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Confused About Treatment Options

Hi all,

i have been suffering severe pain in the left tmj for about 12 months. I saw a maxillofacial surgeon about 9 months ago who basically told me nothing, did nothing (except lighten my wallet) and told me once every other treatment avenue has been exhausted to come back and see him.

My family doctor has been giving me acupuncture regularly which has helped with short-term pain relief, i've taken nsaids, diazepam (valium) and other miscellaneous pain killers which all work to an extent but I get the feeling all I have been doing is like cutting the wires to the oil light on the dash - the problem is not being fixed.

Last week I made my doctor give me a referral to have mri scans done. Now that I have these, things have become a little clearer. I "officially" have fixed anterior dislocation of the left meniscus with both posterior and anterior bands lying anterior to the condyle with the mouth closed and open, and for good measure, "significant degenerative changes within the left tmj with reduced joint space and subchondral cysts seen within the temporal fossa and irregularity of the articular surface of the left mandibular condyle."

is this the sort of condition that splint therapy would be likely to fix? Has anyone else out there had or is receiving treatment for a condition like mine? Would love to hear about what is working. Hoping that surgery is not necessary.

Thanks heaps
peter
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replied December 19th, 2005
Disc Dislocation
I have been dealing with bilateral anteriorly displaced discs for 2 years now. I had a series of shots (steriods and a water like substance to flush the joint out) in the jaw from right below the ear, and this put my right disc back in place but my left one is still a bit forward. I have been taking muscle relaxers and pain killers for the past 2 years and wanted to try to stop this. I have seen many and many of doctos, dentists, etc. And from my opinion (and theirs) a splint will not fix this. Right now it is something I can live with, as your body will adjust. I want to get off the medications and start a family, so this week I am having botox injected into the muscles of the tmj. I had one done, and it was pretty painful, but it lasts a few months. It's definately better than meds!!
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replied December 20th, 2005
Supporter
Hi peter,
the degenerative part of the mri readings bothers me the most. It sounds like arthritis or osteoarthritis and there's really nothing that can be done about that. I have heard of the botox treatment that bedwards mentions in his post. I believe it is like a numbing agent versus "fixing" anything, but anything that will take away the pain is worth looking at. The surgery that bedwards had is called arthrocentesis. I've heard good and bad. My impression of it is that it doesn't "fix" anything really but can help for a short time, especially depending on what is wrong in the joint.

It's also interesting that you have a cyst. They can be removed or left alone. They won't really harm anything except for maybe a rubbing pain if it is in a certain location. Did the mri show exactly where the cyst is?


You probably need to find a dentist/doctor who is much more familiar/educated with tmj to determine if the cyst is in a location that it should be removed or not. I think there is a Dr. Schames here on one of the tmj health boards who answers questions over the internet if you can't find anyone in your area to ask about the cyst.

i don't want to bore or waste your time anymore. There are many different ways to try and cope with tmj pain, but I don't think we tmjers will ever be able to discard medications if we have had tmj for any length of time. I think our age also depends on using meds or not. I didn't touch any type of medication in my 20's or 30's. It wasn't until I got older that when the pain flared up, I took anything to get rid of the pain. Sometimes it worked and too often it didn't. It wasn't until a few years ago in my late 40's that the fight was just too much and I started looking for pain doctors for stronger meds. Other than vicoprofen, I have not found anything to help yet, but my new pain guy just put me on lyrica. Don't know yet.

There are some "tricks" that all tmjers do to cope with the pain as you have found out. Personnally I find heat, ice, and regular massage therapy to be the very best.

I hope you are able to find out what helps you. It also sounds like you need a new tmj doctor/dentist. They can be hard to find, but you have to do it. Bite splints have been good for me, but I still have tmj and pain, so you and your doctor have to determine what's best for you. I do advocate bite splints. They are supposed to take off pressure of the jaw joint and the ones I have used have done that most of the time, but I have also read many people complain about them. Remember this - there are several different types of bite splints for different types of purposes, and a bite splint is as good as its bite splint maker.


God bless...

Carol
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replied October 3rd, 2012
TMJ Surgery Going Happen
I have all the above dislocated discs with mile OA, and my DMD is perfoming surgey Dec 5 2012, that was his first option, my jaw is locked closed presently and has been for 2 months, pain is exhausting me mentally and physically, ears ringing, pain not eating foods I really would like, had this problem for 30 years, now it seems I am permanantly locked, not sure is the surgery is the fix all, tired off addicting meds and fake exercising and splints they really need to give that one a rest. I pray I have found the right surgeon.
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