Tinnitus, TMJ, Headaches, Neck Pain, Facial Pain, etc. — Possible Treatment

@bwspot For the tinnitus I think the approach would be to get rid of the muscle problems and see what tinnitus remains. Also there are clear muscles that cause tinnitus, but it can hard to know what treatment approach is best to get those muscles working again. There may be a series of muscles leading to the dysfunction.

The person you see may be better. The problem is that every practitioner is different and you have to judge each one individually. That is why there should be records of success so you know who works if any. Just like with drugs you test one individually, the same is necessary for therapists that treat this problem I think.

The problem is that there is no testing of each practitioner and no high compensation for those that are effective (assuming they are out there). So where is the incentive to be highly effective? There is a relatively equal pay for everyone, whether they are good or not. That approach doesn't work well on practices that don't rely heavily on drugs because there is much more weight placed on the practitioner. That is true for surgeons too I would imagine.

 

@Mr. Cartman

I think the cause of nocternal bruxism is supposed to be obstructed breathing path or something. However, I wouldn't assume the night bruxism is happening unless is can be observed through a sleep study or something like that. I think they don't like to do any test to confirm this as it is so easy to just blame night bruxism because it is something you have no control over and nobody sees happening, so it is like a ghost.

I'm more likely to think it is the turned neck during sleeping that is the problem. That is very simple and the cause is obvious. You simply turn in your sleep and it can be seen that everyone does this. The problem only arises if there are trigger points in there and then sleeping on the side causes the muscle to shorten or whatever for prolonged time and then you wakeup with more pain. These neck muscles will refer to the jaw, so it doesn't mean your body is actually bruxiing during the night without your control, but maybe it could be. Either way I say prove it.

Do you know how many times people have asked me if I clench my jaw? It is so annoying! Of course I don't clench my jaw! If my jaw hurt why would I do that? They say it is caused by anxiety or something. Is arthritis in the hands caused by people clenching their fists from anger? Is that psychological too? Please.

On an interesting note I've been pressing more and more toward the side of my rib cage in probing my lower back pain. Years ago I started out in the upper right corner pocket between the rib cage and the spine. Then in recent months moved more toward the side on the outside. I recent days I was moving more and more toward the front. I had been working with my psoas more. Now yesterday and today I've been pressing sort of on the side front in a place right at the edge of some of the ribs sort of under the ribs. It is a hard place to describe. However, I pressed gently with just my thumb and noticed some unusual pain in my hip and lower back. This is very interesting as I wonder if it is the cause of some of the pain. Also over the years I have had some minor tingling and numbness on my right lower rib cage in proximity to this area I am now pressing. I has tried to find a spot before, but never could but was looking more in the front than the side. I'm sort of on the side front, lower corner of the ribs now.

I still feel a pull in my shoulder blades and my neck and everything feels tight.

 

We do work on the muscles hoping to find any relation. This stuff is so complicated. Muscle tension adds to tinnitus that is not related to muscles. So many variables. I wish I would be rich and could spend whole day in the office experimenting with different muscles.

 

@applewine

Im more or less open to anything, but I do know that I did start a habbit of clenching my jaw during a very stressful period before all this started and I did show some signs of jaw muscle pain, and my jaw muscle pain has now become severe when I palpate the muscles in the lateral pterygoid area. I have always thought that the jaw clenching I did could be a secondary cause of tight neck muscles and bad posture.

But as you say, it could very well be that its all related to the neck, but my jaw complex does not feel healthy at all.

I pasted some info I found on a website and I also decided to try out their "TMJ Appliance" and bought it off from eBay for about $30.

I dont have any expectations, but I figured its worth a try and Ill let you know if it does something.

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What is TMJ dysfunction?
Temporo-mandibular joint (TMJ) disorder is commonly misunderstood and often goes undiagnosed. It’s an integral part of myofunctional orthodontics because if you have poor oral function (or soft tissue dysfunction) you'll nearly always have some sort of TMJ disorder. First up we have to define TMJ. A lot of doctors don’t really know what we’re talking about in terms of a broader aspect of TMJ dysfunction. What causes it, how do we evaluate the patient, what’s our diagnosis, and how do we treat the problem?

TMJ disorder was first identified in 1934 by Dr J B Costen, and is a condition that occurs when the TMJ's are subjected to excess pressure through misalignment of the teeth, muscles and jaw. Dr Costen demonstrated the fact that ear, head and neck pain could be eliminated by correcting an improper bite and removing excess pressure on the TMJ's by ‘opening the bite’ with intra-oral splints.

The symptoms of TMJ disorder can differ from patient to patient, making diagnosis troublesome.
The TMJ is quite a complex joint. Many doctors think the joint has a rotational movement; however Fonder showed that the opening and closing of the mandible pivots around the C1 and C2 vertebrae, meaning that it’s an integral part of cervical function as well. This is why many patients exhibit neck disorders along with TMJ disorder.

Most of the time the focus is on the joint, when the symptoms aren’t actually related to the joint. The symptoms are more concerned with the cranio-mandibular muscles.

Intra-capsular and extra-capsular
Patients with TMJ disorder exhibit many symptoms and so a common question is “What exactly is TMJ disorder?” It’s a cranio-mandibular cervical dysfunction. Symptoms range from a clicking joint, to more severe intra-capsular issues.
The majority of patients have a wide number of symptoms which affect the neck, head and shoulders. This can be confusing for the dentist who is not used to treating the areas outside of the mouth, but in actual fact treatment is still performed internally by correcting the myofunctional habits

Most of the time the focus is on the joint, when the symptoms aren’t actually related to the joint. The symptoms are more concerned with the cranio-mandibular muscles.

Most patients have both intra-capsular (related to the jaw joint and bone structure) and extra-capsular (related to the muscles of the face and neck) symptoms.
Patients often display both types of symptoms, and all vary in their severity. It can be difficult to effectively define and diagnose the problem.
Muscle and joint palpation exercises can be used to diagnose TMJ disorder.

Diagnosing TMJ disorder
In order to diagnose TMJ disorder there are several quite simple muscle and joint palpation procedures. These cover the temporalis muscle, the masseter muscle, lateral pterygoid, medial pterydoid and the sternocleidomastoid.

Then proceed on to examining the TMJ itself. Map the key functions of the joint - including mouth open measurements, note any clicking when the jaw moves and palpate the joint to see if the patient experiences any pain. Pay close attention to whether one side of the patient’s muscles experience more pain than the other.

( Source: http://myoresearch.com/orthodontics?/tmj#tmj_diagnosis_treatment/slide1 )

 

@applewine

I have also found something interesting.. I have some odd sensations in my ears sometimes that can remind of something that tickles.. And I have found that contracting a muscle that is located between my nasopharynx and oropharynx will trigger this sensation and it will also make my tensor tympani contract.. So it seems like theres a link between the tensor tympani and this muscle. I dont know what muscle it is, but I think its the levator veli palatini. It could also be related to tensor veli palatini, salpingopharyngeus, palatopharyngeus or any of the pharyngeal constrictors. It also directly affects my tinnitus.

 

@Mr. Cartman To me the idea that it is the muscles due to a malfunctioning bite from teeth location without any problem with the join itself makes more sense.

This is the route that I think I liked dentists talking about more. More about muscle functionality rather than there being a problem in the joint or with the disc being dislocated ever so slightly. Medical, anterior, posterior etc. One dentist who says it is all about the joint said that mine was medially displaced which was the hardest to fix and may require small surgery to hold the disc in place after orthodontics and only one surgeon does this surgery.

However I really don't know this is the problem. Also the orofacial dentist guy I saw who is supposed to be very conservative as far as proof goes said that bite does not cause TMJ problems. He said you only chew for like 10 minutes a day or something. He also said he thought my problem was trigger points in the neck and showed me picture of trigger points. I was of course very familiar with trigger points as I had been trying to treat them for years already. He is also the one that referred me to a physical therapist and she didn't seem to be doing anything that made sense and chatted about some weird strength testing that is like homeopathy. I told the dentist and he said there was no evidence that physical therapy works and referred me to a psychologist, but I really don't care about psychology.

 

Yeah, I have never expected disk or joint issues.. Im pretty confident that if its related to my TMJ complex its related to the jaw and neck muscles. The website source in my previous post also shows a nice 3D video of how the lateral pterygoideus pulls the mandible condyle out of its socket.

At least I think its muscle related.. It could be tight muscles compressing nerves of course..

 

Short update, I'm having so much facial pain that my thesis is suffering badly, I just cannot concentrate on the days I have pain. Luckily I had another decrease in T, but it fluctuates together with the pain. Also my physiotherapy started again. Very painfull today, she discussed with me that people should pay attention to the position of their tongue in rest situations. If you tension your tongue, the muscles right under the mandibular become tense as well. And yes, they are tense on my face. The most pain comes today from the stylomandibulare and the sphenomandibulare and the upper ligaments. See picture below

@Mr. Cartman If you want an animation of jaw movement and muscles see here:
http://jkoolstr.home.xs4all.nl/kauw/kauwspieren_3_02.html

Scroll further with the red arrows. The website is from Dutch ACTA which is an academic centre for dental care , located in Amsterdam. If facial pain / jaw pain persists, I opt for going there. But my dental surgeon has to write a referral letter first.

This is the movement of the articular disc is seen in this English animation: http://jkoolstr.home.xs4all.nl/kauw/kaakgewricht_3_07.html

 

@Codaz

Hi buddy! And thanks for the update!

I feel you bro.. Ive had some really great days lately.. To the point where I felt almost completely back to normal, but I did the most stupid thing ever today.. Ive been chewing bubblegum all day, and for some reason, the pain goes more or less away while chewing.. But after I took it out of my mouth and stopped chewing, the pain has almost become unbearable..

My jaw is definitely causing a lot of issues..

Nice catch regarding the resting position of the tongue.. I think it is super important!

I also get some nasty clicking sound in the left side of my jaw if I tense up my jaw muscles and kind of wiggle it..

Also, the images you posted is exactly where I have a lot of pain.. If I palpate the muscles using my finger it is VERY painful.

I really appreciate your updates and dont forget that you are not alone in this jaw/neck shit!

 

@Codaz

I forgot to tell you, but Im up for MRI of my entire infratemporal fossa, both jaw joints and all of my jaw muscles where they will look closely at all the nerves related to the jaw complex.

Ill let you know how it goes

 

It is hard to tell from those pictures compared to where my pain is. I know it is the general area. I don't have extreme pain really. In the beginning I had pain all over my face, muscles under side of jaw, everywhere. I noticed that just about the only food that can tire my jaw is a bagel.

The thing about tongue positions I've heard a lot. They say when you have jaw shape problems the tongue may not rest in the right spot. Mine always rests right there at the top front without trying when I'm just relaxed. My jaw is also lips closed teeth apart.

This is one of the TMJ dentists practices in my area. I saw them but decided I had no proof that their treatment would work or be safe. And of course, though really least importantly, it would be very expensive and medical services would not pay for it: http://sleepandtmjtherapy.com

@Mr. Cartman I saw that device you got. The website seemed to say it was some kind of orthodontics device though. That is for moving the teeth, more than holding the jaw in a therapeutic position.

 

On another note I did a search for "water sensations all over body" and got some results talking about inner ear and dizziness in one person wondering what they were.

http://missionquest.fpb.yuku.com/to...Dripping-Water-Sensations-Common#.VK7H4nstvFo
"
I have the "sprinkling of water droplet feeling" over my entire body. I dread having to go through all the testing etc because last year in 2005 I had a bunch of brain mri's and ct's because of a vestibular disorder that attacked my right ear.
I am not sure if that event has anything to do with the new neuropathy sensations I am dealing with a year later.

Can an inner ear disorder cause weird water like sensations to appear all over the body. Can stress play a role? I dont believe I have any weakness with the sensation. I have had balance and dizziness problems due to the inner ear disorder from last year.
"

Did this person really have a vestibular disorder? Or perhaps they just had trigger points.

and another person but with a different suggested cause:

"I have this sensation also,migrates to different areas.My neurologist explained it was a sensorial neuro disturbance in the nerve endings being out of whack.Like others I have MS.It appears before a flair up.I guess its my warning sign.
"

Aparently these sensations can be caused by many things.

 

That is something. Certainly nothing any of my doctors recommended. But then none of my doctors seem to work in the area of the maxiofacial area, except of course the dentists. The neurologist said basically the MRI didn't cover the nerves after they come out of the brain (cranial nerves I guess). All the stuff in the face and jaw area.

 

Yeah.. That is my impression as well..

I think MRI of all the nerves passing close to the jaw and through the jaw muscles is at least better than nothing.
Another funny thing I have noticed is that some neck/jaw movements (it seems to be related to my anterior neck or jaw) trigger those water sensations you are talking about.. It also seems to be related to muscles tension and/or stress in my case.. Somehow..

This is what their website says:

TMJ Appliance™
The TMJ Appliance™ works best to relax the cranio-mandibular muscles - for extra-capsular relief. It treats symptoms by decompressing the joint through its aerofoil shaped base and eliminating the effects of bruxing with its double-mouthguard effect.

Further relief is provided by the change in the resting length of the muscles when the appliance is in place. This treatment assists in relieving TMJ and cranio-mandibular symptoms, limiting bruxing and grinding, and improves patient comfort.

The TMJ System™
The TMJ System™ is comprised of a series of soft intra-oral appliances specifically designed to assist in the diagnosis and symptom relief of TMJ disorder.

The appliances have a thick section at the back which relieves pressure by gently decompressing the inflamed joints when placed in the mouth. They also automatically correct the alignment of the lower jaw and stretch the tight and painful muscles around the jaws, head and neck area, resulting in an immediate decrease in pain.
Over long periods, this helps to decrease long term pain. Bruxing (grinding of teeth) is also prevented by the patented aerofoil shaped base and dual moulded design.

Directions for use
The appliance should be used for one hour a day and overnight while sleeping. With good compliance, symptoms should reduce in the first few days but sometimes several weeks of use are necessary before pain relief is experienced. Continue to use the appliance for a minimum of 30 to 60 days after which you can determine how much continued use is needed to maintain symptom relief.

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Not sure what to expect of it, but Im going to give it a try.. If it does something Ill let you know

 

@Mr. Cartman I guess as long as you are not wearing it 24/7 it won't change your bite. I wonder how they have one size that fits in every mouth.

Can you describe the water sensations again? I remember you saying they were warm water. Are they still warm water or does it feel like cold water? Also where are you feeling them?

Sometimes I'll feel the water sensations in my ear or something when doing something with my jaw or neck, but not much. Also of course I feel the water sensations often when walking with my shoes on. For some reason if I walk barefoot I don't get the water sensations in my feet. I also don't get them when laying down. I get the water sensations in my arms and stuff too.

 

I won't do an MRI if it does not show any beneficial results. Just simply too loud, and I discussed with several people that it probably won't show anything at all. But if someone can convince me it will show anything, I may opt for it.
But there are several more options that I can try first. I need to speak someone with maxiofacial experience first. And not a dentist, or neurologist.

Putting TENS electrodes in my face makes my T louder, but it helps against the pain and eventually lowers my T.

 

Yeah, Im excited to try the night guard.. Not sure how they make it, but I think its worth a try for $30

In the beginning it felt a bit like warm water, now I think I have the sensations you have which reminds of cold running water mostly in my legs and in my arms, but for me it seems to be tied up to the neck and jaw. I also have it in my ear sometimes as well..

I know that theres something going on with my jaw and neck..

 

The thing is, I still don't trust the traditional splint. Aren't there any 2015 techniques? There is a lot published in the scientific papers about bruxism and/or jaw clenching. But what I have read on a Belgian forum which had a topic about tinnitus was that not all dental surgeons presribe even the standard splint. Really strange.

Why is it so hard to get state of the art medical attention these days? All doctors don't know a thing, they won't try a thing and they don't listen to the suffering a patient has and that something has to be tried. I'm talking with Viking for some time now over PM. He tries drugs, the tries and tries. I still wonder why doctors think it's wise to sent a patient home? Then the problem won't be fixed and the patient will return in a period of time. Or is it the case that doctors think hey they will go to another one so I'm free of this question?

 

Just a bit more for the info box

Re-Lease YOur JAW toDAY using the FELDENKRAIS...

 

I have suspected that my T originated from having TMJ. I was fitted by my dentist with a night guard that ever so slightly moved my lower jaw forward. It also prevented any grinding of my teeth while I slept. I wore this guard off and on for several months, then out of the blue I got T. Just in the last week or so I've been using some home exercises where I open my mouth slightly, place some pressure on my chin that moves the jaw backwards, closer to where it was for years before the night guard moved things around. While maintaining the pressure backwards, I massage all of the muscles and tendons around the TMJ, ear, etc. I've noticed a difference in the volume! It is much much lower than it was before I started this process.

Has anyone else had an experience where the treatment for the TMJ either caused your T or made it worse? I don't think I'm going crazy here, but sometimes I think I am. I'm thinking about going back to the dentist and asking him to somehow get me back to where I was before.

I thought the popping in my jaw was bothersome, but I would now take that back in an instant.

Any advice?

 

@SethL If you had some TMD issues then I would suspect you would have chronic pain in your mastication related muscles as well as the neck. These would include the muscles in your jaw and temples. I have chronic pain in my jaw muscles as well as temples and neck. I also have numbness below the eyes that comes and goes. My cleidomastroid muscle seems to have trigger points.

 

Thanks @applewine for your reply. I never really noticed any consistent pain in my jaw or neck. I had the popping in the left side of my jaw associated with TMD for 7-8 years before I finally went to the dentist to see about treatment. When the T first started I also had severe blocking of the eustachian tube blockage, that feeling that your ears are clogged. If I twisted my head to either side as far as I could, the blockage would immediately go away and the ear felt clear.

I know the TMJ is very close to the ear and the eustachian tubes.

The only nice thing is that the treatment totally worked. I haven't had my jaw pop for several months. But, I would gladly take that back in exchange for the T.

@applewine - do you get any kind of relief when you perform trigger point massage therapy on your cleidomastroid or other muscles in that area?

 

@SethL
I have had very limited relief from any sort of physical treatments I perform. It is not full relief in magnitude or time.

 

Another physiotherapy session today. Lot's of changes I notice in around my ears in the skin. Some fleeting tinnitus on the left side. But overall quite low. On some days the facial and/or neck pain and tinnitus are almost totally gone, and on some days lot's of pain or lot's of tinnitus. Fluctuations...

 

@Mr. Cartman @Sjtof

I was searching some more on the posts muscle. I have some kind of chronic pain in the back and that area. The interesting thing related to the TMJ and the psoas is that I've heard there are connections between the TMJ and hip/psoas.

I just found this page after doing a quick search and it is new to me. I'm going to read it soon.

http://vlmassage.com/psoas/
"any tension within the pelvis will be reflected in the jaw and visa versa"

This is not the first I've heard of a connection.

I actually remember reading a study where they did a test on mice. I think they changed the jaw and it changed the hip.

 

@Mr. Cartman @Codaz Another thought I've had in the past but forgotten about. I've wondered if somehow excessive orgasms caused or are causing neurological dysfunction with the muscles or preventing recovery and treatment.

I say this because acetylcholine is the neurotransmitter heavily implicated in both trigger points and orgasms. The motor end plate dysfunction in trigger points is supposed to involve acetylcholine. I just don't know if the peripheral and central nervous system are going to have the same effect here or where the problem is coming from.

One thing I was experiencing during my original neck pain was almost like a bi-polar state. I felt hyper-sexual libido and euphoria all the time and it lasted for about a year. I was exercising a lot so maybe that was it. I was also constantly hungry feeling starving between meals no matter how much I hate. That actually lasted a few years. One day the hunger and other stuff went away and I gained like 20 pounds in a week. I had never gained fat before in my life.

Look at this paper that says they introduced acetylcholine directly into the septal region of the brain. It says she experienced euphoria and often experienced orgasm. Also acetylcholine is released naturally from orgasm.
https://books.google.com/books?id=2...EwAw#v=onepage&q=acetylcholine orgasm&f=false

I've already decided to try this experiment. The problem is I don't know if this is doable for months at a time. I've already started to experience smiles that rush over my face that I couldn't control and laughing out of nowhere. It could be nothing, but this seems to be a difference in neurology.

So I'm wondering if abstaining from orgasms for months, perhaps while doing treatment, would do anything.

It is very unlikely other people have tried this. This is also just one of many ideas I have come up with which are long-shots.

 

Interesting thought, but no idea. No excessive libido for me.

 

Another interesting thing you guys could try which is not necessarily related, but it will reduce the amount of time spent still, which probably increases muscle soreness. Segmented sleep.

Polyphasic Sleep: Segmented Sleep + Dual-Core:...

 

Guys I know this sounds unusual but I did some more googling and found this post:

http://www.reddit.com/r/NoFap/comments/1wwrx6/i_turned_3_my_brief_thoughts_so_far/

"
10fingers11toes31 days 1 point 11 months ago
Congrats on 3 weeks, man! Since people are talking about sleep, I've seen this mentioned a few times, and it's true for me too, that my jaw is less tense with no PMO. Because of fapping so much, I was starting to get TMJ, it's an aching jaw that sometimes progresses to an earache. I don't know how the 2 are related, but now that I'm not fapping, it's gone.
"

 

Found this on another forum:

[–]computerguy0-0 0 points1 point2 points 16 days ago (0 children)
I lived with it for years. Doctor after doctor and nothing was wrong with my hearing...IT WAS DRIVING ME NUTS!
But it's been gone for 5 glorious years now. Do you know what it fucking was? My god damn neck muscles. See a chiro, see a massage therapist, and see a physical therapist. Relax and strengthen those muscle in your neck, get your cervical spine aligned, and bye bye tinitis. Of course, this was just my cause... But it is more common than i thought.
I got lazy with my neck stretches and developed Bells Palsy in December, another thing caused by misalignment and stiff neck muscles. I am almost back to normal 8 months later, SO KEEP UP WITH THE ROUTINE ONCE THE RINGING GOES AWAY!