Pain From TM Disorders: Types of Pain and Why They Happen

Functional disorders at your muscles up with the most common complaint of patients seeking treatment in dental officers. With regard to pain, they are second only to odontalgia in terms of frequency. They are generally grouped in a large category known as masticatory muscle disorders. As with any pathologic state, there are two major symptoms that can be observed: pain and dysfunction.

Certainly the most common complaint of patients with masticatory muscle disorders is muscle pain, which may range from slight tenderness to extreme discomfort. When it originates in muscle tissues, it is called myalgia. Myalgia often arises from increased levels of muscular activity. The symptoms are associated with muscle fatigue and spasms. Although the exact origin of muscle pain is debated, some authors suggest it is related to vasoconstriction of the relevant nutrient arteries and the accumulation of metabolic waste products in the muscular tissues. Within the ischemic area of the muscle certain algogenic substances are released causing muscle pain.

The severity of myalgia is directly related to the function of the muscle involved. It is common therefore to have patients report that the pain affects their functional activity. When a patient reports pain during chewing or speaking, these functional activities are not usually the cause of the TMJ disorder. Instead they have only heightened the patient's awareness of it. More likely some type of muscle hyperactivity is the true etiologic factor, and vast treatment directed at the functional activity will not be appropriate for successful; rather, treatment needs to be directed at diminishing the muscle hyperactivity.

Probably both the occlusal condition and the level of emotional stress play an important role in functional disorders. It must also be remembered that myalgia is a deep pain and if it becomes constant, can reduce more muscle spasms by means of the central excitatory effect. This clinical phenomenon was first described in 1942 and later related to the masticatory muscle by a guy called Schwartz.

Another common symptom associated with masticatory muscle disorders is headache pain. It would appear at first that this type of pain should not be included within the discussion of muscle disorders since there are numerous factors that can contribute to headaches. Certainly the intracranial vascular changes are thought to cause migraine headache do not fall into this category. Likewise, regions and growth within the brain that cause headaches are not related to TMJ disorders. Nevertheless, a significant percentage of headache pain may relate to muscle activity. It has been estimated that 80% of all headaches reported a related to muscle sources.

Assuming that this is accurate, one can see that muscle activity of the head and neck is likely to play a significant role in the aetiology of many headaches. Muscle hyperactivity often leads to muscle fatigue and spasms, which can create imbalances or dysfunction of the entire head and neck musculature. These disruptions are often perceived as low-grade pain radiating over several major muscle groups. The general perception of such pain is described by the patients as a headache. Treatment directed toward decreasing muscle hyperactivity can have significant effects in reducing headache pain. Dentistry must assume a more vital part in the diagnosis and treatment of headache pain. Perhaps your dentist is in a better position than other health professionals to treat some types of headache pain effectively.

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