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PHYSICAL THERAPY is working wonders for me. I'd urge you to try it - but take care to work hard at finding someone who really knows about TMJ (as in, they have actually dealt with it before.) Not all PT folks are going to know about it. And, it might not happen for you immediately, so give it a fair chance (it took several weeks of PT for the results to begin to show up in my case -- but when they did finally begin -- the results have been so dramatic, that it feels like it has happened quite suddenly!
I got lucky and stumbled into Physical Therapy. Having tried about everything else, my (GP) doc finally tried sending me sent to an orthopedic surgeon. He wanted to do some trials to see if the source of the problem was in my spine (the cervical part where I had a ruptured disc removed about seven years ago) and if I was a candidate for some kind of injection or surgical fix. But the trials he wanted to get to that decision point included sending me to Physical Therapy to work on the muscles in my neck. AND, with that PT -- loosening up some extremely tight muscles across the back of my shoulders and up along the back of my head and skull behind my ear -- I noticed that my jaw/tongue pain began to decrease. (Some of my neck muscles were so bound up, that there were places where I could touch back there that NOW feel like the soft tissue it should be -- instead of what I previously THOUGHT was part of the bone in my skull.)
Within a few weeks of the PT, I began to realize that my TMJ/Tri-Geminal Neuralgis/nerve pain was beginning to go away slightly - and that those bound-up neck and shoulder muscles were at least related to the problem, if not the actual root cause of the nerve pain. In my case, my neck and back muscles have been steadily binding up for 20-30 years from a combination of a couple of surgies, some other major and minor injuries through the years, and also from poor posture from unconsciously sticking my neck out trying to "splint" myself away from the pain, and even to the accumulation of normal daily worry tensions of pressures in work, family, or other problems.
Near the close of the first twelve weeks of physical therapy, primarily working on my neck and upper shoulder muscles, I could at last begin to feel a particular point (behind my ear and just "under" the base of my skull) where I could give myself a pressure point massage whenever I wanted - and cut off the jaw pain for (at first) up to five minutes, then ten or twenty minutes, then a whole night of sleep, and then several days at a time. (By the way, it was also great for relieving those headaches that many others have mentioned.)
I am convinced that the nerve involved is finally calming down from being so irritated and angry for these 6-7 years. With the PT, the pain pulses steadily began getting less severe AND less frequent. And, at this point, I've now gone almost a full week without even a single pain pulse.
I'm early into my second twelve weeks of physical therapy (by the way, with a PT who does unbelievable deep tissue massage...the kind that's actually pretty painful and can feel almost like they're bruising you -- and you're sometimes even sore for a day or two afterwards) and he's been busy releasing trigger points in muscles ALL over my back -- and I'm steadily feeling the WHOLE system of muscles beginning to loosen up and get some blood flow -- from my lower back right up to my neck and jaw, and tongue.
In short, my 6+ year ordeal is literally melting away - and sometimes, miraculously, even involving "treating" some muscles with deep tissue massage that are down to even the lower part of my torso and quite far away from my jaw. My PT is working the whole muscle group that ties into the muscles around the jaw.
After all the drugs, after the night-guard (which also did help a little but not permanently), and the accupuncture....through an army of oral surgeons, dentists, neurosurgeons and neurologists looking at a forest of MRI's, Xrays, CT-scans -- I am AMAZED that such a relatively "simple" thing as the soft tissue of my neck muscles has gotten so easily overlooked as a source of the problem, and simple physical therapy as a potential solution.
I can't explain the science of how a knotted muscle could have irritated a nerve so badly -- for so long -- but I am even more amazed at how far out of whack your muscle groups can get.
Obviously I have no way of knowing if what has happened to me will work for you. But, with my dramatic results, I'd certainly encourage you to give it a try.
Mike in Florida
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