TMJ problems (otherwise called Tempro Mandibular Dysfunction), is a rather generic term and it encompasses a broad spectrum of disorders all leading to excruciating pain in the face, head and neck. Your dentist will usually first diagnose it and there are many treatment avenues to explore with him.

However, these problems have usually been persisting for years before they are correctly diagnosed and there is therefore always a degree of muscle wasting and compensation (i.e. using the wrong muscles to do the job), both of these will cause pain in their own right and exacerbate the existing problem. TES can be used to address these muscular complaints and when supplemented with exercises and slight postural changes magnificent results can be achieved.

TMJ PROBLEMS: A FACT SHEET

What is it?

The Tempro Mandibular Joint is where the jaw bone (the Mandible) joins onto the face (the temporal bone). It is essentially a hinge joint which allows the jaw bone to swing downward and thus open the mouth.

You can feel the TM joint by putting your fingers on the slight lump in front of your ears. Open and close your mouth a few times, in severe cases you may be able to feel the distortion or difference between them for yourself.

Who diagnoses it?

TMJ problems are usually diagnosed by your dentist. He will perform a few tests examining the opening of your mouth and deviation of the jaw. The dentist may then take an x-ray of the TM joint to look for organic problems.

Why do I need emg testing?

Although the original problem stems from the TM joint there is actually a range of contributing factors. You will try and avoid pain by compensation i.e. by altering the way in which you use your jaw, often tending to shift as much activity as possible i.e. chewing to the unaffected side. This will cause temporary relief of problems but over time leads to muscular issues that need to be resolved. There can be disuse on the affected side and compensation on the ‘good’ side. Alternatively there can be a situation of chronic overuse in the affected side shown by gross over activity of the muscles at rest.

The electromyographic testing provides a pain free way of in effect listening to what the nerve is saying. This will allow the physiotherapists to determine the type of muscle imbalance problem you have and they can then tailor the treatment accordingly. Repeated testing at reviews will show on paper improvements which are objective and often welcomed where most measures of outcome in pain treatment are subjective.

What would stimulation do for me?

Trophic Electrical Stimulation plays signals to the muscle that the nerve would do in its healthy state. These signals can be used to increase blood supply to the area and build up the red muscle helping to combat muscle imbalance and fatigue problems i.e. those that get worse as the day progresses. The correct pattern of signals can also teach the system to shut off and thereby reduce gross over activity patterns thus stabilising the rest levels and freeing up the movement, reducing stiffness. Patients are required to treat themselves daily at home and so a large degree of commitment is needed. Whilst you may feel better after even the first treatment, it will take several weeks for sustained improvements to begin to occur.

Patients report being able to decrease their daily intake of painkillers, being able to eat a wider range of food without exacerbating symptoms, better mouth opening and less spasm.

I have already used a TENS unit. Why is this different?

TENS is a type of stimulation that is used to stop the nerve transmitting pain signals to the brain. It is often used in patients with chronic pain problems for pain relief purposes. It acts as a nerve blocker and its effects cease when the unit is turned off.

TES (trophic electrical stimulation) sends signals down the nerve and facilitates the pathway. It is therapeutic which means that physiological changes are made to alter the system to a more healthy state and changes remain once the unit is switched off. It decreases pain by helping restore muscle balance and correct movement patterns.

Have you treated other patients with similar problems?

Yes. The Lindens Clinic is a specialist centre for the treatment of facial paralysis and pain; as such we have treated a wide spectrum of disorders with a variety of onsets. Note the underlying problems with the joint and contributory factors like bruxism need to be treated by you dentist. The treatment plans are complimentary i.e. you can do both at the same time.

How do I make an appointment?

Ring the Lindens clinic (0161 718 8620) and ask for an appointment. Because we are a private clinic we can accept self referrals and do not need a GP or Dentist referral letter, although these are always useful if they can be provided.