#15 Understanding Tennis Elbow is critical to understanding TMD/TMJ

The greatest breakthrough in understanding TMD/TMJ originated with the
realization that Tennis Elbow and TMD/TMJ were variations of the same problem
associated with different joints in the body. This realization then led to the
explanation of why the painful symptoms of TMD/TMJ seem to move around
from place to place and are confused with so many other medical and dental
Tennis Elbow is a well known and understood problem usually treated by
Orthopedic Surgeons. Tennis Elbow is described as continuous or intermittent
pain of the muscles of the forearm and elbow and pain directly on the lateral
bump of the elbow. It is caused by long term repetitious movement of the elbow
and commonly seen in tennis players, therefore the name Tennis Elbow.
However, other types of repetitive motions of the forearm can cause the problem
as experienced by carpenters, painters, and plumbers. These repetitive motions
cause damage and inflammation of the bump on the elbow called the lateral
epicondyle. It is this inflammation of the lateral epicondyle which triggers the
muscles of the forearm to “tighten up” in an attempt to limit the damage to the
lateral epicondyle. When the lateral epicondyle is damaged and inflamed the
brain is sent a signal through the autonomic nervous system indicating the
damage, and the brain returns a signal to the muscles of the forearm to “tighten
up” in an attempt to hold the elbow motionless. Eventually, with a constant
signal from the brain to stay rigid the muscles eventually start to hurt and become
painful. The pain occurs where the muscles are attached to the bone and the
muscles themselves can have a burning sensation as if you just finished weight
training. “Feel the Burn!”
The Temporomandibular Joint operates exactly like other joints in the body. Its
health is monitored in the same way the elbow is monitored by the brain. Similar
to the damage and inflammation of the lateral epicondyle caused by constant
repetitive motion, TMD is caused by repetitive motion of the lower jaw on the
Temporomandibular Joint creating damage and inflammation within the joint.
Constant clenching and grinding of the teeth (Bruxism) is the most common cause
of TMD along with acute jaw trauma and functional jaw growth problems. Once
inflamed, the TMJ sends an autonomic signal to the brain verifying the damage
and the brain responds by sending a signal to the muscles that move the jaw to
“tighten up” in an attempt to limit movement. If the inflammation does not
subside, the brain sends a signal to all the muscles that attach the head to the
shoulders to “tighten up”. The muscles obediently tighten up and eventually
cause pain primarily where the muscles attach to the bone. The points of muscle
attachment are in multiple areas around and throughout the head and face, neck
and shoulders. The signals to “tighten up” are not always sent to the same
muscles at the same time and therefore the pains are not always located in the
same location and can move around. Patients describe these pains in many
different ways and, depending on location, are often confused with migraine
headaches, earaches, dental pain, sinus infection and various neck and shoulder
pains. Some patients even describe arm, hand and finger pain, tingling, and
numbness. Treating medical providers are usually quite bewildered listening to
the patient’s varied and confusing symptoms. Most medical providers are not
tuned into thinking about TMD/TMJ as the cause unless the pain is directly over
the jaw joint.
In addition to helping patients understand the source of their symptoms, TMJ
Services, Dr. Urbanek, and Dr. Urbina are dedicated to helping other heath care
providers understand TMD/TMJ in order to limit the misdiagnosis, mistreatment,
and misdirection of this devastating disease that has been so common over the past decades.