TMJ MRI

Discussion in 'Support' started by kelpiemsp, Jul 18, 2018.

    1. just1morething
      Benevolent

      just1morething Member Benefactor

      Tinnitus Since:
      It started
      Cause of Tinnitus:
      Bad luck
      @Greg Sacramento, thanks for your info! I woke up to static again. Maybe it is just HF hearing loss? I thought there was a possibility that my TMJD was causing my noise but maybe not? I hate this damn noise. Waking up to this crap is just the worse.

      Sometimes I got relief from prednisone so I thought there was a inflammation component to this noise. I guess I’ll keep trying. Funny how my right ear is affected when it started out in my left ear.
      The noise I wake up to is almost intolerable.

      I went off hydrochlorothiazide for a couple days and I seemed almost cured and then it came back after a bad dream.
       
    2. Shera
      Bookworm

      Shera Member

      Location:
      USA
      Tinnitus Since:
      12/9/2016
      Cause of Tinnitus:
      head trama caused TMJ/neck problems/ETD
      I keep hearing more and more about botax for TMJ. Anyone tried it?
      The night before I woke up because my tinnitus suddenly got super loud in my sleep. Apparently I was shoving my face in my pillow while side sleeping and it was messing with my jaw which in turn messes with my tinnitus.

      I rolled over onto my back, massaged my jaw like I do, and the noise quieted down. I fell asleep and when I woke up everything was back to "normal".
       
      • Informative Informative x 1
    3. Greg Sacramento

      Greg Sacramento Member Benefactor Hall of Fame

      Tinnitus Since:
      April 2011
      Cause of Tinnitus:
      syringing and now somatic T dental work
      @just1morething I always though for you (I know for sure with myself) that HF hearing loss has involvement and from that nerve fibers any place from shoulders above can intensify ears causing louder tinnitus from position, movement, stress, and having even a little infection.

      For you, I would think that noise caused some hearing loss, but not tinnitus until an injury (maybe a mild whiplash) happened. Your scans notes (MRI of TMJ) - show injury, but not all that concerning as self, including infection. Your neck needs to also have involvement. Your HF hearing loss tinnitus has a somatic nature which means that physical tinnitus is the larger gatekeeper. You have been able to lower tinnitus for periods of time with certain treatments - both physical and systematic treatments such as with medications. This probably shows that your body favors one side and (posture) with also forward motion having effect. Your MRI of TMJ shows that and it also shows a neck injury. One can read a thousand studies about this, but the best way to find out what treatments may be best is nerve conduction studies.
       
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    4. just1morething
      Benevolent

      just1morething Member Benefactor

      Tinnitus Since:
      It started
      Cause of Tinnitus:
      Bad luck
      Did the TMJ steroid injection reduce your tinnitus?
       
    5. jeas

      jeas Member Benefactor

      Tinnitus Since:
      October 25, 2018
      Cause of Tinnitus:
      TMJ/Neck
      @just1morething

      I think it reduced my fluctuations. My tinnitus can go from quiet to a extreme high pitched hissing/frying pan sound. I think it reduced how often my jaw would act up and my tinnitus would increase.

      I still have fluid in my ear and ETD symptoms. It helped the snapping/clunking that was happening when I opened my mouth mostly.
       
      • Informative Informative x 1
    6. just1morething
      Benevolent

      just1morething Member Benefactor

      Tinnitus Since:
      It started
      Cause of Tinnitus:
      Bad luck
      I see this place does TELE-TMJ consults. They are closed because of the coronavirus but I think they would do a telephone or video consult. I left a message and will also send my TMJ report via email.

      http://portlandtmjclinic.com/tmj-disorders/symptoms

      SYMPTOMS
      TMJ disorders produce what is known as a constellation of symptoms. There are a wide variety of them, and not a consistent pattern to their presence. The most common ones are facial pain, difficulty chewing and swallowing, limited mouth opening, unexplained (phantom) tooth pain, headaches (including common migraines), blocked eustachian tubes (stuffy ears), dizziness (vertigo), ringing or whooshing sounds in the ears (tinnitus), subjective hearing loss, and chronic neck and postural tension. All these symptoms rarely occur together in one patient, and most patients suffer from only a few of them. For example, some only experience headaches, some only experience facial pain, and some only experience ear problems. A few TMJ disorder patients also suffer from unusual neuromotor disorders (such as facial twitching), neurosensory disorders (numbness), and a variety of minor visual problems.

      ADAPTATION eventually eliminates the symptoms, because TMJ disorders are self limiting conditions. Longitudinal studies of tens of thousands of untreated patients have shown that everyone eventually achieves normal or near normal opening and relief of symptoms, because the TMJs undergo adaptation characterized by fibrosis of the retrodiskal tissues. This adaptive fibrosis may require anywhere from days to decades, but it almost always occurs by middle age. The process is described in MANAGING THE ARTHRITIC TMJ.

      GENDER certainly plays a big role. Women are disproportionally affected because of their average more downward and backward facial growth pattern, which diverges from the average male facial growth pattern at puberty when females also become much more susceptible to TMJ disorders and then continues during adulthood. The gendered growth pattern does not stop after the second decade when other growth processes stop. Adult jaw growth does not stop, because it was designed to compensate for tooth wear in our ancestors, which also did not stop. Today it still continues in adulthood, even though it is no longer needed to compensate for tooth wear.

      CHILDREN rarely suffer from serious TMJ disorder symptoms, because their extensive capacity for growth adaptation will change their facial structure to accomodate even extreme bite strain rather than allowing the strain to create tissue damage.

      ELDERLY rarely suffer from serious TMJ disorder symptoms, because the adaptation that eliminates the symptoms almost always occurs by middle age, even as the deterioration of the TMJs continues with age as seen in X-rays and MRI. The adaptation occurs because the decrease in reflex reactive jaw muscle tightening that occurs with advanced age removes a key element from the symptom generating cycle in which cellular damage in a TMJ triggers reactive jaw muscle tightening, which causes more cellular damage, which causes more jaw muscle tightening. This arthrokinetic reflex was designed to protect acutely damaged joints by bracing the muscles that surround them. In the small number of our ancestors who lived into middle age, this protective jaw muscle tightening had to diminish or it could be triggered so frequently by the arthritic changes of normal aging that it could prevent normal function. Thus, to allow joints to withstand the inevitable arthritic changes of old age, neuromuscular reactivity diminishes in the elderly, which removes one of the key links from the symptom generating cycle. As a result, older people may experience difficulty with mechanical operation of the joints, a shifting bite that causes difficulty chewing (like operating a door off the hinges), chronic postural muscle tightness extending to the jaw muscles (myofascial pain), and some ear problems (dizziness, tinnitus, and stuffy eustachian tubes); but they are unlikely to develop persistent TMJ inflammation or acute painb, and any TMJ disorder symptoms they do experience respond quickly to almost any treatment.

      TMJ PAIN, directly in the area of joint, is rare, because joint surfaces are designed to withstand large compressive forces and therefore cannot have sensory nerves in the area between the bones. The pain sensitive nerves in joints are located in the capsule surrounding the joint and in the attachments of the ligaments that reinforce the joint, and they only signal pain when the joint capsule is stretched by swelling or the ligaments are pulled too tightly.

      ACUTE TMJ PROBLEMS are usually accompanied by TMJ inflammation. Since the TMJs are located on top of the back ends of the lower jawbone, the swelling produced by inflammation there pushes the affected condyle down and away from the skull, thereby slightly changing the cant of the long lower jawbone and making it difficult and painful to touch the teeth on the side of the swelling, because it requires driving the condyle through the area of inflammation.

      JAW MUSCLE TENSION always accompanies TMJ disorders, because damage to any joint produces a reflex tightening of the muscles which cross that joint. The muscles that cross the TMJ are the jaw muscles. When they function on a damaged TMJ, they reflexively hold themselves braced in readiness to protect it, so they can never fully relax. Their chronic low level tension can inhibit resting circulation in their capillary beds and thereby prevent them from being able to adequately flush out waste products. In this manner, the jaw muscle tension produces the pain, but the TMJ inflammation produces the jaw muscle tension. Treating the jaw muscles produces short term relief, because it helps flush waste products out of the capillary beds, but it ignores the cause of the muscle tightness; therefore treating the jaw muscles without also improving the conditions in the joint was like massaging the leg muscles of someone who has an untreated broken ankle. The massage helps relieve the pain, but the muscles tighten up again as soon as the patient gets off the table and resumes walking.

      HEADACHE is a primary TMJ symptom. Since the jaw muscles attach all over the sides of the head, jaw muscle tension can apply enough pressure to interfere with circulation. In monkeys, biting forcefully bends the whole skull and opens the sagittal suture along the top of the head. In humans, the jaw muscles are weaker, but the skull is thinner, so the jaw muscles can still apply significant pressure to the head. Chewing has been shown to increase cranial circulation. Sustained pressure from jaw muscle tightness can probably cause headache by disrupting the normal balance of fluid pressures in the cranium, which encloses the brain in a bony shell that cannot expand and contract in response to variations in fluid pressure as easily as other organs. As a result, different headache types (including common migraine) are often responsive to treatment that affects the jaw muscles - whether the pain is located at the front of the head (described as sinus headaches), in the middle of the head (described as temporal headaches), or at the back of the head (occipital or cervical headaches).

      POSTURAL MUSCLE TENSION also accompanies TMJ disorders, and it can cause pain far from the TMJs, because the jaw muscles function as members of long myofascial chains running up and down the length of the body, and a change in the resting length of one muscle affects all the muscles in the chain. Backward jaw posture, which is a central feature in most TMJ disorders, can cause forward head posture, which triggers an adaptive response of body posture to maintain physical balance, an open airway, and a level head. The adaptive change in body posture can cause degenerative changes in the intervertebral joints which limit their ranges of motion, depriving the specialized articular surfaces of the rubbing movements they need for local circulation. Because the weight bearing surfaces of joints function under compression, they cannot be directly supplied by blood vessels. Instead, they receive their nourishment from a hydrostatic process that circulates fluids by repeatedly rubbing the surfaces together in a manner that moves the area of compression all around the articular surfaces. Each area of the articular surface releases fluids when it is compressed and then gets replenished when the compression moves to a different area. Movement of the bones at the joint should be smooth and variable enough to spread this compression and release process widely around the surface of the joint in order to keep the entire surface of the cartilage healthy. Because of this accessory circulation process, passively moving a damaged joint has been shown to dramatically reduce its healing time, and immobilizing a healthy joint to eliminate its functional circulation causes it to undergo arthritic changes. Restoring normal ranges of motion to injured joints is one of the mechanisms by which chiropractic adjustments provide relief.

      When postural muscles have been held tight for long periods of time, they shorten anatomically and acquire a decreased resting length in a process known as contracture. When your jaw muscles are in contracture, your mouth no longer hangs so far open at rest, like when you fall asleep in a chair, your teeth may be held touching lightly, and they may go into a tight clench whenever overall resting muscle tensions are increased even slightly by stress (as explained below). Muscles in contracture have diminished resting circulation which can cause trigger points - commonly described as pea shaped nodes or knots that are exquisitely sensitive to manual pressure and cause pain at locations surprisingly far away in typical "pain referral" patterns. They can persist long after their original cause has been eliminated.

      EAR SYMPTOMS include dizziness and disorientation, tinnitus (ear ringing), stuffiness (blocked eustachian tubes), and frequent difficulty hearing what people say (subjective hearing loss).

      The ear symptoms can be produced by tightness of the jaw muscles, which share the same motor root as the jaw muscles. Increased resting tension in the tensor tympani and stapedius muscles, which tighten the ear drum, may cause the subjective hearing loss that causes TMJ disorder patients to complain they often miss things people say, even though hearing tests show normal results. Increased resting tension in the tensor veli palatini muscles, which normally pull open the eustachian tube during swallowing, can prevent the tube from clearing to equalize pressure between the middle ear and the outside air when you go up or down in a plane or over a mountain, making the ear feel blocked or stuffy. These two ear muscles also wrap around the hamular notch in the upper jawbone.

      Most of these same ear symptoms can also be produced by fluid pressure from TMJ swelling. Anatomical studies of TMJs with dislocated disks have shown that most of the tissue bruising occurs at the extreme back end of the TMJ, located only 1.5 millimeters from the front of the middle ear. Bruising produces inflammation, which increases fluid pressure that easily crosses the thin membrane bones separating the TMJs and the ears.

      BALANCE DISORDERS are frequent consequences of inflammation in a TMJ, because the body's balance mechanism is located in the inner ear. Serious injury to the balance mechanism can make a patient too dizzy to walk. Mild injury to that same mechanism produces feelings of disorientation, inability to concentrate, a tendency to bump into things, and "spaciness".

      EUSTACHIAN TUBE BLOCKAGE can be caused by an inflamed TMJ or sustained increase in resting tonus of the tensor veli palatini muscle. The eustachian tubes pass just behind the TMJs, and swelling of a TMJ can cause increased fluid pressure that pushes a tube closed. In some cases, a TMJ disorder can hold a eustachian tube partially closed for long enough to narrow its lumen. Then any inflammation of the inner lining of the tube from a cold or an allergy can further narrow its lumen until it becomes blocked.

      TINNITUS (ringing, roaring, or buzzing sounds in the ears) can also be caused by an inflamed TMJ or by tightened jaw and ear muscles, as well as a blow to the head, a drug, or a loud noise. Its presentation tells us nothing about its cause. In addition, the symptom can remain long after its cause has gone. A number of studies have shown that it responds to TMJ treatment in about half of the patients. That 50% cure rate would be considered poor for many medical conditions, but it is considered great for tinnitus, because there are so few other treatments that are effective.

      INDICATOR SYMPTOMS

      No matter which symptoms you have from a TMJ disorder, they all move in the same direction. Whatever makes your TMJ disorder worse will make your symptoms worse, and whatever makes your TMJ disorder better will make your symptoms better, but some symptoms respond faster than others. The more rapidly responding symptoms serve as indicator symptoms - they let us know if the treatment is on the right track. Pain is the best indicator symptom, even mild pain such as facial soreness. The ear symptoms are the worst indicator symptoms, because their response is more irregular. Tinnitus is the most irregular. It can even get worse before it gets better.
       
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    7. just1morething
      Benevolent

      just1morething Member Benefactor

      Tinnitus Since:
      It started
      Cause of Tinnitus:
      Bad luck
      I have an appointment on 6-9 to have both my left and right TMJ injected with a steroid. I think my noise is a brain/ear thing but I’m desperate. Rode both my motorcycles to our different house today. I did wear a helmet but forgot to use earplugs. My head is full of noise. :( Not sure how to shut it off.
       

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