I have had TMJ since I was pre-teen, but not treated until college when my jaw locked up. I have worn a mouthguard for 30 years. About 15 years ago, I began having episodic migraine, which I haven't had since I was a young teenager. The migraines became daily and chronic 10 years ago. I am now 50. I had to quit work at 40 and am still fighting for disability benefits. For daily migraine, some of which is caused by TMJ, I receive botox, trigger point injections, Rf nerve ablation, counseling, psychiatry, acupuncture, biofeedback, PT, CT Scans, MRIs. I see a specialized dentist and take many supplements, herbs, essential oils. My neuro suggested I see a particular PT, and it has given me 1-2 low-pain days per week! I do daily jaw exercises, and put heat on my jaw, near my ears. I have a ThermaZone machine that provides heat. Cold is not recommended on the jaw joint, but I use the cold setting of ThermaZone on my eyes and forehead for head pain. An MRI recently revealed arthritis in my jaw, as well as lower in my back, along with buldging discs. The jaw arthritis is one of several causes of my migraine, ear pain, jaw pain. My dentist used computer imagery to test my jaw, and half my jaw was doing all the work. Using the computer, he was able to precisely file down ever so slightly problem areas on the tooth surfaces; he evened out my bite and jaw so that both sides worked equally. My neuro prescribed baclofen and tizanidine. The cyclobenzaprine (flexaril) I had been taking apparently doesn't work above the neck. The PT, heat, and meds worked for a while, but I had to give up my long-term custom mouthguard because, coincidentally, my teeth started rapidly shufting. I now have invisalign braces (traditional braces would have stressed my jaw too much.) I have had to stop wearing my mouthguard, and my jaw hurts now a lot more. But my PT is adjusting treatment, and we are working to get back on track. In 2 years I will have my teeth and jaw re-calibrated by the computer, and I will get a new mouthguard for clenching. I no longer get a 1-2 days/week reprieve from migraine, but in the long-run I should do better. A good habit to develop is to always have your tongue itouching the roof of your mouth at all times, except while eating or talking. Also, try not to have your back teeth touch top-to-bottom, That will help you not clench during the day. Try baclofen and tizanidine to relax your facial muscles. Tizanidine is a strong muscle relaxant that kicks in immediately; instant sleep. It can also cause hallucinations in high doses, so start slow and if you are bothered by side effects, your neuro will help you taper down safely and carefully to a manageable dose. I worked my way up to 4 Tizanidine at bed, then cut back to only 2 pills. I take 2 baclofen pills 4x/day. TMJ does not "go away." I thought mine had disappeared thanks to the mouth guard, but it simply shifted from facial pain to severe, debilitating head/ear pain. The dentist also did a 360 degree xray, and he also could see the arthritis in the jaw, as well as a stuck, flattened disc. I get botox in my jaw joints now, and a practitioner uses dry needling and e-stim (electric stimulation) in the muscles of my jaw. The dry needling did not work well for me, but with e-stim, my jaw muscles twitch away. They have been frozen for so long, they need help learning to move again. TMD, the new way to refer to what used to be called TMJ, requires many specialists depending on symptoms. I go to a pain clinic, specialized dentist, neuro (who specializes in headache), PT, and practitioner of e-stim. I am on pills for anxiety, depression, muscle relaxants. I take narcotics twice per week, and migraine-specific abortive and preventative drugs. I was told by neuro NOT to see a chiropracter, as there is a risk of stroke when the neck/jaw is involved. The PT focuses on muscles and joints, and gently massages my jaw from the inside and outside of my mouth. She manipulates my head and neck gently with stretches. I wish you all the best. TMD is a serious, debilitating illness, that is not often covered by insurance. I use a combo of medical and dental insurance, plus out-of-pocket expenses. I hope my story helps you.

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