A woman in her early 40's came to me with a complaint
of pain and soreness in front of her ears and near the temples
every morning. She said that it felt like a dull headache, which
would disappear as the day progressed. On further case taking it
became apparent that she was under a great deal of tension. Her
husband had observed that lately she has been grinding her teeth
in her sleep. This grinding is medically known as Bruxism. I diagnosed
her as suffering from Temporomandibular joint disorder or TMJ.
WHERE IS YOUR TEMPOROMANDIBULAR JOINT LOCATED?
Your TMJ is located in the area right in front
of your ears on either side. This is where the upper jaw and lower
jaw meet. It is a hinge joint with a small disc of cartilage separating
the two bony surfaces which prevents one bone from rubbing against
the other. We use this joint numerous times a day for chewing food,
yawning, talking, biting. There are a number of muscles, tendons
involved in these movements and together with the joint it enables
us to perform all these tasks. Normally all these components are
functioning well and there is no pain but if you are experiencing
discomfort, pain, headaches, clicking sounds, or locked jaw then
you have TMJ disorder.
WHAT ARE THE CAUSES OF TMJ DISORDERS?
There are many different causes for developing
a TMJ disorder. Here are a few of the common ones.
1. BRUXISM - teeth clenching or grinding subconsciously
causes a wear and tear on the disc of cartilage between the two
bony surfaces. Usually the person is completely unaware of this
and is noticed by someone else. Sometimes the only way it is found
out is when your dentist notices the wear and tear effect on the
teeth. Grinding of teeth or jaw clenching is a sign of tension and
anxiety leading to overuse of the muscles. Myofascial Pain Syndrome
is caused by nocturnal bruxism. In Homoeopathy we have a special
remedy known as Chamomilla which helps in such cases of Bruxism
especially when the child is highly irritable and clenches his teeth
subconciously giving rise to pain which he cannot bear.
2. TRAUMA OR INJURY TO THE TMJ - if there is any history of fracture
or trauma to the TMJ then this can cause immobility or limitation
in movements. For such traumatic injuries Arnica would help the
patient a great deal.
3. DENTAL PROBLEMS - people who have a misalignment
of teeth suffer from TMJ problems. If the person experiences difficulty
in finding a comfortable bite or the way the teeth fit together
then they should get a dental check up. Sometimes chewing excessively
only on one side of the jaw can cause TMJ disorder.
4. ARTHRITIS - various different types of arthritis
can affect the TM joint. Infectious arthritis is not very common
but can occur when a blood borne infection localizes in the joint
or it can happen as a direct extension of an adjacent infection.
The area gets inflamed, there is tenderness, and restriction of
movement. Traumatic arthritis can set in after an injury or fracture
of the TMJ. Osteoarthritis can affect the TMJ too. It is usually
seen in older people. They complaint of stiffness, mild pain while
eating, cracking sounds. This is all due to wear and tear of the
joint and its cartilage. Rheumatoid arthritis of the TMJ is encountered
in adults and children who are suffering from RA in more than 50%
of the cases. Pain, swelling, inflammation are the common findings.
5. HABITUAL GUM CHEWING OR NAIL BITING
6. OCCUPATIONAL HAZARDS - telephone operators
use to suffer from this earlier as they had the habit of holding
the phone between the head and shoulder.
WHAT ARE THE SIGNS AND SYMPTOMS OF A TMJ DISORDER?
The signs and symptoms depend on the cause of
the problem but there are a few which are common to almost all the
1. Tenderness of your jaw muscles. There may be
soreness when you wake up in the morning or after movement of the
2. Headache is one of the most common complaints experienced. Facial
pain is another. Moving the joint while opening and closing the
jaw causes pain. Facial pain can also be aggravated by cold weather
or the draft of the air condition as this causes the muscle to contract.
3. A clicking, crunching, popping or grinding sound is a symptom
of TMJ disorder which a lot of people experience.
4. If Ear pain is present inspite of there being no infection in
the ears or sinuses then TMJ should be strongly suspected especially
if the pain is situated in front the ear.
5. Limitation of movement and locking of the jaw occur in some TMJ
disorders. This makes it difficult to open and close the mouth while
eating, talking, yawning.
6. Some patients do complaint of dizziness though this is not very
common with TMJ disorders. The dizziness is vague and there is a
slight sense of imbalance. It is very different from the dizziness
felt in vertigo.
WHAT IS THE TREATMENT FOR TMJ DISORDERS?
Treatment is usually determined by the cause of
the problem. Along with medication there are a number of ways in
which the person can take care of her or his TMJ. Here are a few
self-care tips given below.
a. Stress is one of the main risk factors for
developing TMJ. It causes excessive grinding of the teeth and the
person is not even aware as it is usually present during sleep.
Women seem to suffer from this more than men and especially during
their early 20's or during perimenopause. Dealing with this stress,
tension or anxiety is essential. You can effectively cope with stress
by doing simple things like deep breathing, meditation, Yoga, relaxation
of the muscles by certain exercises, dancing, playing sports, art
b. Taking care of what you eat is essential. Stay
away from hard, chewy, crunchy food. No chewing gum or eating hard
sweets and chocolates. Raw vegetables like carrots, radish, cucumber,
fruits like apple, pear all should be either chopped or grated and
c. Ask your dentist to check your bite and give
you something called a Biteplate (also called a splint). This is
needed if your jaws are wrongly aligned.
d. If you are in the habit of grinding your teeth
at night you should get a little device known as a night guard.
You have to insert it over your teeth so that they are protected
from wear and tear.
e. When the pain is acute then ICE therapy will
give tremendous relief. The ice helps to reduce the inflammation
and pain. Sometimes doctors advise alternate Ice and Heat therapy
as it helps to reduce the muscle tension and spasm.
As a homoeopathic physician we always first try
to ascertain what is the cause of the symptoms that the patient
is suffering from. Is it just mechanical like an injury or chewing
gum continuously or is there a deep seated underlying cause. The
patient's personality and nature are extremely important, is she
the anxious, nervous kind who gets tense easily which causes the
grinding at night. Here are a few remedies which have given great
results in TMJ disorders.
A 40 year old woman came to me complaining of
severe throbbing headaches. She felt as if someone was hammering
her head and could not bear to be touched. Even the slightest noise
brings on the terrible pain. Her husband added that her nature had
changed drastically. She was normally a very jovial, happy person
but now extremely irritable and even violent sometimes.
Another point he made was that she had started grinding her teeth
at night which she was not aware of. On further case taking she
told me that she was going through lot of stress and emotional problems.
This was the cause of the grinding of teeth leading to terrible
She was only better by pressure and sitting semi-erect. Eating or
chewing is painful and worsens the pain.
This woman's symptoms matched those of Belladonna
and she was given Belladonna 200, 5 pills four times a day which
gave her tremendous physical and mental relief.
This remedy works wonders on the affections of
the Jaws especially if the problem is caused by an injury to the
bone. Hecla lava also is a remedy for necrosis and caries of the
jaw bone. The TMJ area is very sensitive and painful. The Hecla
lava patient will not allow the area to be touched.
There is normally a swelling along with the pain. Hecla lava is
also extremely useful in abscesses of the gums, gum boils, toothache.
5 pills of Hecla Lava 200, fours times a day will
give great relief.
Rhustox has a great affinity for affections of
all joints in the body including the temporomandibular joint. All
the pains are worse at night-time. The patient complaints of severe
tearing, shooting pains which are worse from touch. The first movement
of the joint is especially painful but the pain gradually reduces
on subsequent movement.
There is also a cracking sound on chewing or moving the jaws. These
patients are affected by cold, wet weather and drafts of air.
They get relief by heat and rubbing the area. Rhustox is one of
the remedies for different types of arthritis and other affections
of the bones, tendons, ligaments and joints.
Rhustox 200, 5 pills four times a day should be
given to cure the patient.
A mother brought her 5 year old boy to me saying
that her son was complaining of headaches especially after getting
up in the morning. At first she thought it was an excuse to miss
school but even on holidays he would say the same thing. She also
added that he constantly itches his anus and picks at his nose.
The boy was cranky and constantly tugging at his mother to carry
him. When asked about his appetite the mother said he ate very well
and was constantly hungry though he had not put on too much weight.
This child was suffering from worms which causes grinding of the
teeth in some people.
I prescribed Cina 200, 5 pills four times a day
and also advised the mother about hygiene, boiling water and not
to give raw uncooked food to the child.