TMJ
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A commonly forgotten area in regards to headache and neck pain is the temporomandibular joint. The temporomandibular joint (TMJ) is the physical connection where the jaw meets the skull. The TMJ is needed to keep the jaw in proper alignment, especially when talking and eating. A painful and clicking TMJ is called Temporomandibular Joint Syndrome (TMJS). TMJS symptoms are very similar to those of Barre-Lieou Syndrome. The symptoms, such as dizziness and vertigo, that physicians ascribe to the TMJS, may actually be due to Barre-Lieou Syndrome.
It is well-known that there is a relationship between head posture and jaw position. This can easily be shown by a person putting the head in proper alignment. This position will be comfortable if the lower jaw is back. If the lower jaw is forced forward while the neck and head are in the position, tension is felt in the hack of the neck.
Typically in TMJS the lower jaw (mandible) is extended forward. A head forward posture exaggerates the problem. This forward mandible aggravates the cervical ligament laxity which increases the neck pain. Again an endless cycle of pain and disability is created in the neck, head, and face region. Prolotherapy injections to strengthen both the cervical vertebrae and the temporomandibular joint will solve this problem.
Eventually the mandible moves forward to the extent that it will stretch the lateral TMJ ligament and produce pain. Once the lateral TMJ ligament becomes lax the joint will click. It is important to note that clicking in any joint is an indication of ligament laxity of that joint. Joint clicking is never normal or a good sign. Joint clicking, whether it is in the TMJ, knee, neck, or lower back is always abnormal. It is a sign that the bones are beginning to rub against each other. The body's compensatory mechanism for such a situation is to tighten muscles and to grow more bone. The end result will be degeneration, arthritis, and stiffness in that joint. Prolotherapy can stop this process. Prolotherapy will stop a joint from clicking and stop the arthritic process from continuing.
Another reason why a patient may have a lax TMJ ligament is a person's sleeping position. For example, if a patient sleeps with his or her head turned to the right, the TMJ on the left side wilt be continually stretched throughout the night. Over many decades, continually sleeping in this manner, puts the left TMJ at risk for TMJ ligament laxity. The person with a TMJ problem is advised to sleep with the head turned to the side of the problematic TMJ.
Treatment of TMJ Syndrome
Louis Schultz, M.D., an oral surgeon, reported in 1956 that, after 20 years of experience in treating hypermobile temporomandibular joints with Prolotherapy, the clicking, grating, or popping was controlled in all of the several thousand patients that had been under his care, without any reported complications or deleterious effects. Dr. Schultz wrote, "various types of treatment used in the past (for TMJ Syndrome) and still employed by some operators appear to he unsatisfactory. Surgery is one." One problem with surgery is the resultant scars. Anywhere surgery is done, scar tissue will form. Again, as in all chronic painful conditions, there are a myriad of treatment options. A treatment that includes a surgeon's knife should be reserved until all conservative treatment options have been exhausted.
Prolotherapy in TMJ is very simple. One to two cc's of a mixture of 25 percent Dextrose, 20 percent Sarapin, and 0.4 percent Lidocaine is injected into and around the temporomandibular joint(s). The patient is placed on a soft diet until the mouth is able to fully open. The TMJ Prolotherapy injections cause an awkward bite and a tight jaw for a couple of days. The patient should not force the mouth open during this time period.
WHAT YOU SHOULD BE TAKING AND EATING TO ENHANCE PROLOTHERAPY
Nutritional Supplements: The Total Program Optimizing the benefits of Prolotherapy through connective tissue proliferation and repair requires providing the body with all the substrates (building blocks) it needs to grow the connective tissue. All athletes should be on an aggressive vitamin, mineral, and supplement program because of the massive amount of connective tissue damage that occurs with each workout, which then needs to be repaired. Athletes may even wish to check their vitamin, mineral, and/or antioxidant levels in the blood.
Exercise itself causes damage to cells, which release free radicals, which then travel throughout the body destroying things and making connective tissue repair less likely. It is imperative that everyone take the correct amount of antioxidants. Too few antioxidants cause excessive free-radical damage. Too much antioxidant activity will blunt the stimulatory effect exercise has on inducing muscle hypertrophy, strength, or endurance. It is now possible to perform blood tests in the office to see if antioxidant status is adequate.
We use various supplements, depending on goals and specific athletic\exercise events. Here are some general guidelines:
To enhance muscle strength, especially for those who do sprint work or weight-training: Creatine, L-carnitine, pyruvate, American and Siberian ginseng, tribulus terrestris, cayenne, prickly ash, lipoic acid, lutein, and calcium pantothenate.
To replenish electrolytes during workouts: Sodium, potassium, magnesium, calcium, phosphorus, and zinc, preferably in an alkalinizing form such as bicarbonate or citrate.
To enhance speed, especially for runners, swimmers, and other speed sports: Pyruvate, dihydroxyacetone, whey protein, branched-chain amino acids, and adenosine triphosphate.
To enhance connective tissue repair in general: MSM, folate, SAMe, betaine, horsetail, PABA, calcium pantothenate, vitamin A, stinging nettles, proteases, enzymes, bromelain, trypsin, chymotrypsin, bioflavanoids, Panax ginseng, antioxidants, glucosamine, chondroitin sulfate, and gotu kola.
*These are only general nutritional guidelines. Ask your healthcare provider about these supplements and sports nutrition. Never use supplements on a self-help basis or to treat a disease, always consult your physician.
Nutritional, herbal, mineral supplementation can be beneficial in certain health circumstances but not in every circumstance. Before using any nutritional supplement it is strongly advised that you seek the guidance of a licensed health care professional to help guide you in choosing any supplementation program.
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