Chronic Pain

The physical therapists I've been seeing are concerned that I haven't shown much improvement, other than some temporary relief from headache pain (which is more that worth it in my opinion).

Instead of using the 10% hydrocortisone creme with ultrasound last night, we used the regular gel. Afterwards we did iontophoresis.

It looks like a TENS setup. One pad on each side on the back near the shoulder, one as close to each jaw joint as possible. The ones on the joints have anti-inflammatory medication in them. The current from the small battery powered timing device supposedly forces the medication into the body.

To me, it felt like my arms feel when I have allergy shots. There was a strong needle piercing feeling for 15 minutes while it worked. It was uncomfortable, but bearable.

This morning the joints do feel less painful, although they're making more crunching/snapping noises than usual. It's not a huge difference, but enough to be noticeable. The only downside is that it brought back the headaches. I'm wondering if that will go away with future treatments? I swear I can hear much better through my right ear, maybe that's why I'm noticing the noises my joints are making.

I'm curious to know if other TMJD patients have had success with this and how it went for them.

Thanks

Hi Alex!
I have had iontophoresis several times both before I had surgery and post operatively to help with range of motion and swelling. I felt the same sensations you did (burning, redness) but I did not feel any relief after the treatments. I also did not feel like ultrasound helped very much. I think what did really help from physical therapy was the stretching we did and the fact that the physical therapist taught me about ergonomics and sleeping positions. If your physical therapist hasn't gone over it with you yet, I highly recommend asking, because they are knowledgeable on this subject.. and I know you sit at a computer a lot, so learning how to sit correctly without straining muscles is imperative to your overall well being.
Many insurance companies who do cover TMJ disorder explicitly do not cover iontophoresis. In fact, they spell out in the policies that it is considered experimental or not proven to work. This does not mean that it doesn't help some, but basically that there is absolutely no research that has been done on it either way.
I guess my opinion is - whatever helps you, that's great!! Since we're all so different it is hard to compare... as I always say, "What works for one, may not work for another," ya know? But, hopefully some others will weigh in on the subject soon.

Hope you are still feeling better!

stacy

We've gone over ergonomics. Not just the physical therapists, but my OMFS and the pain center doctors too. I do have a little work to do there. I need to get a stand for my monitor at work, I know I'm looking down at it instead of straight ahead. I think the rest of my setup at work is fine, as is home for the days I telecommute.

I actually thought about sleep this morning when I realized I had a killer headache. I'm going to ask the therapist tomorrow. I'm probably supporting my head in bad ways just to keep weight off the joints. I can't sleep on my back, so it's one side or the other. It might also explain why one side of my neck is incredibly tight, but the other isn't.

I think they're billing my insurance for each session, not each treatment. It hasn't been a problem so far, I'll keep an eye out.

Thanks for the ideas.