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Tmj Disorder Eye Pain

The temporomandibular joint – the TMJ isthe joint between the lower jawbone the mandible and the temporal bone of the skull.The TMJ is responsible for jaw movement and enables chewing, talking and yawning. Temporomandibulardisorders, or TMD, refer to a group of conditions characterized by pain in the jaw area andlimited movement of the mandible. TMD may be caused by problems in the joint itselfor in the muscles surrounding the joint. Problems in the joint include: arthritis, inflammationand internal derangements. When the problem is in the muscles, the condition is calledmyofascial pain syndrome. Myofascial pain syndrome is very common andcan occur in patients with a normal temporomandibular

joint. The syndrome is characterized by presenceof hyperirritable spots located in skeletal muscles called trigger points. A trigger pointcan be felt as a nodule of muscle with harder than normal consistency. Palpation of triggerpoints may elicit pain in a different location. This is called referred pain.Trigger points are developed as a result of muscle overuse. Commonly, the muscles of chewing,or mastication, are overworked when patients excessively clench or grind their teeth unconsciouslyduring sleep. The medical term for this condition is “nocturnal bruxism�. A trigger pointis composed of many contraction knots where individual muscle fibers contract and cannotrelax. The sustained contraction of muscle

sarcomeres compresses local blood supply,resulting in energy shortage of the area. This metabolic crisis activates pain receptors,generating a regional pain pattern that follows a specific nerve passage. The pain patternsare therefore consistent and are well documented for various muscles.Trigger points in the masseter refer pain to the cheeks, lower jaw, upper and lowermolar teeth, eyebrow, inside the ear and around the TMJ area. Trigger points in the temporalisare also associated with headache and toothache from upper teeth. The main culprits of myofascialpain in the TMJ area are the pterygoid muscles. Trigger points in medial pterygoid refer painto the TMJ region in front of the ear, inside

the mouth and upper outside of the neck. Theymay also manifest as sore throat and difficulty swallowing. Pain from lateral pterygoid triggerpoints can be felt in front of the ear and on the upper jaw.Treatments aim to address bruxism, to relieve muscle spasm and release trigger points. Treatmentoptions include: Therapies: stress management, behavior therapy,biofeedback to encourage relaxation. Dental night guards: Splints and mouth guards to protect the teeth from damage. Medication: pain relievers, muscle relaxants,botox injections. Trigger points release techniques such asneedling and “spray and stretch�.

Myofascial Pain Syndrome and Trigger Points Treatments Animation

Myofascial pain syndrome is a common chronicpain disorder that can affect various parts of the body. Myofascial pain syndrome is characterizedby presence of hyperirritable spots located in skeletal muscle called trigger points.A trigger point can be felt as a band or a nodule of muscle with harder than normal consistency.Palpation of trigger points may elicit pain in a different area of the body. This is calledreferred pain. Referred pain makes diagnosis difficult as the pain mimics symptoms of morewellknown common conditions. For example, trigger point related pain in the head andneck region may manifest as tension headache, temporomandibular joint pain, eye pain, ortinnitus.

Symptoms of myofascial pain syndrome includeregional, persistent pain, commonly associated with limited range of motion of the affectedmuscle. The pain is most frequently found in the head, neck, shoulders, extremities,and lower back. Trigger points are developed as a result ofmuscle injury. This can be acute trauma caused by sport injury, accident, or chronic muscleoveruse brought by repetitive occupational activities, emotional stress or poor posture.A trigger point is composed of many contraction knots where individual muscle fibers contractand cannot relax. These fibers make the muscle shorter and constitute a taut band a groupof tense muscle fibers extending from the

trigger point to muscle attachment. The sustainedcontraction of muscle sarcomeres compresses local blood supply, resulting in energy shortageof the area. This metabolic crisis activates pain receptors, generating a regional painpattern that follows a specific nerve passage. The pain patterns are therefore consistentand are well documented for various muscles. Treatment of myofascial pain syndrome aimsto release trigger points and return the affected muscle to original length and strength. Commontreatment options include: Manual therapy, such as massage, involvesapplication of certain amount of pressure to release trigger points. The outcome ofmanual therapy strongly depends on the skill

level of the therapist. The Spray and Stretch technique makes use of a vapor coolant to quickly decrease skintemperature while passively stretching the target muscle. A sudden drop in skin temperatureprovides a pain relief effect, allowing the muscle to fully stretch, and thus releasingthe trigger points. Trigger point injections with saline, localanesthetics or steroids are well accepted as effective treatments for myofascial triggerpoints. Dry needling insertion of a needle withoutinjecting any solution is reported to be as effective as injections.

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