Neck/back pain - poss jaw problem?, Ortho? Chiro? Physio?
Discussion
Bit of an odd one this but I wonder if it's anyone's area of expertise or experience....sorry it's a bit long!
Had a car shunt May 2008, nice lady drove into the back of me at traffic lights (car survived, she hit the bike rack and the towbar! her car survived less well...)
I've been having "whiplash" problems (no really - not just a claim), from about one hour after the shunt. I have pain in predominately the right side of my neck, the upper right quadrant of my back and the lower left quadrant. Plus an increase in headaches, migraines etc.
I had chiropractic treatment for the first year following the accident and then switched to physio about 12 months after the accident when it was clear that there was a lot muscular going on, lots of muscle spasms and the chiro was struggling to move anything because I can't relax the muscles.
Fast forward to recently, I'm still having physio and there is no real indication that anything is getting better which is incredibly frustrating.
I was chatting to my dentist and mentioned the neck/back pain...she had a chat with the chiropractor
and they have come up with a theory that this is a TMJ/TMD problem.
The dentist has constructed an "appliance" to sit on my front teeth to take the pressure off the back teeth and to allow the muscles to relax. The chiro's were very excited by the prospect, I was much more sceptical!
Day 1, after night 1 using the appliance was fantastic, for the first time in ages my neck was free moving, I found it hard to believe that the appliance could make an immediate difference and put it down to the power of positive thought! Day 2 after night 2 was poor which just reinforced my scepticism.
I went back to the dentist yesterday (Day 2) and she had to put a huge amount of adjustment into the appliance as she says the jaw position/muscles have moved significantly already and that Day 2 was potentially bad because the adjustment was needed.
The suggestion is that whilst I've always had an overbite my body was pretty adept at dealing with it but with the additional problems caused by the car shunt all the muscles etc. have gone into overdrive and it's all stopped working together hence the problems...
I'd be really interested in whether anyone can give me any info, advice or their thoughts on this. Today is Day 3 and it seems pretty good - I'd love to think that this might be the solution...
Had a car shunt May 2008, nice lady drove into the back of me at traffic lights (car survived, she hit the bike rack and the towbar! her car survived less well...)
I've been having "whiplash" problems (no really - not just a claim), from about one hour after the shunt. I have pain in predominately the right side of my neck, the upper right quadrant of my back and the lower left quadrant. Plus an increase in headaches, migraines etc.
I had chiropractic treatment for the first year following the accident and then switched to physio about 12 months after the accident when it was clear that there was a lot muscular going on, lots of muscle spasms and the chiro was struggling to move anything because I can't relax the muscles.
Fast forward to recently, I'm still having physio and there is no real indication that anything is getting better which is incredibly frustrating.
I was chatting to my dentist and mentioned the neck/back pain...she had a chat with the chiropractor
and they have come up with a theory that this is a TMJ/TMD problem.
The dentist has constructed an "appliance" to sit on my front teeth to take the pressure off the back teeth and to allow the muscles to relax. The chiro's were very excited by the prospect, I was much more sceptical!
Day 1, after night 1 using the appliance was fantastic, for the first time in ages my neck was free moving, I found it hard to believe that the appliance could make an immediate difference and put it down to the power of positive thought! Day 2 after night 2 was poor which just reinforced my scepticism.
I went back to the dentist yesterday (Day 2) and she had to put a huge amount of adjustment into the appliance as she says the jaw position/muscles have moved significantly already and that Day 2 was potentially bad because the adjustment was needed.
The suggestion is that whilst I've always had an overbite my body was pretty adept at dealing with it but with the additional problems caused by the car shunt all the muscles etc. have gone into overdrive and it's all stopped working together hence the problems...
I'd be really interested in whether anyone can give me any info, advice or their thoughts on this. Today is Day 3 and it seems pretty good - I'd love to think that this might be the solution...
Edited by Piglet on Saturday 13th February 09:31
I've had headaches for the last 10 years or so, and in the past 3-4 years increasing neck/back pain. No specific cause such as a car accident but thought i'd share my experiences.
Long story short - I was told that my teeth were biting very badly (only 1 tooth was really where it should be). This was putting strain on my jaw muscles as they were never able to settle into their natural relaxed state, even when I was asleep. I eventually took the plunge and have had orthodontic work, including 2 operations (wisdom teeth out, and then an osteotomy to move my lower jaw into the correct place).
The only time i've been headache free has been in the weeks after each of the osteotomy when my jaw was held shut whilst it healed, however the headaches have slowly returned. It seems that the most likely cause is that i'm still grinding my teeth at night, so the muscles still never relax.
I'm certain that it's my jaw that is causing the headaches, and the subsequent neck/shoulder muscle pain. Despite physio/osteopathy to help, i'm going back to the orthodontist to request a splint (the NTI-TSS is one of many available).
By the sounds of it, your dentist is already quite supportive in getting you this kind of treatment so that's half the battle over. I would say stick with the process you're doing at the moment and see how it goes. I'd be interested to hear how you get on after a couple of months.
Do you wake up with a headache, or does it develop during the day?
Good luck!
MrChips
Long story short - I was told that my teeth were biting very badly (only 1 tooth was really where it should be). This was putting strain on my jaw muscles as they were never able to settle into their natural relaxed state, even when I was asleep. I eventually took the plunge and have had orthodontic work, including 2 operations (wisdom teeth out, and then an osteotomy to move my lower jaw into the correct place).
The only time i've been headache free has been in the weeks after each of the osteotomy when my jaw was held shut whilst it healed, however the headaches have slowly returned. It seems that the most likely cause is that i'm still grinding my teeth at night, so the muscles still never relax.
I'm certain that it's my jaw that is causing the headaches, and the subsequent neck/shoulder muscle pain. Despite physio/osteopathy to help, i'm going back to the orthodontist to request a splint (the NTI-TSS is one of many available).
By the sounds of it, your dentist is already quite supportive in getting you this kind of treatment so that's half the battle over. I would say stick with the process you're doing at the moment and see how it goes. I'd be interested to hear how you get on after a couple of months.
Do you wake up with a headache, or does it develop during the day?
Good luck!
MrChips
Hi Mr Chips, sounds like we have similar issues!
I wake up with headaches and migraines - if you look at the link for the site posted above http://www.nti-tss.com/ - watch the vid clip on the right about the link to migraines and especially the bit about those who have problems think a good day is a day without waking up with a migraine! That's me for the last 18 months - I regard waking with only a headache as a good day and apparently that's not normal....
My dentist has been fab, this was her suggestion when I said that I didn't seem to be getting anywhere with the neck/back problems and she and the chiro have talked a lot about it and think that this may well be part of what is going on with me.
Today I am also headache free and again my neck feels much free'er than it has done for a long time.
I have to say even when she was fitting the appliance I was pretty sceptical, but having had some really good days since and having now read a lot about TMJ/TMD I'm becoming a lot more convinced. I know it's easy to tick boxes on lists of symptoms, but I have discovered that I do tick most of the boxes on this one.
I don't grind my teeth at night and I'm pretty sure that I don't clench my teeth routinely in the day BUT I do have an overbite and it's likely that the jaw muscles do not relax at all and allowing them to relax at night gives them a chance to recover.
My dentist is in Bristol - so not very far away from you, she is very very proactive about this stuff and more than happy to work holistically with the chiro and the physio so I don't feel that I'm trying to manage this on my own. I paid £150 for the appliance and the original fitting and then £50 when I went back to have it adjusted (although that was also an extra for another issue as well. Not cheap but if it makes the difference it will be well worth it.
The jury appears to be out on whether in my case this is likely to be something that I would have suffered from anyway without the car crash or whether the neck/back disturbance from the original injury was enough to tip the balance over the edge.
I wake up with headaches and migraines - if you look at the link for the site posted above http://www.nti-tss.com/ - watch the vid clip on the right about the link to migraines and especially the bit about those who have problems think a good day is a day without waking up with a migraine! That's me for the last 18 months - I regard waking with only a headache as a good day and apparently that's not normal....
My dentist has been fab, this was her suggestion when I said that I didn't seem to be getting anywhere with the neck/back problems and she and the chiro have talked a lot about it and think that this may well be part of what is going on with me.
Today I am also headache free and again my neck feels much free'er than it has done for a long time.
I have to say even when she was fitting the appliance I was pretty sceptical, but having had some really good days since and having now read a lot about TMJ/TMD I'm becoming a lot more convinced. I know it's easy to tick boxes on lists of symptoms, but I have discovered that I do tick most of the boxes on this one.
I don't grind my teeth at night and I'm pretty sure that I don't clench my teeth routinely in the day BUT I do have an overbite and it's likely that the jaw muscles do not relax at all and allowing them to relax at night gives them a chance to recover.
My dentist is in Bristol - so not very far away from you, she is very very proactive about this stuff and more than happy to work holistically with the chiro and the physio so I don't feel that I'm trying to manage this on my own. I paid £150 for the appliance and the original fitting and then £50 when I went back to have it adjusted (although that was also an extra for another issue as well. Not cheap but if it makes the difference it will be well worth it.
The jury appears to be out on whether in my case this is likely to be something that I would have suffered from anyway without the car crash or whether the neck/back disturbance from the original injury was enough to tip the balance over the edge.
When I have patients with TMJ Dysfuction, Bruxism, etc, I go through a soft bite raising appliance over the lower jaw - worn nightly for 3 months or so and then try low dose anti-depressants. In most cases the bite raising appliance alone is sufficient relief.
The appliance is not something to be assessed overnight, or even over the course of week. It will take more than a month for the effects to be fully felt. Anything earlier than that would just be just as likely to be variation within the condition.
Not familiar with the NTI-TSS system - so I will have to refrain from commenting on it.
While TMJ dysfunction can add into the back/neck/shoulder problem it would be relatively uncommon for it to the crux of the whole issue.
TMJ dysfunction and related symptoms are not one of those conditions which have a clear cut treatment modality to follow and treatments given depend on the practitioner and patient.
The appliance is not something to be assessed overnight, or even over the course of week. It will take more than a month for the effects to be fully felt. Anything earlier than that would just be just as likely to be variation within the condition.
Not familiar with the NTI-TSS system - so I will have to refrain from commenting on it.
While TMJ dysfunction can add into the back/neck/shoulder problem it would be relatively uncommon for it to the crux of the whole issue.
TMJ dysfunction and related symptoms are not one of those conditions which have a clear cut treatment modality to follow and treatments given depend on the practitioner and patient.
Hmm I'm not sure...I was pretty sceptical about it all but the dentist was pretty confident that I would notice a swift difference. Possibly because mine isn't necessarily a joint problem it appears to be muscular which is knocking on to the spasms that I get in my neck/shoulders?
Dunno, TBH I'm pretty desperate for a fix right now so I clearly want it to work.
Dunno, TBH I'm pretty desperate for a fix right now so I clearly want it to work.
sinizter said:
While TMJ dysfunction can add into the back/neck/shoulder problem it would be relatively uncommon for it to the crux of the whole issue.
TMJ dysfunction and related symptoms are not one of those conditions which have a clear cut treatment modality to follow and treatments given depend on the practitioner and patient.
I'd definitely agree with this. TMJ dysfunction and related symptoms are not one of those conditions which have a clear cut treatment modality to follow and treatments given depend on the practitioner and patient.
If you look at the treatment i've had, i've now got an almost perfect bite by orthodontic standards, yet i've still got jaw muscle pain and neck/shoulder pain and headaches. It's much better now than a couple of years ago, but it is still there and hasn't gone completely.
For me, having headaches (and occasionaly migraines) seems to be resulting from several factors, including bite issues, teeth grinding, stress, bad posture etc etc.
Piglet - My advice would be to see how you get on with just the splint, and give it a good 6 months before considering how bad the pain/headaches are. Only then should you consider other treatments if you're still having problems.
Oh, and watch out for taking painkillers too often. I've taken paracetemol regularly for too long now, so to complicate things, I also need to get out of what is to some extent a habit. Only take painkillers if you need then, and avoid ibuprofen/codeine etc as these are more likely to have long term effects.
On a more positive note, i've found it's really important to keep a positive attitude when trying to get it resolved. It's rare that having a headache will actually stop me doing something/going out etc, and I think quite often by ignoring the pain, you learn to forget that it's there!
Edited by MrChips on Sunday 14th February 16:20
MrChips said:
Piglet - My advice would be to see how you get on with just the splint, and give it a good 6 months before considering how bad the pain/headaches are. Only then should you consider other treatments if you're still having problems.
La la la la, I'm not listening! The last couple of days have been so good that I refuse to believe that it isn't anything other than the appliance and I therefore consider myself cured and refuse to accept that it might just be a good patch 
I don't take anything other than migralieve (and some similar stuff that is prescribed that I can't remember the name of) and I try really hard only to take it when I really need to - I'm quite worried about getting too reliant on pills.
I need to see what happens over the next few week, I'm due at the physio's this week so I'll see what she thinks.
The difficulty is that my condition does appear to be cyclical, I have points in time which are good and then times that are bad. Until now, nothing has made a real difference....so I really do have my fingers crossed.
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