I am a 33 year old female patient. I have been suffering with pain associated to TMJ. With the exception of TMJ and associated pain, I am overall in excellent fields of medicine to help me achieve relief caused by TMJ.
My first round with TMJ was in 1998. At that time, I was a new mom and under a significant amount of stress along with my bite being off due to my wisdom teeth coming in. One morning I woke up in severe pain and could not open or close my mouth completely. My general practitioner believed it to be stress related and put me on Zoloft and pain killers. This did not help and my pain was getting worse. Dr. was at a loss and tried different pain medicine prescriptions and muscles relaxers. At last, though a family member, I was introduced to a wonderful oral surgeon and orthodontist. Upon exam the oral surgeon suggested an upper bite splint be made by the orthodontist. Then, after two weeks of splint therapy I was scheduled to have wisdom teeth removed. At that point I continued to wear splint at night only. I had immediate relief from pain with this treatment and my life resumed to normal. I continued to have pain in neck and orthodontist introduced me to an amazing chiropractor. After a few sessions with chiropractor pain in all areas were decreased to the point where an occasional ibuprofen was needed. I continued to same see chiropractor for occasional adjuntments.
In 2003, we relocated to Florida. During lunch one afternoon I noticed my right jaw getting extremely tight. I made an appointment with local chiropractor (not same one as before) and had adjustment. Within hours my jaw was thrusting forward and shifting to the side. I was in excruciating pain and was having anxiety of TMJ problem coming back.
Unfortunately, TMJ problem came back much worse than before. I flew home to Indiana immediately to be evaluated by same oral surgeon and orthodontist. A new appliance was made for me since I didn’t have old one anymore. This time oral surgeon suggested braces and jaw surgery. However, there was no guarantee that surgery would cure my problem. So, I decided to hold off and explore my options. At this point, every day and every night was a struggle to get through with the pain. The pain Killers and muscle relaxers made me feel like a zombie.
Thankfully, my husband’s job relocated us back to Indianapolis. I then made the decision to go ahead with full jaw surgery. Soon, I found out I was pregnant and would have to put surgery off for at least nine months. I was then referred to TMJ specialist to look into a different splint for relief. With clearance from my OBGYN, I had new full set of x rays and tomagraphs to be evaluated. I was treated with a lower bite splint that brought my jaw slightly forward to create a better jaw position for my upper and lower mandible. This therapy would help me though the next nine months. Although there was never a pain free day it was bearable.
After the birth of my son, TMJ specialist referred me back to the same oral surgery practice as before. However, this time with a different physician that specializes in arthroscopic jaw surgery. This type of surgery helps remove adhesions that may be keeping disc from returning to normal position. New oral surgeon wanted to see MRI of both jaw joints to see exactly what damage we would be dealing with.
MRI of 2005 showed adhesions to the right TMJ. I then elected to have an arthrocentisis to joint to release adhesions. This procedure is done in the in the office and is an attempt to loosen the adhesion without surgery. Although the procedure failed I felt more comfortable trying the less invasive procedure first. I then elected to have arthroscopic surgery to right TMJ to remove adhesion to the joint and surrounding tissue. This procedure was a success in the release of the adhesion (scar tissue). At the time of the surgery I was also injected in several areas around both tmj joints with steroids and hyleronic acid.
As prescribed by oral surgeon I began physical therapy exercises and seeing PT twice a week for soft tissue and stretching exercises to help get range of motion and function back in jaw and surrounding structures. After several week post op I realized that surgery had been a success in treating adhesions. However, bite force and function were still extremely weak and pain would set in immediately if I pushed it too much.
At my six week post operative appointment oral surgeon referred me to a pain specialist. He suggested I discuss some trigger point injection therapy with the pain specialist. Having over ten years experience in TMJ myself, I decided to do some exploring of my own. I began to look into the studies that had been done on TMJ sufferers with botox. Having had botox injected for cosmetic reasons I understood how botox would/could work. It made complete sense to me. After all, It had always been muscle pain that had felt. Tightness in jaw, temples, shoulder, neck and face had always been the symptoms I had from my TMJ problem.
Dr. Hamilton had injected me several times with botox and other fillers for cosmetic reasons. I have always been impressed with the precision of his work. Having the up most confidence in his knowledge of the facial muscles and their function I asked Dr Hamilton if he would consider injection my jaw and surrounding muscles to treat my TMJ pain. In October of 2007, I had first round of botox with Dr. Hamilton. In my opinion, the results have been a miracle!
Within one week of having my first injection I was able to relax facial muscles that had been over worked for ten years. For the first time in three years I did not need to sleep in my bite splint. I was able to chew food without the headaches that would normally follow. I looked and felt more relaxed. Those close to me started to make comments like: Your face looks really pretty… what have you done? Maybe it’s your skin.
With my muscles relaxed and headaches COMPLETELY gone I began to feel overall better. The relaxation of these muscles that had once been so tight I began to have more energy. I felt less stressed and tense in general. My chiropractic sessions which had been twice a week at one point diminished to one or two during the several weeks botox was active. Chiropractor felt as though without jaw being in spasm his adjustments were able to be more effective.
Several weeks after botox injections in jaw I noticed headaches to return slightly. This did happen all at once but I started to tell botox was starting to wear off around weeks 10-12. I then saw Dr. Hamilton for a second round of injections and same great relief has resulted from the botox. I couldn’t be more pleased with both Dr. Hamilton and the botox product itself.
We have come along way with the off label of uses in the last ten years with botox injections. Perhaps my battle with TMJ would have been a lot shorter if I had known of botox in 1998. I am thankful for the care that Dr. Hamilton has shown to me. The professionalism of him and his staff is impeccable. If you are a TMJ sufferer or know someone that is I hope that this information has been useful. I have seen some of the finest physicians in the field of TMJ and related areas to assist me in my journey with TMJ.