Have you ever been to a massage therapist for lower back pain and been surprised when they spent most of the appointment treating your thighs? Or maybe you’ve visited your doctor with an aching hip and they’ve recommended insoles for your feet? If so, you know that pain or discomfort in one part of your body can actually be triggered somewhere else entirely. The complaining body part isn’t always the part that needs care.
The same can be true for tinnitus patients. While doctors believe that the majority of tinnitus cases are related to hearing loss or damage to the ear and its nerve signaling systems, it can also be brought on by dysfunction in other parts of the body. And one of the most common culprits is temporomandibular joint or TMJ.
What Is Tinnitus?
Tinnitus is sound you hear that doesn’t have an external source. Most people describe tinnitus as ringing in the ears, but patients can experience it in many different ways including whistling, buzzing, chirping, hissing, humming, roaring or even a heartbeat. It can be loud or soft, occasional or constant, a mild annoyance or an incapacitating chronic condition. Some 50 million Americans have experienced tinnitus symptoms and of those, 2 million experience severe debilitating symptoms.
What Are Temporomandibular Disorders?
Your TMJs are the joints located on each side of your head that work your jaw. These joints coordinate with muscles, ligaments, discs and bones in your face, head and neck to help you chew, yawn and talk.
The TMJ is a complex joint. It moves side-to-side and front to back. Plus, the muscles that make the jaw move are some of the most powerful in the body. As a result, the TMJ problems can arise pretty easily. TMJ pain can have a number of causes including:
- Grinding or clenching your teeth
- Stress that causes you to tighten your facial muscles or jaw joint
- Dislocating the soft cushion or disc between the ball and socket
- Osteoarthritis or rheumatoid arthritis
- Injury to your jaw, head and neck
If your TMJs gets damaged and you develop ongoing TMJ pain, tenderness or discomfort, you may have developed a TMJ disorder or TMD. Symptoms of TMD include:
- Facial, neck or shoulder pain when you chew, speak or open your mouth widely
- Inability to fully open your mouth easily without jaw pain
- Locking of your jaws
- Clicking, popping or grating sounds in your jaw when opening or closing your mouth
- Difficulty chewing or discomfort when biting
- Swelling on the side of your face
- Toothaches, headaches or neck aches
How Are Tinnitus and TMJ Disorders Related?
There are several theories that explain why TMJ disorders often lead to tinnitus or make it worse, but most revolve around the fact that many of the structures of the jaw and the ears are interconnected. The chewing muscles are near muscles that connect to the middle ear. Ligaments that attach to the jaw are also attached to one of the bones that sits in the middle ear. The nerve supply from the TMJs has connections with the parts of the brain that are involved in hearing and the interpretation of sound. In addition to all of these connections between our jaws, ears and brain, the pain and discomfort of TMJ symptoms can lead to stress that has been proven to cause tinnitus or make existing tinnitus symptoms worse.
How Can You Treat TMD-Related Tinnitus?
There’s good news and bad news for patients with TMD-related tinnitus. The good news is tinnitus that is brought on by TMJ disorders can often be lessened or alleviated by treating the TMJ. The bad news? Treating TMJ disorders can sometimes be just as complicated as treating tinnitus. However, many patients once they have a TMD/TMD-related tinnitus diagnosis, find relief by working with their dentist and experimenting with the TMD treatments below to find the ones that are right for them.
- At-home therapies: these include moist heat and ice compresses, switching to a soft diet, relaxation techniques, massage, sleeping on your side, over-the-counter pain relievers and using your fist to support your chin when you yawn so as not to aggravate the joint.
- Splints: there are two types of splints that can be used. 1) Stabilization splints that are worn to prevent teeth grinding and clenching. These types of splints cover all of the teeth and are typically just worn at night; 2) Repositioning splints are splints designed to adjust the positioning of the jaw. These splints are typically worn all day, every day.
- Bite adjustments: these irreversible treatments adjust the way your bite comes together and in theory, reduce the tension on your jaw joints causing your TMD. These treatments include braces to change the bite, crown and bridge work to balance the bite, and grinding down the teeth to bring the bite into balance.
- Injections: some providers recommend injections to relieve pain and relax tense jaw muscles.
- Surgery: TMJ surgery is controversial, permanent and should be avoided when possible. There is little proof that surgery as a TMJ treatment option can benefit patients.