinnitus. Figure 4 presents the mean amplitude of saccades and standard errors for each direction of the saccades and side of the tinnitus. Figure 5 presents the mean velocity and standard errors for each direction of the saccades and side of the tinnitus. Figure 6 presents the absolute mean fixation drift after saccades and standard errors for each direction of the saccades and side of the tinnitus.
Figure 7 presents the mean saccade disconjugacy and standard errors for each direction of the saccades and side of the tinnitus. Table 2 summarizes the mean values of latency, of saccade amplitude and disconjugacy for leftward, rightward, upward, and downward saccades made by our tinnitus patients (TSL and TSR groups), and by 12 healthy subjects (mean age = 25 years old) in the studies of Vernet et al.
In most cases, there are no significant differences between tinnitus patients and control subjects in terms of saccade latency; only rightward and upward saccades showed longer latencies in TSR patients than in controls. As far as we know, there is no evidence that age can affect saccade amplitude, at least for the two age ranges concerned.
Overall, the data indicate abnormalities in the tinnitus patients in terms of saccade amplitude and disconjugacy that are more marked for right sided tinnitus. In line with these prior studies, the multiple eye movement abnormalities in tinnitus patients reflect dysfunction of many oculomotor subsystems (saccade, vergence, binocular coordination). According to the National Institute of Dental and Craniofacial Research, TMJD affects between 5-12% of the population. It has an articular disc, stabilizing ligaments, a retrodiscal space (that is vulnerable to inflammation), and several muscle attachments.
Dental or orthodontic work, arthritis, grinding or clenching your teeth, and stress may also be aggravating factors.

We will do a thorough assessment to better understand the individual factors that are contributing to your jaw pain before developing a treatment plan. This includes the medial and lateral pterygoids, masseter, temporalis, digastric, and occipitofrontal muscles, all the muscles responsible for helping you chew, talk, and make funny faces. It allows better positioning and movement of the bones as well as an unwinding of tension in the cranium and teeth.
Snow after trying many different physiotherapists, chiropractors and other health professionals. She is so good with kids and not only does she check for spine alignment and she practices brain gym with my son.
Amanda Stevens at Valeo Health Clinic is a given!  After years of lower back and neck issues, I am much more comfortable. This means that you will not need to remember your user name and password in the future and you will be able to login with the account you choose to sync, with the click of a button.
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Recent studies demonstrated abnormalities in several types of eye movements (smooth pursuit, optokinetic nystagmus, fixation, and vergence) in ST patients. ST is experienced by around 10% of the population and can strongly impair the quality of life (Holmes and Padgham, 2011). To our knowledge, quantitative studies of saccades in ST patients have not yet been done, leaving alone the possible differences between right and left sided tinnitus. Written consent approved by the committee was obtained from all subjects after the nature of the examination had been explained. All patients attended a tertiary care tinnitus clinic at European Hospital Georges Pompidou in Paris; tinnitus perception being stated as their main medical complaint.
One condition elicited tinnitus modulation in 10 patients, two conditions in seven patients and three in the remaining three patients.
Yet, this group of subjects is homogenous because of their spontaneously modulated tinnitus following different types of movements. Subjects were comfortably seated in an adapted chair with a chin rest to stabilize the head at about 57 cm from the computer screen. The eye velocity of the conjugate signal was computed using a symmetrical two-point diffentiator after low-pass filtering with a Gaussian FIR filter with a cut-off frequency of 33 Hz. Mean values and standard deviation of latency, amplitude, and disconjugacy for leftward, rightward, upward, and downward saccades in control subjects (Vernet et al., 2008a,b) and tinnitus patients (TSL and TSR). However, it has to be noted that the delay between the offset of the central target and the onset of the peripheral target (gap paradigm) is known to shorten the latency of saccades (Fisher, 1987). When you open and close your mouth, the mandible should move in a smooth, symmetrical fashion as it rotates down and forward.
For most people, treatment for TMJD includes massage therapy and soft tissue work, craniosacral therapy, homecare exercises, and addressing any causative factors (like stress or perhaps dental appliances).
Not only did she help soothe my pelvic and hip pain during the final weeks of pregnancy, she also helped my new baby girl, Zoe, reach optimal health. The present study investigates horizontal and vertical saccades in patients with tinnitus lateralized predominantly to the left or to the right side. Pathophysiology of ST remains poorly understood despite extensive animal and human research aiming at deciphering the neural correlates of such illusory percept to promote effective treatments (Elgoyhen et al., 2012).
But to explain both tinnitus persistence and tinnitus induced intolerance, different pathophysiological models (for a review, see Kaltenbach, 2011) highlight the crucial role of sub-cortical and cortical plasticity, resulting from the maladaptive efforts of auditory and non-auditory pathways to compensate such deficit (Yang et al., 2011).
Interestingly, lateral gaze has also been shown to interact with ST percept (Coad et al., 2001).
Of particular interest in the perspective of the present paper is the question whether there is a different clinical pattern between left sided and right sided tinnitus. They were selected for this study because of their ability to modulate their tinnitus by somatic stimuli (movements, muscle pressure). The pathological conditions being present at the onset of tinnitus were either otological (right otitis media, left otosclerosis surgery, bilateral noise induced hearing loss, sensorineural hearing loss) or neuro-muscular (acoustic neuroma, right meningomia, meningitis, left head trauma with TMJ luxation, cervicalgia, abdominal, or orthopedic surgery).
This is in line with previous reports of the high prevalence of hearing impairment in tinnitus (Nicolas-Puel et al., 2002). The task involved saccade eye movements to the four directions (left, right, up, or down) from the center in every instance. On the vergence signal, we measured for each saccade the disconjugacy (horizontal disconjugacy for horizontal saccades, vertical disconjugacy for vertical saccades). Post-hoc comparisons were done with the Tukey's Honestly Significant Difference (HSD) test.

In addition, controls are younger than tinnitus patients and age is known to affect latency of saccades.
In the present set of data, amplitude hypometria appears to be significantly higher in patients compared with controls for leftward, rightward, and for upward saccades.
This requires proper joint positioning, good mobility of the articular disc, appropriate muscle tone in the attaching muscles (not too much, not too little, just right), and the absence of swelling and inflammation. Compared to left sided ST, tinnitus perceived on the right side impaired almost all the parameters of saccades (latency, amplitude, velocity, etc.) and noticeably the upward saccades. However, there is strong evidence suggesting that an auditory peripheral insult and related deafferentation could trigger complex neuroplastic subcortical and cortical maladaptive changes involving auditory and non-auditory brain areas (Roberts et al., 2010). These somatic modulations of ST are putatively supported by the cross-modal wiring and talking between somatosensory and auditory pathways. Actually, clinical evidence indicates that in many cases tinnitus is lateralized, at least it is perceived predominantly to the left or to the right of the median sagittal plane and that tinnitus laterality is related to different clinical features (Mazurek et al., 2010). None of them had acute clinical vestibular dysfunction at the time of testing as attested to by the absence of vertigo or dizziness or spontaneous nystagmus. Eye movements in the wrong direction, with latency shorter than 80 ms (anticipation) or longer than 800 ms, or contaminated by blinks were rejected. For downward saccades, the amplitude was similar in TSL and controls but for TSR patients amplitudes were significantly larger than for control subjects.
In a more extensive study, they reported specific abnormalities in vergence eye movements, particularly in divergence, and abnormal interactions between saccade and vergence (Yang et al., 2010).
This has been demonstrated at a sub cortical level (dorsal cochlear nuclei, inferior colliculi) via a trigeminal modulation of auditory function in a behavioral animal model of ST induced by an auditory damage (Shore et al., 2007). This study examines the parameters of ocular saccades toward four directions (left, right, up, and down) in patients suffering from lateralized (predominantly left or predominantly right) chronic ST. Unusually stressful circumstances were indicated by 11 patients; these patients had a mean score higher than 100 on the Holmes and Rahe life events related stress questionnaire (Miller and Rahe, 1997). The calibration factors for each eye were extracted from these recordings; a linear function was used to fit calibration data. For each of the 40 saccades, the initial central dot was turned on for a random period varying between 1500 and 2000 ms to reduce anticipation; at the immediate end of this period, the next peripheral dot was simultaneously turned on for 1000 ms (see Figure 1). Finally, relative to controls, amplitude, and disconjugacy of the saccades appear to be globally poorer in this tinnitus population compared with control subjects, specifically in TSR. Although the precise mechanisms linking ST and saccadic control remain unexplained, these data suggest that ST can lead to detrimental auditory, visuomotor, and perhaps vestibular interactions. Neuronal pathways, by which the somatic afferences interact with the central auditory pathways, are not ascertained.
Many multiple parameters of the saccades were examined related to cortical-subcortical brainstem functions. Tinnitus was predominantly left sided in 12 patients and predominantly right sided in eight patients.
Even if the stress is not direct cause of tinnitus it can be considered as a trigger of tinnitus intrusiveness (Andersson and Westin, 2008; Hesser and Andersson, 2009). For both saccade and vergence, the process was performed automatically by the computer, and the verification was made by visual inspection of the individual eye position and velocity traces. It could be argued that the greater undershooting of saccade amplitude in TSR may be partly due to the greater average drift before the saccade.
Finally, saccade disconjugacy was significantly higher for TSR patients than for controls and for several directions (rightward, upward, and downward); for TSL patients, disconjugacy was higher than for controls only for downward saccades. These parameters concern the preparation of the saccade (latency, drift of the eyes before the start of the saccade), its execution (amplitude, velocity, saccade disconjugacy), and the immediate period after its completion (drift after the saccade).
In humans, jaw protrusion modulation of tinnitus assessed with functional imaging (fMRI) also showed increased activation in cochlear nuclei and inferior colliculi but decreased cerebellar activation when compared to controls (Lanting et al., 2010).
PET data on gaze evoked tinnitus support the hypothesis of the emergence of abnormal links between brainstem systems controlling eye movements and auditory structures (Lockwood et al., 2011).
A comparison will also be made with data from healthy subjects from two other studies from our group (Vernet et al., 2008a,b) using similar experimental setups.
Neural plasticity induced by tinnitus could then interact at many different levels with neural circuitries involved in saccade programming and execution.

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