December 4, 2002
By Flora Parsa Stay D.D.S.
Approximately three to six million Americans have been diagnosed with fibromyalgia. This debilitating disease is most commonly associated with women who are experiencing hormonal changes during pre-menopause or after a hysterectomy. Besides hormonal changes, onset of fibromyalgia could be from physical trauma such as an automobile accident, unusual and extreme emotional trauma or stress, infections, rheumatoid arthritis, or lupus. Symptoms seem to appear between the ages of 20 and 50. There are no laboratory tests such as x-rays or blood tests that can verify this disease. Fibromyalgia is usually diagnosed by locating 18 "tender points", starting at the back of the neck and extending to the knee area. These points are very tender to the touch and can be felt most of the time.
Fibromyalgia is usually characterized by pain in the muscles and joints; anxiety disorder and panic attacks; irritable bladder; depression; chronic fatigue; sleeplessness and TMJ (temporomandibular joint disorder). The pain experienced in fibromyalgia and TMJ are very similar. Both have multiple trigger points (tender points) in various muscle groups, which create intense pain. These trigger points have been described as lumps and bumps that feel like knots in the muscles. When severe, these lumps illicit extreme pain all the time.
Both TMJ and fibromyalgia effect the muscles of the face, head, neck, shoulders, back and even the calves. Recently, trigger points have been isolated and confirmed by electromyography imaging. The points can also be felt by touch. Unfortunately, both TMJ and fibromyalgia are often not diagnosed and the person may suffer for years with severe pain and not receive any appropriate treatment except pain medication and some sort of tranquilizers, having been told it’s all in their head.
Many people who suffer from fibromyalgia also suffer from TMJ. TMJ is most commonly seen in women between the ages of 20 and 50 and the cause is very similar to fibromyalgia as described above. Those suffering with TMJ have had some sort of trauma to the head and neck, either from an accident, even braces or a neck brace during orthodontic treatment. Most of the time, the person is under tremendous stress and they either clench or grind their teeth. As a result of the clenching or grinding, the jaw joint become damaged or dislocated resulting in clicking, ringing, and popping noises which are heard in the ears, often causing dizziness. Missing teeth or ill fitting dentures may also cause TMJ pain.
Individuals suffering with TMJ commonly show symptoms of dizziness, neck, shoulder, back pain, headaches, pain and pressure behind the eyes, sinus problems, and headaches. The treatment for TMJ includes replacing any missing teeth, an orthotic occlusal plate to help stabilize the bite and help balance the skeletal-musculature in the jaw, and head and neck area. Physical therapy and massage are also very helpful for both TMJ and Fibromyalgia treatment.
Stress must be brought under control with accompanying life style changes as needed. Another very important factor is diet and nutrition. It is not uncommon for the person suffering with fibromyalgia or TMJ to be a type A personality. They may have a tendency to be a workaholic or perfectionist with no time to relax and pay attention to good eating habits.
During the initial stage of treatment medication may be necessary to help relax the muscles, control pain and help with sleeplessness. However, the best treatment would also include, (eventually eliminating all medication) physical therapy, massage, plenty of vegetables and fruits, and water. Detoxing the body under supervision of a trained practitioner is also very helpful.
Since both TMJ and fibromyalgia are so closely related, proper diagnosing of both is very important. Treatment involving a multi-disciplinary approach where life style changes as well as addressing physical pain will make both TMJ and fibromyalgia much more manageable.
© 2002 Flora Parsa Stay D.D.S. Reprinted with permission from the author. Visit Dr. Stay’s website for more information: http://www.drstay.com/
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