cervical spine | Sleep & TMJ Therapy https://www.sleepandtmjtherapy.com Thu, 29 Feb 2024 21:42:50 +0000 en-US hourly 1 https://wordpress.org/?v=6.5.2 The Case of the Confused Craniofacial Case https://www.sleepandtmjtherapy.com/the-case-of-the-confused-craniofacial-case/ Wed, 08 Nov 2023 07:34:08 +0000 https://www.sleepandtmjtherapy.com/?p=729 When it comes to treating your craniofacial pain, there are actually a number of diverse ways to go about it. When a person lands at my office, the first step is really to try and figure out the underlying cause of the pain by doing an in-depth analysis of the problem. This process (in most [...]

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When it comes to treating your craniofacial pain, there are actually a number of diverse ways to go about it. When a person lands at my office, the first step is really to try and figure out the underlying cause of the pain by doing an in-depth analysis of the problem. This process (in most cases) will entail an MRI to look at the discs that cover and cushion the condyles (top of the jaw bones). The second diagnostic tool is a good CBCT X-ray to look at the cervical spine and the cranial bones, not just the jaw area. In almost all cases of craniofacial pain, the articular discs in the jaw joints are displaced. This displacement will then affect the position of the condyles and cause the bite to be uneven. It may seem to the patient that the muscles are the problem when the real source of the problem is the slipped discs. The treatment involves wearing a splint on the lower jaw and most likely an appliance on the upper jaw. The lower splint provides spacing for the disc to move back into place while the upper splint helps level the asymmetry of the cranial bones.

Another approach, however, vastly different, is to use medications to calm the pain and at least get some degree of relief almost immediately. In some of these cases, the practitioner would prescribe Cymbalta to alleviate the anxiety often associated with the pain. Cymbalta is a well-known drug used to treat depression and anxiety. Admittedly, many TMD patients are hurting so badly that they become depressed, and anxiety sets in as they worry about how their future is looking. Unfortunately, this drug has a host of side effects that may make it not so worthwhile, but as a temporary measure, it might help for now. Some practitioners use Xanax along with the Cymbalta since it takes time for the Cymbalta to activate the desired response.

In other cases, something like Cymbalta is used in conjunction with injections into the muscles of the head and neck region to calm those muscles that have been irritated from the slipped discs. Injectables like Botox®, cortisone, prolotherapy and stem cell therapy have been documented to reduce muscular tension. This also provides some degree of temporary relief and may even help to ‘reset’ the muscles into a better pattern.

Of course, there are the surgical approach options. The least desired surgical treatment entails breaking the jaws and resetting them into a more ideal position, however, this approach may not work very well. Cutting apart the bones of the skull may be more risky than other modalities. A more conservative approach to dealing with the displaced discs in the jaw sockets entails simply putting the discs back on top of the condyles. A 20-minute surgery called plication. By far, this is more conservative and simpler than the other surgeries.

So as a patient, you have a choice: try to figure out the underlying issues and deal with them accordingly, or mask over the symptoms and hope things settle down. As I tell our people, it is up to you and I am simply here to guide you on the journey.

Read more about TMD.

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TMJ Disorder and Exercise https://www.sleepandtmjtherapy.com/tmj-disorder-and-exercise-2/ Fri, 30 Jun 2023 20:33:15 +0000 https://www.sleepandtmjtherapy.com/?p=661 When seeking effective treatment for temporomandibular joint disorder (TMD), various factors must be taken into account. TMD primarily involves the displacement of articular discs, which cover the condyles (cartilage on the upper part of the jaw bones), resulting in the compression of nerves and blood vessels. Consequently, individuals experience pain in the head and neck [...]

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When seeking effective treatment for temporomandibular joint disorder (TMD), various factors must be taken into account. TMD primarily involves the displacement of articular discs, which cover the condyles (cartilage on the upper part of the jaw bones), resulting in the compression of nerves and blood vessels. Consequently, individuals experience pain in the head and neck region. Additionally, TMD commonly leads to compression of the cervical spine (neck), exacerbating nerve compression further. Given the interdependency of the cervical spine and TMJ, the condition of one can significantly impact the other.

Now, let’s explore the implications of exercise and its impact on the effectiveness of TMD treatment. Engaging in activities such as running can subject the neck to significant impact, leading to compression of the spinous processes. Consequently, this compression can adversely affect the temporomandibular (TM) joints. Therefore, it is generally not advisable to engage in running while undergoing TMD treatment. An alternative to running is the use of an elliptical machine. This low-impact device provides an excellent cardiovascular workout without putting strain on the neck. It is crucial to prioritize the well-being of the TM joints and cervical spine during the exercise routine.

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TMJ Disorder and Exercise

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The Case of the X-Ray and the Analogy https://www.sleepandtmjtherapy.com/the-case-of-the-x-ray-and-the-analogy/ Sun, 23 Apr 2023 06:28:34 +0000 https://www.sleepandtmjtherapy.com/?p=652 Recently, like two weeks ago, my beautiful and amazing CBCT (fancy X-ray system) basically went on the fritz and died. Multiple technicians showed up at my office saying they could fix the problem and bring life back to my machine, but alas, it has remained broken all this time. Technician after technician has shown up, [...]

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Recently, like two weeks ago, my beautiful and amazing CBCT (fancy X-ray system) basically went on the fritz and died. Multiple technicians showed up at my office saying they could fix the problem and bring life back to my machine, but alas, it has remained broken all this time. Technician after technician has shown up, told me they could fix it, and yet they gave up after several days. They had packages galore show up with parts for replacement and one technician even said he had basically rebuilt the entire machine!

As frustrations grew and more and more of my patients were being delayed on their X-rays, tempers flared. Both my patients and I were not happy that the treatment was being delayed. The X-ray company even offered to refund me the entire cost of the machine! But all was not lost. A new guy showed up out of the blue ( I use that term only because it sounds cool and mysterious at the same time) and within two hours he literally fixed the machine, and it now works. All of this because we finally got the right person for the job. We got the guy who knew what the problem was and how to make it right!

And now the analogy, if I may. Every day of the week I meet new people (patients, if you will) who have been through multiple doctors and done all sorts of treatment for their TMJ problems. They report going through PT, Chiropractic, ENT, dentists, Gastro, PCPs, etc, etc, etc. Did I say etc. enough? You get the picture; they’ve been  all over town. The analogy to this X-ray technician is that when patients finally land at my office, their symptoms are quite severe in many cases, yet the diagnosis is actually quite simple! It just takes the right person to know how to spot the problem. I don’t mean to brag about this, but I do feel like when someone comes to my office that they have come to the right place.

Every day of the week I meet someone new, listen to their symptoms, hear their story and how long the problems have been there. Most of the time it takes a few seconds to figure out the source of their problem – displaced discs in the jaw joints, or asymmetry of the skull, or even malalignment and compression of the cervical spine. It’s really not that hard to figure out what is going on and of course I get an MRI  to confirm the diagnosis.

The hard part of what we do at my office is explaining the problem to the person and setting their expectations accordingly. In so many cases, I meet a person and can figure out how bad the jaw joints are and then the expectation is for a quick fix! It’s never that easy. And to make it even more difficult, if insurance does not pay for their treatment, because either the carrier only covers surgery or not at all, the patient is oftentimes more adamant that they expect it to be fixed quickly! So, although I have many of the answers they might be looking for, managing a patient’s expectations can indeed be difficult.

And now as this long day comes to an end, I sit back and smile knowing that my X-ray machine is working once again because of a smart technician and my office is humming along well and helping people get better. This is what makes us feel good at the end of the day – we helped our patient!

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TMJ Disorder and Exercise https://www.sleepandtmjtherapy.com/tmj-disorder-and-exercise/ Wed, 22 Mar 2023 06:46:24 +0000 https://www.sleepandtmjtherapy.com/?p=636 When is comes to TMD (Temporomandibular joint Disorder), there are many things that a person has to consider when looking for successful treatment. With TMD, most of the time the articular discs that cover the condyles (the cartilage on top of the jaw bones) are displaced and will pinch nerves and blood vessels. This leads [...]

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When is comes to TMD (Temporomandibular joint Disorder), there are many things that a person has to consider when looking for successful treatment. With TMD, most of the time the articular discs that cover the condyles (the cartilage on top of the jaw bones) are displaced and will pinch nerves and blood vessels. This leads to head and neck pain. Oftentimes too, when a person has TMD, their cervical spine (neck) is compressed, so now you have more nerve compression as well. Since the C spine and TMJ work together, one can greatly affect the other.

So now let’s discuss the ramifications of exercise and how it can and will affect the outcome of TMD treatment. When a person runs, as you can well imagine, the neck takes a pounding which compresses the spinous processes. This can, and will, in turn affect the TM joints. This is why running during TMD treatment is really not recommended. An alternative to running is the elliptical machine. This is a no impact device that allows for a great cardiovascular workout with no compaction to the neck. You have to keep your mind on improving the health of those joints and cervical spine.

Another aspect of exercise is weightlifting of course. Most people really do not want to hear that they should not be lifting weights during their course of TMD treatment. The reason for this is that when you lift something fairly heavy, this pulls on the neck muscles- the sternocleidomastoids. These muscles connect directly into the jaw joint and will pull on a displaced disc. You can well imagine that is not a good thing. Another factor is that lifting above shoulder level causes the body to pull more on the neck than it should. This can hurt the joints as well. Once again, this type of exercise will compromise your ability to heal.

Now let’s bring up a four-letter word that comes up quite often: GOLF. So here you are newly retired, living in a house at the country club, new to the game, or just looking to a retirement in place where you can play golf every day of the week. Along comes the TMJ specialist who tells you not to play until you are better. You have a choice: Get better or not. One path means that you must take a hiatus from using those amazing Ping custom made clubs and telling your friends about the hole in one you got. The best choice is to sit at home and use the elliptical machine and get better. This problem occurs whether it’s golf, tennis, or pickleball. You must make a choice and live with it for some time.  This is not permanent but when you get back into it, you may find your stroke and strength improved. As you can see, dealing with TMD takes some effort. For some folks it means sacrificing their normal activities so it’s good to understand all this before treatment begins.

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The Case of Why We Need a Gorgeous Smile (From a TMJ Perspective) https://www.sleepandtmjtherapy.com/the-case-of-why-we-need-a-gorgeous-smile-from-a-tmj-perspective/ Wed, 19 Oct 2022 06:57:07 +0000 https://www.sleepandtmjtherapy.com/?p=587 What a gorgeous smile means to most of us is a great set of pearly whites that show off how healthy we are and how much we care about ourselves. Caring about your smile also translates into caring about your entire body which just makes good sense. What this means to you is that by [...]

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What a gorgeous smile means to most of us is a great set of pearly whites that show off how healthy we are and how much we care about ourselves. Caring about your smile also translates into caring about your entire body which just makes good sense. What this means to you is that by keeping all your teeth, your TMJ’s (Temporomandibular Joints) are well supported. This helps reduce the possibility of future TMJ disorder and the concomitant displaced discs associated with this problem.

Did you know that a gorgeous smile with great teeth and well-supported Temporomandibular joints also means less neck pain?  It’s so true! Time and time again it has been shown that losing a tooth means that the structural integrity of the cervical spine is compromised. This is why it is not advisable to remove any teeth unless completely necessary. In so many cases, it is necessary to remove the patient’s wisdom teeth.  For this reason, many people would benefit from wearing the ALF appliances to maintain support of the bones of the skull during the healing process. When wisdom teeth are removed, the research indicates there will be about 16 square centimeters of holes in the skull and the bone has a tendency to collapse from this. The ALF appliance will help to support the bones of the skull and more readily allow the bone to fill into the holes created by the extractions, without causing a collapsing effect.

In the past, it was much more commonplace to have all your teeth pulled out and have dentures made. The problem with the denture route is that most of the time the dentist’s lab uses a type of plastic material and the dentures have a tendency to wear down quite quickly. What happens next is the top of the jaw – the condyle – will more readily jam into the socket and we have more TMD problems. This is why it is good to avoid dentures and go the implant route.

When a person has implants done, it would be wise to get the implant crowns to the proper height. This would require working with someone like a TMJ specialist who understands that the condyles must be in the right place to protect the joints from degeneration. By paying attention to the vertical height of the implant crowns, this will allow the patient to feel better with their brand-new smile!

Another facet of dealing with a gorgeous smile is that a great smile looks better if the bones in your skull are more balanced and symmetrical. When you think about it, it kind of makes sense. If your cranial bones are level, the body is happier and looks better. Again, this is what the ALF wire is all about – symmetry and balance – and this creates a more beautiful appearance too.

So, make sure that beautiful smile translates into a beautiful and healthy YOU!

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