TMJ Dysfunction Pain
Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction
Hauser R, Hauser M, Blakemore K. Dextrose prolotherapy and pain of chronic TMJ dysfunction. Practical Pain Management. 2007; November/December:49-55.
Many of the subjective symptoms of pain, stiffness, and crunching sensation in patients with TMJ dysfunction were reduced greater than 50% in 92% of the Prolotherapy patients in this study.
In the last issue, Dr. Hauser et al reported on a retrospective study on successful dextrose prolotherapy for patients with chronic neck pain. In this study, the authors report on fourteen patients who suffered from TMJ pain for an average of 5.4 years and had seen, on average, four medical doctors—including half who were told that no other treatment options were available. Overall, substantial improvements were reported in range of motion, pain medicine utilization, disability, depression/anxiety, quality of life, and patient satisfaction. These improvements persisted through follow up at eighteen months after the conclusion of prolotherapy treatments. As Dr. Hauser at al report, these positive outcomes resulted despite the inability to individualize treatment protocols since they were done at a charity clinic having limited resources.
According to the American Dental Association, more than 15% of American adults suffer from chronic facial pain.1 One of the most common causes is Tempomandibular Joint Disease (TMD), a collective term used to describe a group of medical disorders causing temporomandibular joint (TMJ) pain and dysfunction, and is estimated by The National Institute of Dental and Craniofacial Research of the National Institutes of Health to affect 10.8 million people in the United States at any given time.2 It occurs predominantly in women, with the female to male ratio ranging from 2:1 to 6:1, with 90% of those seeking treatment being women in their childbearing years.3,4
The TMJ is often predisposed to similar degenerative changes and pathologies seen in other synovial joints as a consequence of the frequent and repetitive stresses that the TMJ undergoes.5 Symptoms commonly associated with TMD include pain at the TMJ, generalized orofacial pain, chronic headaches and earaches, jaw dysfunction including hyper- and hypo-mobility and limited movement or locking of the jaw, painful clicking or popping sounds with opening or closing of the mouth, and difficulty chewing or speaking.6 While pain is the most common symptom, some people report no pain, but still have problems using their jaws. Sometimes the bite just feels “off.” Additional symptoms may include ringing in the ears, ear pain, decreased hearing, dizziness, and vision problems.7