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Tmj cause ear pain: Don’t Ignore These Five Signs of TMJ

Is Your Ear Pain an Infection or TMJ?

TMJ is sometimes called “the great imposter” because it shares so many symptoms with other conditions. That’s partly because TMJ symptoms are so numerous, diverse, and widespread that it’s hard to see them as connected with each other or with your jaw joint.

One common confusion is that people with TMJ may think they just have an ear infection. Ear symptoms are common in TMJ– nearly 80% of people with TMJ report ear symptoms. But if you have symptoms of ear infection that recur, persist, or don’t respond to usual treatment, you should consider that you might have TMJ.

Ear Infections Are Uncommon with Adults

Ear infections are common in children. Most likely, a child has some form of illness, like a cold or flu, which then spreads to the middle ear. Viruses or bacteria reproduce in the middle ear, and they, along with your body’s immune response, create swelling and excess fluid that can lead to clogging of the narrow passage.

Ear infections are more common among children with poorly developed immune systems and narrow ear passages. Adults are unlikely to experience ear infections, even if they got ear infections commonly as a child.

Overlapping Symptoms

When the middle ear gets clogged, people may experience many symptoms that can be common with TMJ. People with both conditions may experience a variety of ear-related symptoms, such as:

  • Ear pain
  • Ringing in the ears (tinnitus)
  • Sensations of ear fullness
  • Diminished hearing
  • Headaches

With all these symptoms in common, it’s not surprising that people might confuse the two conditions. Especially if you have a history of ear infections, you might jump to the conclusion that you have another ear infection.

But it’s important to look for symptoms that can distinguish between these two conditions.

Distinguishing Conditions

If you have an ear infection, you’ll know it because:

  • You are recovering from a recent illness
  • You have a fever or localized warmth in the ear
  • There’s discharge coming from your ear

If you haven’t been sick recently–or aren’t sick now–then you probably don’t have an ear infection. Fever is a dead giveaway of some kind of infection. TMJ won’t cause discharge from your ears, so that’s a definite sign of an infection. Remember: discharge may come from your outer ear or through your eustachian tubes.

But TMJ is more likely if:

  • Your doctor says you don’t have an ear infection
  • The symptoms don’t resolve on their own
  • The symptoms don’t respond to antibiotics
  • You have other TMJ symptoms like jaw sounds or tooth wear
  • Your symptoms seem to flare up after intense jaw activity

If you think you have an infection, you may not go to a doctor because viral infections tend to clear up on their own. But if symptoms persist and your doctor either clears you or gives you medication that doesn’t help,it’s time to consider that TMJ may be the cause of your ear symptoms.

This is when you should consider what other TMJ symptoms you may have. Jaw sounds, jaw pain, and tooth wear are all clear indicators that TMJ could be causing your problem. Another giveaway is that your symptoms come on when you work your jaw hard. This may be chewing a tough meal, talking a lot, talking loudly, or clenching your teeth due to stress.

If this sounds like your ear symptoms, then it’s time to talk to a TMJ dentist like Dr. Chris Hill in St. Louis. Please call (314) 375-5353 (Downtown St. Louis) or (314) 678-7876 (Clayton) today to schedule an appointment at City Smiles.

Do You Have An Ear Infection or Suffer From TMJ?

One of the problems with TMJ is that it can be hard to diagnose. TMJ has so many symptoms that many of them overlap with other common conditions. People are commonly misdiagnosed with these other conditions and may be treated for them, unsuccessfully, for years before getting a proper diagnosis of TMJ.

One of these conditions that overlaps significantly with TMJ is an ear infection. Nearly 80% of people with TMJ report ear symptoms , with ear pain being the most common. If you have ear infection symptoms that persist, recur, or don’t respond to treatment, you may have TMJ.

Ear Infections Are Uncommon with Adults

For children, ear infections are common. For adults, they are much less so. Even if you used to get ear infections commonly as a child, you’re less likely to get them now.

An ear infection occurs when bacteria or a virus makes it into your middle ear. They multiply there, and they can attack the tissue there and create fluid that clogs the ear and interferes with function.

Most often, an ear infection is an offshoot from another type of illness, such as a cold or flu.

Overlapping Symptoms

It’s understandable that people might confuse these two conditions because they can have some important overlapping ear symptoms. Both conditions can cause:

  • Ear pain
  • Diminished hearing
  • Tinnitus
  • Sensations of ear fullness

And if you have a history of ear infections, you’re especially likely to think you have an ear infection and may not consider that there could be another cause.

Ear Pain Is Common in TMJ

The link between TMJ and ear pain goes beyond the simple fact that the temporomandibular joint is so close to the ear. In fact, the temporo- part of the joint is the temporal bone, which houses the inner ear. However, there are strong functional connections between these two systems. Two of the tiny bones that make up our hearing system (the malleus and incus) evolved from the jaw bones that let snakes and other reptiles dislocate their jaws to eat large prey. These bones retain some of their muscle connections to the jaw, so when the jaw isn’t functioning properly, it can interfere with ear function, too, leading not just to ear pain, but tinnitus, dizziness, and feelings of ear fullness.

Plus, the nerves that run from the ear to the brain might experience pressure from swollen or displaced jaw bones or muscles.

Distinguishing Conditions

However, there are signs you can look for that will help you distinguish between these two conditions. An ear infection is more likely if you:

  • Have or recently recovered from a cold or the flu
  • Experience discharge coming from your ear
  • Have a fever or localized warmth

Because an ear infection is likely related to a prior illness, having ear pain after another illness is an important factor. And TMJ isn’t going to cause ear discharge. Remember, discharge can come from your ear or from your eustachian tubes. A fever or localized warmth are related to the activity of bacteria or your body’s immune response.

  • Have been cleared by a doctor as not having an infection
  • Experience other TMJ symptoms such as headache or tooth damage
  • Have symptoms that relate to jaw activity

If you have ear symptoms, it’s not a bad idea to see an ENT about them. But if your ENT says you don’t have an ear infection, your next stop should be a TMJ dentist. Especially if you’re experiencing TMJ symptoms like headache, tooth damage, and more that aren’t associated with ear infection.

But perhaps you’ve never been to see a doctor because your symptoms always go away quickly. In that case, look for a pattern for when they recur. If they tend to recur after periods of intense jaw activity, then you should consider TMJ.

If you think that TMJ might be causing your ear pain and related symptoms , please call (248) 480-0085 today for an appointment with TMJ dentist Dr. Jeffrey S. Haddad at the Michigan Center for TMJ & Sleep Wellness.

Why That Earache Isn’t Going Away

Pain in the ears causes a lot of discomfort and will rob you of the much needed tranquility and quiet everyone wants after a long, hard day. An earache can also rob you of sleep, which is a critical component of good health.

A common way of treating pain in the ears is a dose of antibiotics to get rid of an ear infection. Most infections respond to normal drug therapy, whether it is a chest, tooth or throat infection. Relief from pain indicates that the infection has been dealt with.

But, what do you do when medication fails to alleviate the discomfort? The following post points to what could be the cause of your “untreatable” earache:

Do You Have an Ear Infection or Is It Really TMJ?

At least once a day, someone comes into our offices complaining of ear pain. Most of our patients think that they have an ear infection based on assumption (the pain is coming from the ear region after all!) … but it may come as a surprise that most ear pain has nothing wrong with the ears.

The most common cause of ear pain in an adult is the temporo-mandibular joint or TMJ. The temporo-mandibular joint is located extremely close to the ear canal and middle ear. The muscles that surround the temporo-mandibular joint and the fascia and ligaments that hold the bones in place are intricately connected with the ear and the nerve that supports the ear. Read more at Berger Henry…

As the post above explains, many people confuse ear infections with TMJ-based earaches. Because the ear is closely connected with the jaws and other facial muscles, the pain can be rooted in problems affecting these surrounding areas.

It might sound complicated when you first hear about TMJ ear pain so let’s take a closer look at the kinds of ear pain that are TMJ related. The following post gives some of the characteristics of this kind of earache:

TMJ Pain Characteristics

TMJ ear pain might be a dull, ongoing irritation or it could be a sharp, searing pain. It may even cause minor spasms in some of the muscles that comprise your face. You’re more likely to feel it, of course, whenever you move your jaw to talk, chew, yawn or swallow. Although this pain affects the tissues covering the joint just in front of your ear, you might also feel it in the surrounding facial area along the side of your head, neck, temple, cheek, lower jaw and teeth. Ear pain is often accompanied by a clicking sound or grating sensation, according to Mayo Clinic, and it can be difficult to open your mouth as wide as you would be able to normally. Read more at Colgate.com…

Does the description in the above post help to identify the type of discomfort you are experiencing? If it does, then you are on your way to getting the relief you desperately crave.

A proper understanding of TMJ ear pain and its origins will allow us to accurately treat the root cause of your earache rather than simply address the symptoms. A lot of research has been done on TMJ and the related conditions that come with it. The following post describes the causes of TMJ ear pain:

What Causes TMJ Ear Pain?

Before we get into the TMJ ear pain treatment, it’s important to realize what is causing your TMJ ear problems. Essentially, the temporomandibular joint, or TMJ, gets worn down. The joint is responsible for connecting the lower jaw to the skull, and it is the joint that makes your jaw move. Through excessive grinding, jaw clenching, or other repetitive motions, the cartilage and other connective tissues get damaged, resulting in a constant TMJ earache that you can’t get rid of. Read more at Fairfield Sleep TMJ…

To get rid of your earache, you need treatment that tackles the issues with your TMJ. Fort Collins Headache Center uses a breakthrough, FDA approved treatment called TruDenta to correct problems with the TMJ and provide relief.

Book a consultation exam with Dr. Jared Ward today to see if you are a candidate for our cutting-edge therapy. If you are, we will create a treatment plan for you that will have you symptom free with just 12 or fewer weekly visits. Call Fort Collins Headache Center at 970-672-8517 or use the contact form on this page. We look forward to hearing from you.

How TMJ and Ear Pain Are Related

Ear pain is characterized by a sharp, dull or burning pain in one or both ears. While ear pain is typically not life-threatening, it can be quite disorienting and bothersome. A common misconception holds that most ear pain is caused by an infection. However, a more common cause of ear pain is temporomandibular joint (TMJ) disorder (TMD). In this blog post, Dr. Ivan Stein of the Headache & TMJ Center explains how ear pain and TMJ disorder are related, as well how to treat the pain.

Understanding TMJ Disorder

TMJ disorder can occur for several reasons. For instance, if you have ever chewed a piece of gum for a long time, you may have experienced jaw pain and subtle muscle spasms. An improper bite, teeth grinding and stress can also put pressure on your jaw muscles, resulting in pain and soreness that travels through the bones of the skull, from the jaw, face, neck and into the ears. In some cases, the pain can result in ringing in the ears, a condition known as tinnitus.

It’s very common for patients to consult an ear specialist, believing that their ear pain is a result of an infection. However, this is typically not the case. If the ear pain is not associated with loss of hearing or damage to the eardrum, TMJ disorder may be a more probable cause.

TMJ Disorder Symptoms

If you suspect your ear pain is due to TMJ disorder, schedule an evaluation with Dr. Ivan Stein. Other common symptoms of TMJ disorder to look out for include:

  • Jaw pain or soreness
  • Clicking or popping when opening or closing the mouth
  • Stiffness of “locked” feeling in the jaw
  • Swelling on the side of the face
  • Difficulty chewing
  • Misaligned bite
  • Sinus pain
  • Toothache
  • Neck ache
  • Dizziness

Schedule an Evaluation with Dr. Stein

Because each patient experiences different symptoms, treatment for TMJ disorder varies. Dr. Stein offers several treatment options, and he will customize your treatment based on the severity of your symptoms. To discuss your treatment options with the West Orange TMJ dentist, schedule an evaluation by calling (855) TMJ-DOCS or (855) 865-3627 today.

Why The Pain You Feel Isn’t An Ear Infection

Ear Infection Uncommon in Adults

Even if you got painful ear infections often as a child, you are unlikely to get them as an adult. An ear infection typically occurs when an infection elsewhere, such as a cold or flu, spreads to the middle ear. High numbers of bacteria and/or viruses clog the narrow passage. The clogging gets worse as your immune response causes swelling and the production of fluid in the ear. In children, the ear passage is narrow and easily clogged.

In adults, the ear passage is wider and less likely to get clogged. Plus, our immune response changes as we get older. Generally, this means we don’t get as much swelling.

Why TMJ Could Be Causing Your Ear Pain

A few common causes of ear pain aside from trauma include ear infections, inflammation of the ear canal, and blockage of the ear canal. These complications call for the attention of a physician for treatment. Physicians may also check your parotid gland, a salivary gland just in front of the ear, which may produce stones that put pressure on the ear canal. If an ear, nose, and throat specialist has ruled out the above causes of your ear pain, however, your trouble could be caused by TMJ.

The three bones that make up the inner ear are housed inside the temporal bone, which our jaw presses against. TMJ puts excess pressure on the temporal bone, leading to increased pressure within the ear. That pressure causes ear pain.

Another reason that TMJ can cause ear pain is because it puts pressure on the trigeminal nerve. This nerve controls most of the movement of the ear. Poor alignment of the jaw can cause spasms along the trigeminal nerve, leading to ear pain.

Ear pain may be accompanied by tinnitus, which is roaring or ringing in the ears that can have many causes (and frequently has no known cause). In the case of TMJ disorder, tinnitus is often caused by the pressure on the trigeminal nerve which can create tension on inner ear muscles.

How to Tell an Ear Infection from TMJ

If both an ear infection and TMJ could be causing your symptoms, how do you tell the difference? It’s likely you have an ear infection if you:

Suffering From Ear Pain When Swallowing? It Could Be TMJ

Do you experience pain in your ears when chewing or swallowing? Do you experience unusual pain or pressure in your ears? While it’s common to experience these symptoms when you have an ear infection or ear-related problem, your jaw could also be causing your ear pain when swallowing due to TMJ disorder. TMJ stands for your temporomandibular joints. They are the joints that connect your jawbone to your skull. When this particular joint stops working correctly, everyday tasks such as chewing or swallowing will no longer be taken for granted due to constant pain. If you are suffering from ear pain when swallowing, it could be TMJ.

How Does TMJ Affect Your Ears?

Your ears have a tube that runs from the middle ear connecting it to the rear of the nose. They are called your eustachian tubes. These tubes regulate the pressure in your middle ears. They are also responsible for moving fluid out of your middle ears, preventing infection. A TMJ disorder can cause this area of the ear to stop working properly, resulting in ear pain and congestion.

Why Do I Get an Earache When Chewing and Swallowing?

When you have an earache, you probably naturally assume it is caused by infection. Oftentimes it is. But, if it’s on-going, or, if your doctor isn’t able to treat it successfully, it could be caused by TMJ. If you have a bad bite, damaged or missing teeth, teeth worn from grinding or an underdeveloped jaw, your jaw muscles work overtime. Once they tire, they recruit you to face head and neck muscles to help out. As these muscles become overworked, they tighten up and can put pressure on the nerves that run through them.  This is why it’s common to get an earache when chewing and swallowing. The overworked muscles are the root cause of TMJ symptoms like migraines or ear pain when swallowing.

TMJ Treatment in Los Gatos

If you want to put an end to TMJ ear pain, you need TMJ treatment in Los Gatos from our TMJ dentist, Dr. Nehawandian. First, Dr. Nehawandian will ask you if you experience other symptoms of TMJ aside from ear pain. These can include headaches, jaw pain, sore or sensitive teeth, clenching or grinding, or facial pain. If she suspects your symptoms are related to TMJ, she will analyze your jaw, bite, and your teeth using advanced dental technology.  One technology we use for this is the K-7 Evaluation System which tells us whether your bite is one of the causes of your problem.

Following a TMJ diagnosis, we will determine what your correct jaw position is and use neuromuscular dentistry to balance your muscles, jaw joints, and teeth. If you ever thought a TMJ dentist in Los Gatos could help ease your ear pain symptoms, call (408) 354-5600 to finally put an end to ear pain and treat TMJ for good.

TMJ | Jaw Pain | Rocky Mountain Ear Center in Englewood

You may not have heard of it, but you use it hundreds of times every day. It is the Temporo-Mandibular Joint (TMJ), where the mandible (lower jaw) joins the temporal bone of the skull, immediately in front of the ears on each side of your head. A small disc of cartilage separates the bones, much like in the knee joint, so that the mandible may slide easily; each time you chew you move it. But you also move it every time you talk and each time you swallow (every three minutes or so). It is, therefore, one of the most frequently used of all joints in the body, and one of the most complex.

You can locate this joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and shut it. The motion you feel is the TMJ. You can also feel the joint motion in your ear canal.

These maneuvers can cause considerable discomfort to a patient who is having TMJ trouble, and physicians use these movements to help with diagnosis.
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How Does TMJ Work?

When you bite down hard, you put force on the object between your teeth and on the joint. In terms of physics, the jaw is the lever and the TMJ is the fulcrum. Actually, more force is applied (per square foot) to the joint surface than to whatever is between your teeth. To accommodate such forces and to prevent too much wear and tear, the cartilage between the mandible and skull normally provides a smooth surface over which the joint can freely slide with minimal friction.

Therefore, the forces of chewing can be distributed over a wider surface in the joint space and minimize the risk of injury. In addition, several muscles contribute to opening and closing the jaw and aid in the function of the TMJ.

Symptoms include:

  • Ear pain
  • Sore jaw muscles
  • Temple/cheek pain
  • Jaw popping/clicking
  • Locking of the jaw
  • Difficulty opening the mouth fully
  • Frequent head/neck aches


How Does TMJ Dysfunction Feel?

The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles that are attached to the bones of the skull, face, and jaws. Then, pain can be felt at the side of the head (the temple), cheek, lower jaw, and teeth.

A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from a TMJ dysfunction.

There are a few other symptoms besides pain that TMJ dysfunction can cause. It can make popping, clicking, or grinding sounds when the jaws are opened widely. Or the jaw locks wide open (dislocated). At the other extreme, TMJ dysfunction can prevent the jaws from fully opening. Some people get ringing or a pressure sensation in their ears from TMJ trouble.

How Can Things Go Wrong with TMJ?

In most patients, pain associated with the TMJ is a result of displacement of the cartilage disc that causes pressure and stretching of the associated sensory nerves. The popping or clicking occurs when the disk snaps into place when the jaw moves. In addition, the chewing muscles may spasm, function inefficiently, and cause pain and tenderness.

Both major and minor trauma to the jaw can significantly contribute to the development of TMJ problems. If you habitually clench, grit, or grind your teeth, you increase the wear on the cartilage lining of the joint, and it doesn’t have a chance to recover. Many persons are unaware that they grind their teeth, unless someone tells them so.

Chewing gum much of the day can cause similar problems. Stress and other psychological factors have also been implicated as contributory factors to TMJ dysfunction. Other causes include teeth that do not fit together properly (improper bite), malpositioned jaws, and arthritis. In certain cases, chronic malposition of the cartilage disc and persistent wear in the cartilage lining of the joint space can cause further damage.

What Can Be Done for TMJ?

Because TMJ symptoms often develop in the head and neck, otolaryngologists are appropriately qualified to diagnose TMJ problems. Proper diagnosis of TMJ begins with a detailed history and physical, including careful assessment of the teeth occlusion and function of the jaw joints and muscles. If the doctor diagnoses your case early, it will probably respond to these simple, self-remedies:

  • Rest the muscles and joints by eating soft foods.
  • Do not chew gum.
  • Avoid clenching or tensing.
  • Relax muscles with moist heat (1/2 hour at least twice daily).

In cases of joint injury, ice packs applied soon after the injury can help reduce swelling. Relaxation techniques and stress reduction, patient education, non-steroidal anti-inflammatory drugs, muscle relaxants or other medications may be indicated in a dose your doctor recommends.

Other therapies may include fabrication of an occlusal splint to prevent wear and tear on the joint. Improving the alignment of the upper and lower teeth and surgical options are available for advanced cases. After diagnosis, your otolaryngologist may suggest further consultation with your dentist and oral surgeon to facilitate effective management of TMJ dysfunction.

If you’re experiencing tension headaches on a regular basis or consistent jaw pain, please make an appointment with one of our specialists, and let us help you seek relief from the pain you’ve become accustomed to feeling.

90,000 Tinnitus or Temporomandibular Joint Dysfunction Syndrome?

Tinnitus can be unpleasant and even extremely harmful to your health. Because tinnitus can be a symptom of a variety of conditions, people with tinnitus or temporomandibular joint dysfunction (TMJ) may not be able to pinpoint what they really have.

Tinnitus can be unpleasant and even extremely harmful to your health. Because tinnitus can be a symptom of a variety of conditions, people with tinnitus or temporomandibular joint dysfunction (TMJ) may not be able to pinpoint what they really have.

In moments of silence, a person wants to hear only silence. However, many people have to experience the opposite. They hear high frequency sounds, continuous ringing or even roaring. These noises are long lasting and interfere with concentration or relaxation. This condition is called tinnitus. It is characterized by the appearance of extraneous sounds when a person does not say or listen to anything.

However, such a murmur may be a symptom of TMJ dysfunction (or temporomandibular joint dysfunction syndrome).Because damage to the jaw can negatively affect hearing, TMJ dysfunction can lead to the development of tinnitus. In fact, nearly half of people with TMJ dysfunction have some form of tinnitus.

Tinnitus and TMJ dysfunction

As noted above, tinnitus is characterized by persistent, distracting tinnitus. Noise can be caused by a number of factors, including hearing impairment, blockage of the ear canal, or sudden exposure to loud noises.Tinnitus may be temporary, but persistent tinnitus is a common condition. There are ways to alleviate the problem and mask the noise to some extent, but many cases of tinnitus can be avoided with proper listening mode.

With regard to TMJ dysfunction, this condition is associated with damage to the temporomandibular joint. The disc inside this joint is responsible for connecting the jaw bones, which allows a person to speak, chew, and open their mouth. Damage to this joint can lead to tinnitus along with other symptoms.

Tinnitus can also be a symptom of TMJ dysfunction, which in turn can lead to confusion in the diagnosis of the two conditions. A patient with TMJ dysfunction may mistake tinnitus as a problem in its own right and neglect jaw treatment. To make a correct diagnosis, you need to know the difference between tinnitus and TMJ dysfunction.

How to determine the difference

It is easy to diagnose TMJ dysfunction, especially if you have persistent facial or jaw pain.In addition, patients with TMJ dysfunction may have trouble chewing or opening their mouth, and may experience pinching or clicking of the joint. This makes it difficult to open the mouth wider than a certain position, and the effort to open the jaw can be painful. TMJ dysfunction is common in people with arthritis or facial trauma.

Since the temporomandibular joint is located near the organ of hearing, damage to the intra-articular disc can lead to tinnitus. The best way to determine if tinnitus is associated with TMJ dysfunction is to see your dentist for an appropriate evaluation and diagnosis.

If you suspect you have TMJ dysfunction syndrome, it is best to consult a dentist. With proper treatment of TMJ dysfunction, the likelihood of reducing the manifestations of tinnitus is high.

Unless you have persistent jaw pain, you are most likely not suffering from TMJ dysfunction. Thus, your diagnosis boils down to tinnitus. If you are constantly experiencing ringing in your ears, tinnitus should be diagnosed. The otolaryngologist will consult and carry out the necessary diagnostic procedures.

A referral to a local hearing care professional can be made by your therapist. However, you can also go directly to a hearing care professional for advice and treatment. If you are unsure of where to start, our online hearing aid finder service will help you find reliable professionals in your area. An interactive map contains background information and location data, allowing you to evaluate all options before making an appointment.

(PDF) Temporomandibular disorder as the most prevalent cause of facial pain: Current evidence


4. Cognitive behavioral psychotherapy and biology


In the chronic course of TMD it is recommended:

1. Prescription of the tricyclic antidepressant amy-

triptyline (up to 75 mg / day). The choice of amitriptyline as a

first-line drug is due to the relatively high

risk of developing bruxism while taking selective

serotonin reuptake inhibitors [28].

2. Referral of the patient to the dentist for the selection

of a special muscle relaxant splint (especially in the case of night bruxism

) and assessment of the presence and correction of

occlusal disorders.

3. In the presence of myofascial pain syn-

droma, it is possible to inject an anesthetic into trig-

hernia points in the chewing, temporal and pterygoid muscles


4. Treatment with botulinum toxin type A of painful form

TMJ, which has demonstrated high efficiency in a large volume of studies [9, 29].Such

therapy can allow not only to achieve long-term

and stable relaxation of the muscles of the masticatory group and

relief of pain associated with myofascial pain

syndrome in these muscles, but also temporary remission

nocturnal bruxism, which will reduce the risk of developing

intra-articular TMD.

5. Comprehensive treatment of comorbid diseases

, in particular depression, anxiety disorders,

diseases, chronic pain.

6. In case of proven presence of intra-articular

form of TMJ, dysfunction of the jaw and lack of effect of conservative therapy, the patient should be referred to a maxillofacial surgeon


TMD is considered today as the most common

cause of chronic facial pain not associated with stomatological diseases. It has been shown that pain in the face

in many cases is caused by hypertonicity and myofascial

syndrome in the masticatory muscles without pathological changes in the structures of the joint itself.Since

the prevalence of the painful form of TMJ exceeds

the prevalence of the intra-articular form, the majority of

patients can and should receive effective

assistance from a neurologist. For a complete diagnosis of TMD

childbirth, one should rely on the DC / TMD diagnostic criteria for clinical use. These tests are based on the data of anamnesis and clinical examination (correct palpation of the temporal and masticatory muscles

) and do not require compulsory imaging studies.When typical symptoms of intra-articular pathology (primarily sound

) are detected,

MRI of the joint is shown to confirm the diagnosis.

At present, TMD is considered as a disease with a multifactorial etiology. Myo-

fascial pain syndrome in the muscles of the masticatory group

can be considered as a manifestation of impairment of antinociceptive functions, i. e. be a reflection

of central sensitization and impairment of descending

pain control.

Treatment of painful TMJ at the first stage

should be carried out by a neurologist. Recommendations for the treatment of TMD

include patient education, prescribing

NSAIDs, cognitive behavioral therapy, biological feedback

. With chronic pain, it is possible

to also prescribe amitriptyline, injections

of anesthetics and botulinum toxin type A, as well as referral

to a dentist and maxillofacial surgeon.

The authors declare no conflicts of interest.


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What Can I Do With TMJ Pain?

Temporomandibular joint (TMJ) disease is the medical term used to describe inflammation of one or both joints that connect the mandible or jaw to the skull. The condition is characterized by pain, specifically called TMJ pain. Symptoms can be acute or chronic and may interfere with the ability to speak, chew food, express facial expressions, or even breathe. In addition, the pain and inflammation of the TMJ often migrates to other areas that can serve as trigger points, such as the teeth, underlying connective tissue, and nerves.For this reason, TMJ is often associated with a broader spectrum of disorders known as myofascial pain syndrome.

TMJ can be caused by a variety of oral behaviors. For example, constant chewing of gum or nail biting can push the jaw too far forward or sideways repeatedly. Poor speech habits or a lack of regular visits to the dentist are also to blame. In addition, the temporomandibular joint is prone to disorders that affect other joints in the body, such as arthritis.However, the most common cause of TMJ is bruxism, a condition that involves habitual clenching of the jaw and / or grinding of teeth.

Regardless of the cause, TMJ pain can be constant and severe. Pain can be felt not only in the jaw and face, but also in the ears. Fortunately, the best way to relieve pain is to end the behavior that created it. Of course, this may not apply to TMJ pain associated with displacement or damage to the jaw. However, even in these cases, there are still several options for self-care.

Applying moist heat to the affected area is beneficial for many people. Additionally, holding an ice pack in this area can help reduce inflammation. Eating soft foods and preventing mouth distension during outbreaks will allow the jaw to rest in its natural position. Relaxation techniques can also help reduce TMJ pain associated with bruxism. A simple exercise in this direction is to practice blowing air between the slightly parted lips, being careful not to merge the upper and lower teeth.

Occasionally, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) may be needed to rapidly reduce inflammation and pain. These over-the-counter medications include aspirin, acetaminophen, ibuprofen, and naproxen. Tricyclic antidepressants such as amitriptyline or nortriptyline have also been used to successfully treat TMJ pain. However, these medications must be prescribed by a doctor and can cause unwanted side effects such as drowsiness.

In extreme cases, replacement of the implant in the jaw joint (s) may be warranted.However, keep in mind that the sensation of pain alone is not a critical factor in performing this procedure. In fact, it is usually meant for those who have suffered extensive trauma or damage to the jaw.

It should also be noted that there is no regulatory body or certification that regulates the treatment of TMJ disorders. In short, this means that neither the American Dental Association (ADA) nor the American Medical Association (AMA) recognizes the treatment of TMJ disorders as a specialty in dentistry or medicine.Obviously, this can make it difficult to find a qualified practitioner. However, the best course of action is to consult a dentist and discuss a referral to a practitioner experienced in musculoskeletal and myofascial disorders.


Ear hurts


The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct treatment, you should contact your doctor.

The ear hurts – the reasons for the appearance, for what diseases it occurs, the diagnosis and methods of treatment.

Ear pain can be caused by diseases of different parts of the hearing organ, located nearby organs, head injuries, and can also appear due to the spread of pain from other parts of the body.Such pain is caused by inflammatory, skin, neurological, dental, rheumatic, infectious pathologies.

The nature of such pain does not explain the cause of the disease. The doctor must evaluate the results of laboratory and instrumental examinations in order to clarify the diagnosis.

Types of ear pain

Most often, these pains are a consequence of otitis media – a disease of the outer, middle or inner ear.

Mastoiditis, arthritis of the temporomandibular joint, inflammation of the cervical lymph nodes – these are pathologies of nearby organs that often cause ear pain.

Ear pain can occur due to the spread of pain along the cranial nerves. For example, a toothache is transmitted through the auditory branch of the trigeminal nerve to the ears.

Traumatic rupture of the tympanic membrane is the cause of ear pain due to injuries from falls, blows to the head.

We will tell you about the diseases that most often cause ear pain.

Possible causes

Pain with mastoiditis

Mastoiditis, that is, purulent inflammation of the bone tissue of the mastoid process of the temporal bone, located behind the auricle, is the most characteristic complication of otitis media and a frequent consequence of its improper treatment.

Pain with otitis externa

Otitis externa is an inflammation of the external ear, which consists of the auricle, the external auditory canal and the tympanic membrane separating it from the middle ear.The main symptom of the disease is a furuncle – a purulent inflammation of the hair follicle, capturing the sebaceous gland. Sometimes boils can appear after too hard cleaning the ears, when microtrauma forms on the skin of the ear canal, through which the infection penetrates.

Pain with otitis media

The middle section of the organ of hearing begins behind the eardrum. It is a small, air-filled space in the temporal bone between the outer ear canal and the inner ear.

There are three tiny bones here: the hammer, the incus, and the stapes. The eardrum vibrates with acoustic waves. The vibrations are transmitted to the bones. Through the oval window separating the middle and inner ear, the stapes sends a signal to the fluid that fills the inner ear – perilymph.

Otitis media begins as a complication not of otitis externa, but acute respiratory infections, flu, tonsillitis.

With these ailments, an excess amount of mucus is formed, which enters the Eustachian tube.The Eustachian tube connects the middle ear cavity to the nasopharynx and equalizes air pressure in both directions. If this organ becomes inflamed, eustacheitis develops – a frequent companion of otitis media.

Pain with internal otitis media

Otitis media is also called labyrinthitis, since the inner ear is called a labyrinth due to its peculiar shape. Its main function is to conduct sound waves and convert them into electrical impulses for the brain.The snail, which is part of the labyrinth, belongs to the organ of hearing. The other two parts – the vestibule of the cochlea and the semicircular canals – to the organ of balance.

Usually labyrinthitis is a complication of otitis media.

Less commonly, this disease occurs as a result of microtrauma through the eardrum and middle ear with sharp objects, which are sometimes recklessly used to clean the ears, or as a result of damage to the temporal bone during head injuries.

What diseases cause

Pain with mastoiditis

Ear pain is very strong, often covers half of the head on the side of the lesion, worse at night.

The rest of the symptoms of mastoiditis are found in severe otitis media. This is a noise in the ear, severe hearing loss, an increase in body temperature, a significant deterioration in the general condition, suppuration from the ear, detected by otoscopy.

Pain with otitis externa

The pain gradually increases as the follicle matures, it can radiate to the jaw, neck, and intensify when chewing and pressing on the tragus – a cartilaginous protrusion on the outer ear.The pain is accompanied by itching, a feeling of fullness in the ear. Hearing may deteriorate, body temperature rises.

Pain with otitis media

Earache, throbbing, aching, shooting, often radiating to the teeth and back of the head, usually accompanied by fever. Ear pain with external and otitis media is easy to distinguish. In the first case, it increases if you press on the tragus, in the second, it remains unchanged.

Pain due to labyrinthitis

Such pain in the ear is accompanied by hearing loss, nausea and vomiting, dizziness, headaches, staggering when walking, involuntary twitching of the muscles of the eyeball.

Diagnostics and examinations

Pain with otitis externa

Otoscopy – examination of the external auditory canal and tympanic membrane by an ENT doctor using specialized instruments.

Pain with otitis media

Assessment of hearing by means of an audiometric examination, including tuning fork tests.These are tests with tuning forks to determine if the hearing loss is associated with inflammation in the middle ear or with damage to the auditory nerve. Bacterial culture is performed from the middle ear with determination of sensitivity to an extended spectrum of antimicrobial drugs, X-ray or CT of the temporal bone, as well as tympanometry, in which the mobility of the tympanic membrane is assessed.

90,000 TMJ for Fibromyalgia and Chronic Fatigue Syndrome – Health

Temporomandibular joint (TMJ) disease causes jaw pain, and people with fibromyalgia (FM) and chronic fatigue syndrome (CF or ME / CF) tend to fight TMJ more than people


Temporomandibular joint (TMJ) disease causes jaw pain, and people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME / CFS) tend to struggle with TMJ more than people without these conditions.

It is estimated that more than 10 million people in the United States suffer from TMJ jaw pain, and this condition is more common in women than in men.


The temporomandibular joints connect your jaw to your skull. They are stabilized by the muscles and ligaments that open and close the mouth. Pain or tenderness in or around the joints is called TMJ disorder.

The reasons are still not known, but most experts agree that an injury to the jaw or temporomandibular joint can lead to this.Other associated conditions include anxiety, stress. and rheumatoid arthritis. The pain can range from mild to severe, and treatment usually depends on the severity.


We do not yet know why people with FMS and ME / CFS are more prone to this condition. When the TMJ occurs first, it is possible that pain may contribute to the development of central sensitization, that is, hypersensitivity of the central nervous system. It is believed to be a key component of FMS and ME / CFS.

When other conditions are diagnosed first, TMJ may be associated with weakened connective tissue that is believed to be associated with them. An emerging theory is that all of these conditions may fall under the generic term central sensitivity syndromes.

Because people with FMS and ME / CFS experience pain more intensely than others, they may suffer more from multiple pain conditions.


TMJ diseases are most often diagnosed and treated by dentists.There is no single, universally accepted test. Your dentist may check your jaw for soreness, popping, clicking, and difficulty opening and closing your mouth. Your dentist can also see how well your teeth fit together by taking an x-ray and an impression of your mouth.

It is recommended that you ask your doctor to rule out other causes of facial pain, such as sinus headaches or ear pain. Also, if you have myofascial pain syndrome (which is common in people with FMS), trigger points on the sternocleidomastoid muscles in the front of the neck can cause jaw pain.cause similar symptoms.


Apart from headaches, symptoms are very different from those of FMS and ME / CFS. These include:

  • Pain in the jaw
  • Discomfort or difficulty in chewing
  • Painful clicking in the jaw
  • Difficulty opening or closing the mouth
  • Headaches
  • Blocked jaw
  • Teeth that are not well together
  • 3 Teeth that are not well enough

    3 You should immediately report any jaw pain to your doctor and dentist.Temporomandibular joint treatment will be more effective if you catch it early.


    In some cases, TMJ symptoms go away on their own. If you have persistent symptoms, your doctor may recommend either conservative treatment or a more aggressive approach.

    Conservative treatments include:

    • Stress reduction
    • Chewing gum prohibited
    • Avoid wide yawns
    • Ice packs
    • Anti-inflammatory drugs such as Aleve (naproxen) and Motrin / Advil) (ibuprofen) (ibuprofen).

    More aggressive treatments include orthodontics or surgery. These aggressive treatments are controversial, so you might get a second opinion before considering them.

    TMJ versus FMS / ME / CFS treatment

    TMJ treatment usually does not interfere with FMS or ME / CFS treatment. However, people with temperature sensitivity may find it difficult to tolerate ice packs or recover from surgery due to other conditions. Additionally, some experts believe that many people with ME / CFS are sensitive to certain types of anesthesia, although this has not been proven by clinical studies.

    Whenever you are taking medication for multiple conditions, you should talk to your doctor and pharmacist about possible drug interactions.

    If you are considering surgery, be sure to talk to your surgeon about any special needs you may have due to your other medical conditions.

    Even routine dental visits can be difficult for people with these conditions. Make sure you are ready for the meeting and know how to get through it.

    A word from Verywell

    Temporomandibular joint pain can make it difficult to manage your FMS or ME / CFS, making treatment especially important.

    We are constantly learning more about TMJ facial pain and what it has in common with disorders involving widespread muscle pain. This study may help us better understand TMJ and its relationship to FMS and ME / CFS, leading to better treatment for all of them.

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