Does TMJ cause hyperacusis and/or tinnitus?

[preciousgirl]

I have been diagnosed with TMJ after I was having extreme ear pain in both ears with no infection, extreme teeth pain, facial pain, neck and back pain and severe migraines almost daily. Soon after that(a week or so after all the ear pain started), I developed both hyperacusis and tinnitus in both ears. The tinnitus is only when I lay down with my ear on the pillow on both sides and it sounds like my heartbeat in my ear. I have had all these symptoms since Oct. of last year and I am in excruciating pain all the time. I was wondering if the hyperacusis and/or tinnitus is related to my TMJ disorder in any way?Do any of you know this and have any of you experienced these two symptoms in addition to your other TMJ symptoms?

[TMJDoctor]

It is in all probability a TMJD. Not all dentists who may claim their being a specialist of TMJ, be really equipped. Ask for lot of testimonials and insist on speaking to lot of patients, insist you want to see permanently cured patients who are not any kind of mouthguard or Orthotic.
Check out www.tmjhellpline.com

[TMJDoc]

Neuromuscular is a techhique used to relax muscles to help encourage the lower jaw to 'move' in a more natural posture--that's an over-simplification, but you get the picture (maybe).  Cranial therapy comes out of the osteopathic field and it relates to the natural movement (or lack thereof) of the cranial bones (and where they meet--called sutures) as well as the membranes that surround and support the brain and spinal cord.  The temporal bone is actually quite mobile and out of postition in a fair percentage of people.  This does not however mean that it causes sypmtoms for everyone, but is responsible for things such as ringing in the ears (not all of the time), dizziness (again, other causes), stuffy feeling in the ears.  Discplacement of the disc in the TMjoint can sometimes have similar sypmtoms.  'This is why it takes a Dentist with special training and the willingness to look at more that one cause and/or treatment technique.  One size does not fit all.  Actual diagnosis of orofacial/TMD is quite complex.  Much gets overlooked and too much is over treated.  If your nightguard has offered no help the diagnosis is either wrong or the treatment inadequate.  Pain cycles can be difficult to break and may need multiple disciplines invovled to make progress.  Clenching your teeth or grinding your teeth is most likely a sypmtom of any problem and not the problem itself.  Knock on more doors--anyone can call themselves a TMJ specialist.  Find out how many hours they have in continuing education SPECIFICALLY in the area of craniofacial/orofacial pain/TMD.  A thousand hours and a thousand treated patients would yield a true specialist.  Hope you can find one. TMJDoc

[preciousgirl]

What are neuromuscular treatment and what is cranial therapy? Does a dentist/TMJ specialist do this or who? Is the mouthguard my only way to treat these conditions?(TMJ/Myofacial Pain Syndrome, Hyperacusis and Tinnitus?) Is there any way to treat these?

[TMJDoc]

I am a little troubled with that diagnosis, but don't have enough info to contradict and of course a thorough exam is always necessary.  As Dr. Nassery has alluded to the fact that there are different schools of thought on treatment.  First thing that bothers be is the RSD diagnosis.  First, that term is no longer used universally, it is now referred to as chronic regional pain syndrome, not reflex sympathetic dystrophy, but it stills refers to changes in the sympathetic nervous system.  Not a big factor in facial pain in my opinion.  Fibromyalgia is now considered a central nervous system disorder.  There are TMJ/orofacial pain specialist that focus more on the neurologic aspects of pain, but that leaves a lot of unanswered questions.  The CNS may be the trigger for clenching and grinding, but it may be a structural imbalance/peripheral pain.  Only careful exam and eval would tell--maybe a different point of view.  These structural issues can be caused by pelvic/spinal problems.  They can even be your knees and feet that are causing postural compensations/imbalances.  So you should find a chiropractor, osteopath, physical therapist---someone who evaulates and treats manually to assess your situation.  I've treated patients with your symptoms and they all have different causes.  You'll need a team and some more opinions, so keep knocking on doors until you get some help.  All we can do is help guide from where we sit.  TMJDoc

[Hamidreza Nassery , DMD, FICOI, FAGD, FICCMO]

Well , I read your comments here and I think, TMJdoc would agree with me here that some thing does not add up here.. I am not sure what test your dentist did to acertain that your joint is fine.?? did you do Joint vibration analysis? Sonography? Doppler? Was a computerized jaw tracking done on you,, because I can tell you if I do those things on 95% of the population I can gaurantee that no one is going to have a joint that is fine.. We all have some issues but thank god most of us can cope ..
As for your other comment which makes me crinch a bit about you grinding your teeth and the fact that you have already grounded them quite a bit. This is a sure sign of unhappy muscles, could also be compromised airway, which again would point back to the same thing, posteriorized lower jaw?? makes me think ..
Look there is no one modality of treatment that solves all issues but this is the first time I hear fibromyalgia is cuasing the pain in the head.. usually we think the other way.
What do you think TMJdoc? does the comments above trouble you too?  

[preciousgirl]

I am currently seeing a TMJ specialist who is also a dentist and he specializes in TMJ and facial pain disorders. He says my TMJ joints are fine and that my problem is from my other two pain conditions- RSD and Fibromyalgia. He says they both are causing all the pain and muscle tightness and spasms,etc and he feels the pain is centralized in my brain. He has already examined me and says joints are fine. He made me a mouthguard to wear at night because I do grind my teeth really bad, and he said I have severely worn my teeth down from the grinding. I also clench a lot both at night and during the day due to all the pain I'm in with my pain conditions and also from stress of all these pains. The mouthguard has not helped any of  my pain or other symptoms at all but he told me to wear it anyway to protect my teeth from the grinding. He said there's nothing more he can do for me since the pain is centralized and since he can't stop the RSD and Fibro. He doesn't even think the hyperacusis and tinnitus is related to the TMJ/ Myofacial Pain disorder but I thought it was...it is right?So now I feel like there's nothing I can do since he told me why I have this problem. I was also told there was nothing I could do to get rid of the hyperacusis or the tinnitus since the ENT thought it was due to the RSD,Fibro, and Myofacial Pain Syndrome and they can't do anything to stop or eliminate these pain disorders.

[TMJDoc]

One thing to add to Dr Nesery's fine comment is from osteopathy in the cranial field.  That is changes in the position of the temporal bone (which 'houses' the ear and upper part of TMjoint) which is commonly seen with TMD is primarily responsible for hyperacusis and tinnitus.  I know this because these sypmtoms can be relieved with cranial therapy alone.  However, if there is an internal derangement of the TMjoint, splint therapy is indicated as well. Neuromuscular philosophy is an excellent choice for that.
TMJDoc

[Hamidreza Nassery , DMD, FICOI, FAGD, FICCMO]

The symptoms you mentioned are all part of the total picture of TMD.. most of us.. and by that I really mean most of have our lower jaw too far back and over closed.. now that is a pretty big generalization and all of us have this do differring degrees.. hence different levels of symptomology.
To go back to your tinnitis, your jaw joint could theoritically be so far back and up that it would place a tremendous amount of pressure on your middle ear. That in turn will bring about the issuea you are mentioning. I also see balance issues with the same patient population. The good news is that you can have very good results with nueromuscular treatment and achieve a great deal of releif from your aches and pains.
hope this helps..