TMJD? Jaw Pain, Clicking, Unlocalized Sensitivity, Clenching, Grinding...

My name is Finn, I study flamenco guitar at the Conservatorium.

Last semester I needed to record a 20 min performance. The process involved many takes with the sound of my guitar and the clapping guide coming through the headphones. Can I add a link to the video?

A week or 2 after I put it in, I noticed the ringing was hanging about. (Roughly 10 kHz, cicadas). I freaked out. My first degree was in sound, and I was taught that acoustic trauma related tinnitus is permanent (2011 so not exactly up to date).

Anxiety, depression, suicidal all at once, I was an absolute mess for the first 30 days. GP said it is just wax, it will 100% go once flushed... nope... let’s try antibiotics... no dice... Audiologist said my ears were ok... doctor prescribed 5 mg Valium for the panic, and SSRI’s for depression, which I refused.

The 2 main early stuff ups were... I was critically low on iron and had no idea, so the anxiety attacks that involved convulsive shaking were iron related.
Second was that I read over and over that coffee makes it worse, so I dropped a lifelong coffee habit cold turkey, the result, anxiety, brutal nausea.

I have read of TMJD and all the symptoms are familiar... jaw pain, clicking, unlocalised sensitivity, clenching unconsciously, grinding at night, and all this started shortly after a dentist had filed a bit too much away changing my bite. I got hold of the TMJ specialist in Victoria for a webcam chat (thanks to Australia’s lockdown), he seemed to think that it was a 50/50 that the ringing will go away once my dental issues calm down.

The noise changes when I do certain things with my jaw, like push out like an underbite and the volume goes way up, then straight back down when my jaw relaxes. same if I hold my tongue to the roof of my mouth and open, or try open my jaw with resistance.

Switched chewing to the right side and changed to a soft food diet and the volume dropped quite dramatically. But it is still there.

The thought that it may not be permanent, coupled with higher iron and a coffee, and my anxiety and depression is ok. To be clear, the depression and anxiety is 100% the tinnitus.

In 2 days, I need to spend a fortune on a fitted jaw thingy that may or may not work.

Thoughts?

 

Hi @Finn!

Sorry to learn of your troubles. Tinnitus sucks right!

I'm more replying to say a friendly hello rather than offer advice because I can't say that I've had/got any TMJ issue.

However, I can tell you what has helped me lower my tinnitus.

I take vitamin B12, NAC, zinc, and magnesium. I'm not sure what one works, but I know if I run out, the volume increases slightly.

NAC is good for protecting your ears rather than helping to lower the volume - well that's what I've read (someone correct me if I'm wrong.)

Also you probably already know, but at the moment you must avoid headphone use. Protect those ears from sound at all cost whilst you're in this early stage of tinnitus.

I also wear ear protection when I'm driving and carry around a little pair of plugs I can pop in if I feel my environment is too noisy.

Of course if your tinnitus turns out to be TMJ related, then my advice is probably redundant.

If there's any chance your tinnitus can be lowered through jaw work etc. then I would personally try it. I mean with tinnitus anything is worth a shot at potentially eliminating it.

Hang in though, and if you're really struggling, make sure you keep sound enrichment on in the background. Try as much as you can to disassociate with the tinnitus... Easier said than done! I know!

Tinnitus is pretty intrusive to begin with, and some days I still struggle, but it does become easier for a majority of people. Life can go on, it just has to adjust.

Acceptance is bloody hard. I still struggle myself, but keep yourself occupied as best as you can. Take the supplements, protect those ears, sort out any jaw issues, and try to keep yourself distracted.

Hopefully others with TMJ issues will read and comment on your post soon.

Steph x

 

Hi Steph,
Cheers for the response. Nice to meet you.

I will look into those supplements, although if the TMJ treatment works, I should start hearing an improvement in 2 weeks or so. If that doesn’t work as it should, then I will go get any and every supplement anyone can suggest.

Early stages of tinnitus and quiet though...? The most dangerous thing in my case is myself. After all, a sound only I can hear can’t actually physically hurt anybody. The only danger is a poor reaction to my tinnitus. I needed to play music, to create something, to mask the silence (or absence there of).

Step one for me was to figure out what frequency I needed to mask, then I set up speakers on my bed frame. Rain on a pond in Korea is the greatest for the 10 kHz tone I hear. Each night for 8.5 hours.

Initially the tinnitus was in the left more than right. Not sure if it is the chewing on the other side, or the exposure to the damaged frequencies from the bed speakers, but the side closer to the speaker that plays the rain masking sound has gone down.

The biggest issue with me was the panic, I have made a really good instructional list of what to do when having an attack. Starts with body essentials like food and water, exercise, going outside, Reddit distractions, and it moves from high intensity distractions down to calm things always with the intention of trying to work on uni stuff. It also features criteria on when to take a Valium (second last resort) and when to go to psych ward (last resort).

Once I had that refined, I was much easier able to get on with the productive parts of uni instead of patting my cat and watching mash in a Valium haze.

Thanks for checking in and welcoming me.
Digital hug from afar,
Finn

 

Hi @Finn.

Have your TMJ doctor read this: https://mskneurology.com/association-tinnitus-neck-tmj/

Check posts by @Greg Sacramento or using the search function, very helpful.

Diet helps, sleep helps, bad sleep is due to the shock, nervous system eventually returns to normal. Masking, medication and supplements may interfere with it imo. Search how to improve the parasympathetic.

If you have massive ear fullness, pressure around the ears, eyes and nose, perhaps there is more to do, such as Cortisone pills for a week to fight inflammation. Also, an ENT to check for hearing loss, fluid in middle ear, pressure in middle ear, ETD etc.

From what I have read so far, it can be neck, jaw and neck, jaw and teeth, or even teeth alone. That means muscles, nerves, vessels or even all three, so you have to take it slow step by step and eliminate things.

One thing I do for myself and tinnitus is I write down symptoms to have a better idea what’s happening (in short, how my own body and jaw movements or external factors influence tinnitus). It saves a lot of time for the doctor because he doesn’t have to guess so much anymore.

 

I had the fitting yesterday. No sleep the night before due to anxiety around appointment.

Turns out there is a slipped disc in my jaw (possibly poorly paraphrased). There are also several muscle knots in my jaw.

While he was poking and prodding I noticed that I was in silence. The air conditioner was a quiet model and there were no other sound sources, but there was no ringing. Super awesome and exciting, as I haven’t observed that since it started, but totally useless during diagnosis.

Once I was paying, the familiar eeeeeeeee sound returned. Dammit... also the finished product will be available to me on the 20th, followed by 2 weeks to possibly hear a difference in the tinnitus.

I have spent these months intentionally not looking for it because listening to it gives me anxiety, but maybe it is time I start? how do you monitor success?

Rarely do I feel fullness in the ear, I had a full check at the audiologists about 2 months ago. no hearing loss (slight scoop at 7 kHz, but more likely from sound engineering years ago, as it is not the tinnitus frequency) inner ear pressure normal. That article is a really comprehensive list of ear functions, great resource. Also fantastic idea about a symptom diary for doctor ease as my memory has always been shocking.

 

@Finn I hope it resolves your tinnitus issue. I also have TMJ issues and have been wearing splints for 4 months

For me, a bit of pain improvement but no tinnitus improvement, but I hope yours is milder. As you had moments of silence - that is a good thing.

Having tinnitus is bad enough and throw in jaw issues, just that much tougher.

 

Hey @Finn, did you get your splint? Any progression?

Ken

 

The splint is in the mouth, my appt was on the 27th. There has been a bit of fluctuation in the T over the past fortnight. 3 moments of silence, 2 were after a bath.

Ken, I am sorry for the slow reply. Thanks for checking in on me. I am sorry to hear that the splint has not been the answer for you. I have read that the splint can take longer in som cases. I am assuming you have read the thread “my journey to silence”? I think that was the name.... long story short was that her splint took years, but it did work in the end.

I am trying not to monitor it too bad. I have uni exams coming up and I am trying to keep my headspace in order.

2 concerns I have is that despite what I have read, the TMJD specialist said it would take 2 weeks to see a difference, which means that in 10 days if no more change, I will start to worry that this has all been a waist.
Secondly, I am getting really close to the 6 month mark, where I am to understand that it is way less likely to ever go away.

Seriously considering taking the antidepressants that were suggested months ago. I have made the most of a bad situation thus far, but if all goes poorly, I think I might need a chemical hand finding stability. Uni has helped me be distracted, but it’s just about to be 3 months of holidays. But all consideration is on hold until my exams are done.

Also not sure if it is relevant, but an MRI showed sinusitis. My GP couldn’t tell me why it was relevant, but my GP isn’t the best with communication.

Cheers,
Finn

 

I developed TMD as a result of the intense stress from tinnitus and hyperacusis.

 

Shit man, I am sorry to hear. That might also be my story. (I hope not though).

Have you habituated ok now?

 

The tinnitus is okay, but the pain hyperacusis basically keeps me housebound. I also live with my family so I’m not getting any better from the silence I desperately need. I’m at least going to seek out treatment for the TMD; jaw pain, clicking, grinding; and will see if that helps the hyperacusis.

I too was passionate about music before hyperacusis and would play electric bass and acoustic guitar. I’ve had to put all that on hold now though, as it causes intense pain.

Any tips in terms of what to do or say at the appointments? Should I see a specialist?

 

Never stop playing brother. It is the answer to happiness.
Low frequency bass through good quality gear is heaven to me. If you get a graphic eq, you can find the frequencies that make you uncomfortable.
In this fragile world, we don’t get to control much. In my world, I can vibrate the air with my instrument. That is worth more to me than anything else. It gives me a reason to get up and a safe place to run from the T.

As mentioned above, write your symptoms down. Anything that happens with jaw in any position. When and here does it hurt?, what affects the T? The normal ent channels didn’t point me to TMJD, I had to chase that up myself.
In the end they know what to ask you, that’s why they are the specialist.