TMJ Pain is Ruining My Life!

Outline:

·         When treating TMJ pain seems hopeless

·         Surgery may not be your best solution

·         TMJ pain may not be a jaw problem

Patients with TMJ often see a large drop in the quality of their life:

·         “I feel like a baby because I can’t eat solid foods anymore”

·         “There are times where I just have to stop talking because all I can think about is the pain”

·         “That popping sound creeps me out and drives me nuts”

A lot of people will experience jaw pain for a day or two if they bite into a hard/chewy piece of food, but imagine if your life was plagued with jaw pain every single day. We underestimate the importance of our jaw, but it’s the piece of anatomy that allows you to enjoy some of the finest pleasures in life. Everything from kissing, to chewing, to a casual conversation with friends becomes a burden when your jaw fails to function.

Desperate Times and Desperate Measures

Severe cases of TMD (Temporomandibular Disorders) can make people reach their breaking point quickly. Many of the patients that come to our office are usually looking at surgery as their next and final option because they don’t know what to do.

Even worse is when a patient spends tens of thousands of dollars for surgery but the pain doesn’t go away. Procedures that help to remove or replace a degenerated disc in the joint are sometimes performed to eliminate this pain sensitive piece of anatomy. The problem is that a degenerated disc can show up on imaging, but it isn’t necessarily the cause of the pain.

Unfortunately this happens more often than you might think, and it’s something that can make a patient with TMD hopeless if even surgery couldn’t get the job done.

This isn’t to say that surgery is not the answer, or that surgery can’t help, but we have to remember that TMD is a problem that science has yet to reveal all of the answers, and dental surgery is still working on figuring out what works and when it’s appropriate.

TMJ Pain May Not Be A Jaw Problem

There are many different causes for TMJ pain. They can range from abnormal jaw movement, tight jaw muscles, and degenerated discs. These can all be problem areas for a TMJ patient, but they all have something in common.

In fact, their commonality goes back to some of the same neurological mechanisms that contribute to neck pain and headaches. That’s why people with TMJ don’t just have jaw pain; they often have neck pain and headaches at the same time. It’s because almost all pain signals from the head and neck go through a small piece of spinal cord called the trigemino-cervical nucleus.

Trigemino-cervical…..what????

Sometimes Pain is a Computer Problem

So if you don’t have a medical background, some of that terminology might jump over your head.

Instead of thinking anatomy, let’s talk about it like a computer.

 

Your brain and spinal cord are like a computer chip. The part of your computer chip that feels head and neck pain is the trigemino-cevical nucleus.

Just like all computer chips, the quality of information that comes out is dependent on the quality of information that comes in. If you put junk information in, you get junk information out.

The computer chip of your body relies heavily on information from the muscles and joints. These signals are like computer programs. Whenever these joints move poorly from bad positioning, then it’s like a bad program that gives faulty information about what’s happening inside the body. This can occur from malpositioning of the jaw, faulty jaw movement, neck positioning errors, and faulty neck movement.

It’s like a computer virus going into your system and scrambling important signals into the brain.

This tells the body to produce a junk signals including:

• Tight and tense jaw muscles
• Inappropriate inflammation
• Central pain sensitivity

Can This Program Get Shut Off?

Fortunately your body’s program for pain can be re-written by changing the way these joints move.

A specialist like a neuromuscular dentist can use non-invasive methods to change the way your jaw moves and alter your bite with an orthotic.

Chiropractors that can correct the craniocervical region can create a dramatic impact on the pain programming in the brain.

That’s why both of these doctors frequently see similar patients, and will actually co-manage them between each other. Neck pain patients may get better relief from a dentist changing their bite, while some TMJ patients will get better relief from correcting their neck.

While we can’t say for certain which takes priority, but many patients can benefit from an interdisciplinary approach to care. Take the time to get a Complimentary Consultation to find out what method fits with you. You may even find that getting the entire jaw/neck complex fixed may be the key to solving your TMD.

Call our office today for your free consultation – Premier Chiropractic 248-287-8700

Why Does My Back Hurt When I Breathe? What is it and how to fix it?

Overview:

• Pain from the ribs. How’d it happen?
• Why does it hurt so bad?
• Painful but fixable

“It hurts right here (points to middle of back), especially when I take a deep breath in.”

“It’s like someone is poking a knife in the middle of my back”

“Every time I try to stand up all the way, my back spasms.”

“I just want to crack this pinch in my back.”

There are times when pain can literally take your breath away.  That sharp, stabbing pain coming from a very pinpoint spot in the middle of your back.  Sometimes it’s just a really annoying feeling that won’t go away, but other times it can make you feel crippled by back spasms.

In many cases, this pain comes from the joint where your ribs connect to your spine. Sometimes people will say that you have a rib head that’s “out of place”, misaligned, or sprained. For the sake of today’s article, we’ll just call it rib pain.

It’s a frustrating problem because it can happen out of nowhere. Sometimes you just wake up with the pain, other times it’s from twisting or turning too quickly. Fortunately, even though we don’t know much about the pain, we do have effective strategies to help manage it when you feel it.

Why Does It Hurt So Bad?

The interesting thing about pain from a rib head is that the intensity and level of annoyance is really high for a problem that is pretty harmless. It’s not like a herniated disc where you may have other serious complications that arise, but the pain can sometimes be as debilitating.

Although this joint won’t result in pinched nerves that can cause muscle weakness or loss of feeling, it is extremely dense in pain generating tissue.

The ligaments shown on the image above, as well as the direct connection of the rib to the vertebra can be full of pain fibers called nociceptors. This joint is not supposed to have very much movement. If the joint gets overloaded and sprains the ligament, or if there is too much friction between the joint surfaces, then it stimulates an aggressive pain response in the brain.

When the pain response is initiated, the nervous system often looks to brace an area of injury, this typically comes in the form of muscle tightness and spasticity. As the muscles tighten around your ribs, it limits your ability to breathe in deeply. The muscle spasticity may also compress the nerves, arteries, and veins passing around the curvature of the ribs causing additional sources of pain and discomfort.

Unlike other parts of the body like the hand, shoulder, and low back, you don’t have a choice in moving your ribs. Your ribs move whenever you take a breath, and breathing is a little bit important to the maintenance of life. The more it moves, the more it can agitate the painful joint even if there’s minimal tissue damage.

How to fix it?

For most people, this pain will go away within a week without any treatment. However, if you have the pain for longer, you may need a little bit of outside help to correct the problem.

Most chiropractors can address the pain with a spinal adjustment to the thoracic spine or rib head. Typically patients will feel a substantial amount of relief within a few visits. When combined with some corrective exercise, you probably won’t have any further issues unless you reinjure the joint.

 

Whether your problem is brand new or chronic, a Structural Corrective approach to the spine can lead to substantial relief.

Don’t Crack Your Own Neck....

I’m sure you see it almost everyday. Whether it’s the fidgety co-worker who likes to hear all of his joints pop, or the guy on the plane that’s been rubbing his neck all day.

It’s the serial neck popper. They look straight out of the warm up scene of a martial arts movie, sound effects and all. While most will cringe and bite their tongue when they see it, the serial neck popper looks more focused and at ease. In fact, if their joints were capable of it, these people might pop it more often. It might even be you.

“It feels so good, how bad can it be?”

Some of the people who come into my office for care used to be serial neck poppers. Emphasis on the words “used to be”.  One recommendation for people when they get their first adjustment is to avoid popping or cracking their neck. There’s usually a look of defeat on their face when the recommendation is given. The truth is that one of their greatest sources of relief from neck discomfort was actually the very thing that was making their problem a chronic issue.

The loose ligaments, and uncontrolled forces from self-manipulation prevent this neck from staying in place.

The x-ray on the right is an example of someone who spends a lot of time popping their own neck. He had no history of a car accident, sports injury, fall, or trauma. However, he has been popping his neck aka, self-manipulating multiple times per day for years.

The green line represents the center point where a person’s head and neck should line up. The red line represents how the patient’s head and neck currently line up in their “normal” seated position.

The level of displacement is not hard to see. In fact, most of you would probably notice someone like this who always holds their neck off to the side.

Though he always feels his neck is very tight, the neck tends to be very floppy without a strong degree of stability. Even after several corrections, his neck will continue to have a tendency to slip towards the side until the ligaments tighten up and heal.

What Happens?

So what exactly happens when you self-manipulate?

Despite popular belief, there is nothing insidious about the popping sound made by joints. The classic crunching sound that you hear, and is stereotyped with chiropractic has nothing to do with broken bones, or rubbing bones against each other.  The sound comes from tiny gas bubbles within the fluid that lubricates your joints. When the joint opens up rapidly, these bubbles get released and pop causing those sounds.

It’s more like opening a can of soda than the crunching of a bone. If your neck or back cracks here and there with normal movement, it’s not a cause for concern most of the time.

The sound is ultimately not the problem. What truly is a problem is the way the thrust affects the spine.

In recent years, there have been videos, articles, and books that teach people how to adjust themselves.  Now bear in mind, the neck is one of the most sensitive and important pieces of anatomy in the human body. So people are being taught to manipulate their neck without regard for the following factors:

1. Risk factors – Does your neck have disc bulges or protrusions? Are there plaques or anatomical malformations? Some of these risk factors are susceptible to rotation/twisting forces in the neck. Many of these problems can be identified and planned for with a proper examination, but without one, how do you know?

2. What is the current structure of the spine? – How is the spine currently aligned? Do you know which direction puts you into a better position? Are you moving the right vertebra? Are you pushing the vertebra into a worse position than it already is? 

Our office uses x-rays to identify these malpositions. Can your own hands measure precise alignment in your neck?

3. Constant Manipulation = Loose ligaments = Poor Stability – Every time you manipulate your spine, you are causing ligaments in the spine to stretch like a rubber band. When you stretch a rubber band enough times, it eventually loses it’s shape and becomes less stable. Your ligaments work the same way. If you keep pounding on your neck with self-manipulation, your neck eventually becomes a sloppy mess like the x-ray above.

When people have ligament instability, it leads them down the road where they depend on manipulation to keep feeling good. Not a good situation, and a big reason chiropractors get a bad rap for getting people “addicted to adjustments”.

So what now?

When choosing a chiropractor, it’s important that they are actually measuring what they are doing to the spine. Almost any chiropractor is able to make someone feel better with manipulation. Manipulation sends a rush of feel good signals into the brain. However, a Structural Chiropractic approach is more than about feeling better in the moment.

It’s about restoring your spine and your nervous system to a state of Normal. A normally functioning spine has the ability to heal and maintain itself without relying on constant manipulation.

That’s why the procedures we perform in our office is truly about fixing the problem and getting it to stay fixed. Many times, these corrections can be performed without any rotation or twisting of the spine. It’s very gentle, and very effective.

Self-manipulation, while a temporary rush and feel good sensation can create hyper-mobility and long term structural problems in the neck. Additionally, it’s easy to become addicted to that feeling, and make your body dependent on constant manipulation to feel normal. In our world, we call that getting “hooked on the crack”. There are just too many questions about what can happen when you self-manipulate. It just doesn’t make sense to do something likely harmful for a few minutes of temporary relief.