Due to the complex interaction between the jaw joint, its structures and other structures in the head and neck, patients with TMD often suffer from symptoms that are similar to a number of other related disorders, including the ones we have listed above. In some cases, TMD signs and symptoms simply mimic other disorders. In other cases, related disorders coexist with a TMD problem.

This is why we review your medical history and your dental history in detail. We also consult with your physicians and dentists as needed. With multiple board certifications and 25+ years of combined experience, we have found that this is the best way to provide you with superior care – and, more importantly – treatment that gets results!

Chronic Fatigue Syndrome
In general, in order to receive a diagnosis of Chronic Fatigue Syndrome, a patient must satisfy two criteria:

1. Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis, and
2. Concurrently have four or more of the following symptoms:

• Substantial impairment in short-term memory or concentration.
• Sore throat.
• Tender lymph nodes, muscle pain.
• Multi-joint pain without swelling or redness.
• Headaches of a new type, pattern or severity.
• Unrefreshed sleep.
* Post-exertion malaise lasting more than 24 hours.

Ernest Syndrome

This TMJ-like problem involves the stylomandibular ligament, a tiny structure that connects the base of the skull with the mandible, or lower jaw. If injured, this structure can produce pain in as many as seven specific regions of the face, head and neck: the temple, the TMJ, the ear, the cheek, the eye; the throat, especially when swallowing, and the lower back teeth and jaw bone. It limits jaw movement, keeping it from opening too wide or moving forward too much. Treatment of Ernest syndrome, which is successful about 80% of the time, consists of injections of local anesthetic and medication , physiotherapy, and at times, the use of an intraoral splint..

Fibromyalgia

Fibromyalgia (fibrositis, myofibrocytis) is a chronic, painful muscle condition characterized by pain in the skeletal muscles, tendons (which attach muscles to bones), ligaments (which attach bones to bones) and bursa (sac-like structures which are filled with synovial fluid and provide lubrication and nutrition to joints). People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and multiple tender points. "Tender points" refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips.

Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent, such as a virus in susceptible people. No such agent has been identified.

Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites.

Source: National Institutes of Health
 
SYMPTOMS of FIBROMYALGIA

Fibromyalgia is characterized by generalized muscle soreness and stiffness lasting more than three months, poor sleep with morning fatigue and stiffness, tenderness at 11 of 18 specific sites, and normal blood test results. The more common painful areas are the low cervical spine, the shoulder, the second rib, the arm, the buttocks and the knee. These symptoms are often worsened by stress or a change in the weather. Depression, which may be due to a chemical imbalance in the brain or the development of chronic pain, is common with fibromyalgia. Virtually all physical activity not only increases the patient's pain complaints, but also makes the next few days miserable, producing intense muscle pain.

		CAUSES Fibromyalgia may be caused by physical trauma (such as a motor vehicle accident, a sudden fall, or even the trauma of surgery with a general anesthetic). This terrible disorder may also begin after an illness like the flu. Often, women experience the effects of fibromyalgia due to hormonal changes after a hysterectomy or around the time of the beginning of menopause. Also, the sudden emotional trauma of the loss of a loved one may trigger fibromyalgia.
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CONDITIONS ASSOCIATED WITH FIBROMYALGIA

Many other physical conditions are found frequently along with fibromyalgia.* Each of these can and do occur separately; however, they are also quite commonly associated with fibromyalgia.
 

Migraine

Migraine is a type of headache that is severe and usually one sided. It is frequently accompanied with nausea and vomiting. Patients typically experience warning symptoms, which usually affect the eyesight and are known as an "aura".

People sometimes feel “not quite right” prior to a migraine (e.g., depressed, unusually happy or hungry), and in addition may suffer from visual changes (e.g., flashing, zig-zag lines, or a blind spot). Sometimes the symptoms are even more extreme.

The headache is usually one sided although it is not invariably the same side. Quite quickly nausea and vomiting may follow. The bowels may also be affected, and in children, sometimes there is no headache but abdominal pain instead.

Each person is different but there are some "trigger" factors that are commonly involved:

• Tiredness
• Physical exhaustion
• Stress
• Climatic change
• Hormones (e.g., the "time of the month" in women)
• Foods (e.g. caffeine, cheeses, chocolate, red wine)

Source: Medinfo ®


Occipital Neuralgia

Occipital Neuralgia is a chronic pain disorder caused by irritation or injury to the occipital nerve located in the back of the scalp. It originates at the nape of the neck which may or may not extend or radiate into the sides of the head and ultimately, into the facial and frontal regions. There are actually two major types of occipital neuralgia: lesser occipital and greater occipital, with the lesser type being more common
Symptoms of Occipital Neuralgia
Occipital Pain that may or may not be limited to one side
Pain radiating from back of the head into the sides and finally, into the temples, cheek and forehead
Pain above and behind the eye
Severe light sensitivity
Nausea when pain is severe
Pain radiation in to the ear, shoulder and, at times, the arm

Occipital neuralgia can result from:

• Physical stress,
• Trauma, or
• Repeated contraction of the muscles of the neck.

Trigeminal Neuralgia

Trigeminal neuralgia is a serious disorder of the trigeminal, or fifth cranial nerve. This is one of the most painful problems that plagues human beings. In fact, its description first appeared in the scientific literature in 1672. Another common name for trigeminal neuralgia is tic douloureux which literally means unbearably painful twitch. Far too often, when a person is suffering with severe facial pain with no apparent cause, the diagnosis given is trigeminal neuralgia. Because of this, the patient may be subjected to medications and even very serious surgical procedures which may not be necessary. The symptoms of tic douloureux are very characteristic: sharp electrical pain which lasts for seconds. This pain is triggered by touching a specific area of the skin by washing, shaving, applying makeup, brushing the teeth, kissing, or even cold air. The second division of the trigeminal nerve (the maxillary division), which supplies feeling to the mid-face, upper teeth and palate, seems to involved most. The pain is so severe that the sufferer will do virtually anything to avoid touching the trigger zone, producing the pain.

Arthritis

Arthritis means "joint inflammation" and refers to a group of diseases that cause pain, swelling, stiffness, and loss of motion in the joints. Arthritis is often used as a more general term to refer to the more than 100 rheumatic diseases that may affect the joints. Some rheumatic diseases can affect other parts of the body, including various internal organs. Children can develop almost all types of arthritis that affect adults, but the most common type affecting them is juvenile rheumatoid arthritis.
Source: National Institutes of Health
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Osteoarthritis

Osteoarthritis is the most common type of arthritis, especially among older people. Sometimes it is called degenerative joint disease or osteoarthrosis. Osteoarthritis is a joint disease that mostly affects the cartilage. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over one another. It also absorbs energy from the shock of physical movement. In osteoarthritis, the surface layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint. Over time, the joint may lose its normal shape. Also, bone spurs--small growths called osteophytes--may grow on the edges of the joint. Bits of bone or cartilage can break off and float inside the joint space. This causes more pain and damage. People with osteoarthritis usually have joint pain and limited movement. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs.