Is my jaw ache muscular or nerves? 26 year old female

[Achyjaw]

Hello. About a month ago I had a dull aching in my jaw. I also had some ear pain and my jaw was clicking/popping. I also had some tooth sensitivity. This lasted two weeks and went away. It is now two weeks later and the dull ache is back. I went to the dentist and all my teeth looks great, he thinks I may be clenching my teeth. I have found my jaw feels better when I massage it. I have no triggers, it actually feels better when I’m chewing.  There is also some slight swelling. I have no actual pain, just an achy discomfort.  Does this sound like trigeminal neuralgia or something more TMJ related? Any answers would be great. Thank you!

[supermum_ms]

Your description is not suggestive/consistent with TN...

"What is trigeminal neuralgia?
Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.)

The typical or "classic" form of the disorder (called "Type 1" or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.  These attacks can occur in quick succession, in volleys lasting as long as two hours.  

The “atypical” form of the disorder (called "Type 2" or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.  Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The trigeminal nerve is one of 12 pairs of nerves that are attached to the brain. The nerve has three branches that conduct sensations from the upper, middle, and lower portions of the face, as well as the oral cavity, to the brain.

The ophthalmic, or upper, branch supplies sensation to most of the scalp, forehead, and front of the head. The maxillary, or middle, branch stimulates the cheek, upper jaw, top lip, teeth and gums, and to the side of the nose. The mandibular, or lower, branch supplies nerves to the lower jaw, teeth and gums, and bottom lip. More than one nerve branch can be affected by the disorder. Rarely, both sides of the face may be affected at different times in an individual, or even more rarely at the same time (called bilateral TN).

What are the symptoms of trigeminal neuralgia?
Pain varies, depending on the type of TN, and may range from sudden, severe, and stabbing to a more constant, aching, burning sensation. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. The pain may affect a small area of the face or may spread. Bouts of pain rarely occur at night, when the affected individual is sleeping.

TN is typified by attacks that stop for a period of time and then return, but the condition can be progressive. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. Eventually, the pain-free intervals disappear and medication to control the pain becomes less effective. The disorder is not fatal, but can be debilitating. Due to the intensity of the pain, some individuals may avoid daily activities or social contacts because they fear an impending attack."
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet

There are many alternate conditions that cause similar-same symptoms of TN, the below article *Differential diagnosis of facial pain and guidelines for management by J. M. Zakrzewska* goes into a lot of details and may give you a better idea of why what your dealing with is more at odds with a condition like TN and more likely to be one of the alternatives...

https://watermark.silverchair.com/aet125.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAZ4wggGaBgkqhkiG9w0BBwagggGLMIIBhwIBADCCAYAGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMt1A3TS35rHL9PZpPAgEQgIIBUcTWdgdtcbc08pmMaiQ0fzuxvvbGcHU4Y37tNpxYDjVdh4I-eQ85Y5K2Iuy4-Thz_Xd6ZiUj8tyk_UxrfHceAmE3kqE5aHTEVHSnzv26IoWPRrsNkkTp7yRTH--m-08MQJk47pvddAlPZJFpn5SbU20y80qBCw26KajLcs2yWgGD6PUVxzAGiGc64de9ER1QOhC1RAUP9-b-TPmyo3dGaVQXZxFnCVfUd66zaJhTRz-wGC85jsRmfyWOPXkDKbpKK4rmc_0vIBvok-yFkXvVgdhuFytcLoPEFCbbIqN7WMLFpFsO73pH3yzJr5x2AFsOB0auqAeYSA6i-v9GuFOoQY0j3uhGZxyrbDz7gXE4Ol8ehhDv7MAKQwWpEiTOGPVsrgcRV-l8e0fJwG2JuekkbmWt1OcsxIvq5CL43fJWaU3o8n32-byFHENfs2kCxCPNQNw

Hope that helps.....JJ

[supermum_ms]

Hi and welcome,

It definitely doesn't sound suggestive/consistent with TN, i'm highly doubtful of  TMJ too because your description is basically the opposite of what typically happens ie "feels better when I’m chewing" chewing typically makes it worse,  "I have no actual pain" typically it's very intense lightning strike pain etc

If you've had the health of your teeth and gums assessed and your dentist is suggesting the possibility of it being caused by clenching or grinding your teeth together he/she is quite likely right and you might consider trying things like wearing a night mouth guards, mouth exercises to relax your jaw etc

Hope that helps....JJ

[Achyjaw]

Thank you very much I appreciate your response. I am very relieved to hear it doesn’t sound like TN.

[Achyjaw]

I have read that some people that develop TN will have a prodromal phase but from what I have read it feels more like a toothache or numbness. My jaw just has a dull ache, almost feeling of pressure.