Since the late 1980s, Patricia ("Trish") Romefelt, of Catonsville, Md., has been on a roller coaster ride, seeking relief from temporomandibular joint (TMJ) disorder, which causes pain and, sometimes, dysfunction in the jaw joint and muscles of the neck, head, and face.
She has endured:
- excruciating pain in her jaw;
- intense nerve pain on the left side of her neck, face, and head;
- recurrent, severe migraine headaches;
- an inability to smile or eat properly on the left side of her face (forcing her to go on a soft diet);
- insomnia; and, to top things off,
- pulsatile tinnitus, a condition in which she constantly heard her own pulse, awake and asleep, as a deep booming sound.
"People don't understand what you're going through because you look normal. But you're not," says the 56-year old registered nurse. "TMJ is very complex, so you have to take a multidisciplinary approach. Look for a medical facility that can offer physicians, dentists, pain management specialists, and physical therapists familiar with TMJ. Also, look for psychologists expert in pain management, surgeons specializing in TMJ, and other TMJ experts."
According to Romefelt, the more chronic TMJ becomes, the harder it is to treat. She went from taking the pain killer Motrin, at the beginning of her problems, through four years of mouth splints (day and night), heat therapy, and craniofacial massage, physical therapy, prescription medications, stress relief, and biofeedback relaxation techniques, to, finally, in February 2009, arthroscopic explorative jaw surgery.
The operation revealed that, perhaps due to a long-past injury, there was minimal cartilage in Romefelt's left jaw, and bone-on-bone rubbing was the source of her inflammation and pain. Her surgeon injected a combination of steroids and lubricants to ease the pain and grease her jaw. She was on the road to relief.
Last November, a second exploratory arthroscopy showed improvement in the cartilage and less inflammation. In the future, she will receive injections of the lubricant, as necessary, and may need to continue injections to block—and eventually end—the nerve pain that radiates out from near the jaw to her neck and head.
Romefelt is a realist, however. Because her TMJ became chronic, she understands it will be difficult to make it all go away. "It's a day-by-day battle for normalcy. But thanks to my team of TMJ specialists, I can hold the phone to my left ear now!" she happily reports.
- Temporomandibular joint and muscle disorders (TMJ) are a group of conditions that cause pain and dysfunction in the jaw joint and muscles controlling jaw movement.
- Over 10 million Americans are estimated to have TMJ.
- TMJ appears to be more common in women than men.
- Most TMJ pain goes away by itself.