Wednesday, August 29, 2012

Fibromyalgia and TMD

By Dr. Steven Yen


The temporomandibular joints connect the jaw to the skull. Temporomandibular joint disorder, customarily shortened as TMJ or TMD, appertains to a condition distinguished by discomfort or sensitivity in and/or around these joints. The primary symptoms utilized in diagnosing TMJ disorder are discomfort in the ligaments and muscles that stabilize the temporomandibular joints, agony connected with the joints themselves and clicking sounds when opening or closing the mouth. The causes of TMJ are not well documented but jaw stress is usually acknowledged as a predisposing factor. Metastatic inflammation, anxiousness and stress are also widely cited as conditions linked with TMJ.

Fibromyalgia is a common syndrome indicated by persistent far-ranging tenderness and/or agony in the muscles, joints, tendons and other soft tissues. Its causes remain unknown but research has disclosed several associated factors, principally hysteria, fatigue, depression and sleeplessness. Possible triggers include physical or psychological injury, unnatural pain reply, sleep problems and unspecified viral diseases.

Fibromyalgic patients have a tendency to present with body-wide pain. This pain originates in what are called "tender points", areas of soft tissue in the back, chest, neck, shoulders, elbows, hips, shins and knees. The pain, which may be experienced as either a deep ache or a sharpened, shooting, burning sensation, radiates outward from these tender points. This kind of discomfort is commonly referred to as myofascial agony or muscle pain. The fascia, the connecting tissue that covers the muscles, may become inflamed due to injury, repetitive stress, general fatigue or other considerations. These inflamed areas can act as trigger points which set off discomfort responses in other body parts. This is often known as "referred pain".

In the last decade, 1 or 2 studies have been conducted on possible correlations between fibromyalgia, chronic fatigue syndrome and temporomandibular joint aberrations. Some research has focused on subject populations in which TMJ took place prior to the onset of fibromyalgia while others have concentrated on fibromyalgia as a predisposing condition. Among the latter, a recent Brazilian study inspected a population of fibromyalgic patients to evaluate the prevalence and frequency of signs and symptoms associated with TMJ disorders. The study was conducted on a sample population of sixty subjects of both sexes, all of whom had been formerly diagnosed as going through protracted fibromyalgia. Utilising the Research Diagnosing Criteria for TMD, all the subjects were examined for suggestions of TMD.

The reported results indicate a high level of predominance of TMD signs and symptoms. According to the principal researchers, the study's observations signify a need for the development of integrated diagnosis and treatment protocols to better address the needs of fibromyalgic patients displaying TMD symptoms. The writers also suggest that fibromyalgia could be characterized as a medium or long-term risk factor for the development of TMD.




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