Treatment of
TMJ Syndrome
Ross Hauser, M.D.

A commonly forgotten area in regards to headache and neck pain is the temporomandibular joint. The temporomandibular joint (TMJ see research TMJ Prolotherapy) 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. (Watch where do Prolotherapy injections go and do they hurt?)

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.

The worst case of TMJS to come into the office was a man we'll call T.W.  T.W. 's jaw popped so loud that the action of opening his mouth could be heard in the other room. The first Prolotherapy session to his TMJ caused a 60 percent reduction in the clicking of his jaw. After the second treatment, the clicking was eliminated completely. T.W. told me his dentist was amazed. Most dentists and oral surgeons believe TMJ Syndrome is permanent and the best hope is for temporary symptom relief. I can verify in my own practice that TMJ Syndrome can be cured with Prolotherapy. By the way, did the dentist call me to find out what I did? No, they never do.
 

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.

Modern medical practitioners will pressure sick people to utilize their services. Options now available for people with head and neck pain are TMJ arthroscopic surgery, TMJ implants, cervical spine surgery (many varieties), botulinum toxin injections into muscles, and the latest gizmo, surgical cauterization, which zaps the bones with a radiofrequency wave destroying the treated area. This last technique may eliminate a patient's pain because it destroys the fibro-osseous junction, where the pain originates. Why destroy or remove a structure when there is a treatment that will help strengthen and repair it? Prolotherapy causes a permanent strengthen mg of ligaments and tendons and eliminates the root cause of the pain.