The source of this neck and face pain is hard to diagnose

Neck and cheek pain can be due to TMD, but may prove difficult to diagnose as it is often mistaken for other medical conditions. — dpa

I have heard a lot about this term, TMD. What is it in the medical sense?

TM stands for your temporomandibular joint and the D stands for dysfunction. TMD is also known as TMJ (temporomandibular joint) disorders.

What is our temporomandibular joint?

You know your jawbone? Well, the temporomandibular joint is the joint connecting your jawbone to your skull. It is a type of hinge joint.

It is called temporomandibular because it connects your mandible, which is another word for your jaw, to the temporal (side) bones of your skull, which are in front of your ears.

This joint allows you to move your jaw up and down, and from side to side.

These important basic movements allow you to talk, chew and yawn.

I have been suffering pain around my neck area and cheek for a long time. I thought it was due to my teeth. I visited many dentists and they could not find any problems with my teeth. I even pulled out my wisdom teeth, but the pain did not abate. Finally, I went to a neurologist who said it was my temporomandibular joint.

TMD can be a difficult diagnosis because the pain in that area can come from so many different parts of your body.

Most general practitioners (GPs) would not think of it as a first diagnosis, so you could end up going to specialist after specialist – all whom are specialists in their area (such as dentists and orthopaedics), but who do not necessarily think of TMD first either.

As a result, you get treated for a whole host of other conditions that are suspected of causing your pain, e.g. in your teeth or cervical spine.

To complicate matters, you may actually also have other problems in those areas.

So the specialist treats that specific area and fixes one problem, but your pain doesn’t go away because the TMD is not addressed.

How would I know if I have TMD?

There may be:

  • Pain or tenderness in your jaw.

  • Pain in your temporomandibular joints – you can feel it in the hinge joints in front of your ears.

  • Pain in and around your ears.

  • Pain during chewing or difficulty in chewing – some people confuse this pain with dental pain.

  • Aching facial pain.

  • Crackling or grating sounds or sensations whenever you open or close your mouth.

  • Locking of your temporomandibular joint, which makes it difficult to open or close your mouth.

Why is there pain when I have TMD?

The exact cause of pain is often difficult to uncover, but it is likely to be due to a combination of many factors.

Let’s examine the components of your TM joint. It consists of two bones interlocking with one another, and is maintained as a joint with a covering of cartilage.

The two bones are also separated by a small disc, which acts as a shock absorber and keeps your movements smooth.

Therefore, pain in TMD can happen if any of these components are damaged, such as:

  • Bone damage around the joint

    This may occur during a blow or sudden impact, e.g. if someone hits you in the side of your head, if you have an accident, or if you play rough contact sports like American football or rugby, and are not protected by sports gear.

  • Cartilage damage

    This can happen if there is arthritis of the TM joint, which occurs if there is damage to that area.

    It can also happen as part of rheumatoid arthritis or osteoarthritis, especially if you have other joints in your body affected by these diseases.

  • Disc damage

    If your disc erodes or moves out of its proper alignment, it can damage itself fast.

  • Long-term clenching of jaw or grinding of teeth

    This is called bruxism. It happens mostly in your sleep, and sometimes, you are not even aware of it.

    It happens because you are stressed, or because your neck muscles are not toned or relaxed enough.

    Or it could be a combination of those factors.

Many doctors are unable to diagnose the exact cause of your TMD pain.

How is TMD treated? Help! It’s driving me crazy!

In most cases, the pain is only temporary. Doctors usually give you painkillers and anti-inflammatory agents, and the pain will go away.

Some doctors also give muscle relaxants to relax your muscles and other tissues.

You can also be given mouth guards to protect your teeth if you grind them. This can also relieve your pain.

There are also physiotherapy treatments like heat and ice, and ultrasound.

Avoid clenching your jaw or grinding your teeth, and do not bite your fingernails, as all these movements can aggravate TMD.

A last resort is surgery.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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