Neck & Back Pain

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Relieving Neck and Back Pain Can Make You Sane Again

neck-and-back-pain-chicagoDo you have a stiff neck, back pain, aching shoulders that have been tormenting you for far too long?  Dr. Shapira likes to see patients when their pain is present.  Relieving their pain in a few minutes allows him to understand and diagnose the unique underlying causes of their pain.  Most patients pain even if it has been present for years can be temporarily relieved in just a few minutes.  These few minutes are an important part of the diagnostic process.

Have you been to the doctor to find out what was causing the pain? Suffering from neck, back or shoulder pain day after day certainly isn’t normal. Chronic pain is unlikely to be caused by being tired or overworked.

If you have been unsuccessful at finding effective treatment, it could be you’ve been looking in the wrong place or you have been treating only a part of the problem. Your pain could be caused by a problem in your jaw joints and the surrounding muscles and fascia. These joint complexes are known to be strongly related  neck and back pain when they are not functioning properly. The good news? If these joint complexes are the source of your pain, there may be relief in sight.  These joint complexes are by nature complex.  Understanding the entire physiologic system is necessary to achieve success.  We are not treating just joint noises or just joints.

Do I have TMJ Disorder?

Symptoms include migraines, neck pain, jaw pain, lower back pain, snoring, sleep apnea.
Use our Free TMJ Disorder Assessment Tools

How your TMJ can be a pain in the neck

Neck, shoulder or  back pain can be caused by a malfunctioning temporomandibular joint (TMJ). This is the joint that is found at both sides of your mouth allowing you to speak and chew through up and down, back and forth, and sideways movements.

It is a sensitive part of your body and, if your bite moves out of alignment, it can lead to significant pain radiating out to all different parts of the body, including the neck, back, and shoulders.  More than half of all input to the brain comes through the trigeminal nerve as it passes through the reticular activating system.

When your jaw is out of alignment, it causes the surrounding muscles to work extra hard to correct the misalignment. As your jaw muscles tire, they recruit other muscles, the ones in your neck, shoulders and back, to help. When they tire, chronic neck, back or shoulder pain is often the result.  Forward head posture is a frequent issue in TMD patients creating significant changes through the entire spine.  These patients frequently are treated by chiropractors, which offer temporary relief. Long term relief entails correction of the underlying causes.

This condition’s medical name is temporomandibular joint disorder (TMD). If this is what you are experiencing, you are not alone; TMD affects up to 20 million Americans on a daily basis.

There’s no reason why TMJ can’t be beat

If your TMJ is what’s causing your neck and back pain, there is good reason to believe that it can be resolved with modern physiologic dentistry techniques.

Sometimes, it’s just a matter of elimination. TMJ problems are known to cause painful symptoms, so, when no other diagnosis seems to fit, TMJ should be suspected. With TMJ problems it doesn’t matter how many pain killers you take, they will only give temporary relief. Long-lasting relief comes with TMJ correction that focuses on realigning your bite.  Long term postural correction may require physical therapists , osteopaths or chiropractors working together.

See our patient testimonials

Balance your bite

tmj-neck-biteBy booking a dental appointment, a TMJ diagnosis can be made. The first step your dentist should take is to check your medical records to confirm there isn’t a medical problem behind your neck and back pain.

The next step is to measure your jaw function and relax your jaw’s muscles by massaging them with an electrical stimulator at a low frequency which stimulates the flow of the blood. As soon as the tension has been relieved in your muscles the best position for your bite will be found.

Once relaxed and back in alignment, there are various treatments used to keep your bite in the right position.This can include a custom-made, non invasive orthotic device or diagnostic physiologic orthotic  that is positioned over your teeth to help stabilize your bite, relieving the muscle strain that can create neck and back pain, among other symptoms. Orthodontics and dental restorations are also effective TMJ treatment but in most cases are done following pain relief and physiologic stabilization with the diagnostic orthotic.  The exception is the DNA Appliance that uses epigenetic orthodontics to change phenotypic gene expression.  In special circumstances it can be used as an initial treatment .

Once relieved of your pain, you’ll be amazed at how good it feels to comfortably  move in a pain free fashion again.  Normal physiology and function promotes ongoing health and wellness.

Watch Dr Shapira’s Patient Testimonials:

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  1. nice site

  2. My neck pain began with the extraction of tooth #18 several years ago. The tooth had undergone a root canal prior to extraction. I began to have pain immediately after the tooth was extracted and it has gotten worse over time until at this time, it is unbearable and encompasses my neck and left shoulder. I don’t seem to be able to find any dentist who can or will help me and I am sure there was TMJ damage at the time of the extraction.

  3. There are many issues connected to pain arising after tooth extraction. There may be direct or indirect trauma to the jaw muscles or jaw joint. Difficult extractions could affect the atlas-axis joints. Changes can occur secondary to extended opening of the mandible that can lead to brain inflammation. Activation of myofascial trigger points is more common. Entrapment of pre-brachial plexus nerves between anterior and medial heads of scalene muscles are possible.
    I suggest coming in for a consult as your first step. I will have my team contact you.
    In the meantime please visit my youtube channel to understand what can be done to improve your quality of life.

  4. Does Dr.Shipia know any TMJ specalist in the South Bay Area in California? I’ve got terrible TMJ from 2 accidents I was involved in from direct head & face trauma and whiplash in both cases, which required extractions if 4 teeth 2 top , 1 loose, 6 lower molars are now gone do to being cracked from the face trauma.

  5. Hi there,

    I have had severe TMJ pain/anxiety/dizzy spells since March of this year. My jaw dislocated on its own in March after decades of minor pain. My MRI shows the discs have moved forward. I have daily jaw/neck/shoulder pain (and even burning sensations in left shoulder/arm.

    I am scheduled for arthroscopic surgery to clean out scar tissue and put in a joint lubricant on 12/7 of this year at UNC Hospital in Chapel Hill.

    I had gone to a TMJ specialist, but the treatments/orthotics did not work very well over the course of 3 months.

    I am getting wary of the surgery, as I feel like all my attempts to relieve this problem has caused more pain/suffering.


    Thank you!

  6. I have experienced frequent headaches along with jaw, neck, shoulder, and upper back pain for the last four years. I’ve been in the ER countless times in excruciating pain with imaging done multiple times and everything seems to be fine. My labs and imaging are always great. I recently found info on TMD possibly being the cause of my pain. I’m a 29 year old female and have young children to care for, this is ruining my quality of life. I had my wisdom teeth removed a year ago, hoping that was the cause, but it did not relieve my symptoms. Could you tell me what my next step should be? I’m not opposed to traveling.

  7. Dear Jennifer,

    I have been treating patients with stories like your for many years. You are a prime candidate as a young mother. I know it is frustrating when lab tests and imagining shows that everything is normal but that is good news. Removing wisdom teeth is rarely an answer and often makes the problems worse.

    It is frequently possible to see significant improvements very quickly and I often see long distance patients. Please visit my youtube channel to hear my patients stories:

    In addition to starting with diagnostic neuromuscular orthotics I address the myofascial pain component and the autonomic nervous system components. I frequently teach patients to self-administer SPG Blocks which can often let you skip trips to the ER and to physicians offices.

    I will post this response and have a team member contact you. I have appointments available in December but I am out of the country for the first two weeks of January.

  8. Hi,
    I started going to a holistic dentist last year. I never had any jaw pain or muscle issues prior. He told me my TMJ was misaligned and I went through the whole procedure like your article describes with the splint and the teeth equilibration but it started making my jaw hurt especially with chewing (which it never had before). I stopped using the splint to try and “relax” my jaw because my jaw tenses up with the splint in. Now several months later, my neck shoulders and upper back are in so much pain I can’t take it any more. Any reasons why I would start having problems with my jaw and neck/back/shoulders ONLY after I did the TMJ adjustments and do you think I just need to wear the splint again more longterm? How long does it take for the adjustment to “stick” and not have to wear it all the time? (I wore it for at least 4 months straight only taking it out to eat). Any advice would be greatly appreciated because I feel like I am desperate and in pain!!! Also, Is there some kind of permanent device you use for patients so they dont have to take it out to eat? Thanks so much!!!

  9. Dear Jen,
    I rarely suggest treating a totally non-symptomatic TMJ disordr without a specific reason. Equilibration is a irreversible procedure that should always be approached with great caution. If there is pain that is getting worse instead of better it is probably wiser not to begin equilibration.
    What were you issues causing you to seek a “Holistic Dentist” The head, neck jaw shoulders and spine are all connected. I suspect that you are now dealing with widespread myofascial pain. See to better understand MPD the muscular side of TMD. Wearing a splint long term that causes pain is probably not a good idea.
    Lonfg term “permanent ” device is not a good idea when you are desperate and in so much pain. What were the issues that initially caused you to seek out Holistic Dentist?

  10. Hi,

    My daughter had braces and now suffers from severe TMJ. Here back muscles are so tight she has a hard time standing up straight. This has been going on for 2 years and no one has been able to fix it. They say we might need to break her jaw. I am really concerned and looking for other opinions. We live in VA and at this point I am not sure what to do. Is there a Dr. you could recommend in the area? Please help.
    Mrs. Thomas

  11. There are many issues with your daughter from your description. I frquently see long distance patients and in the first 2-3 days sometimes enormous improvement can be made.
    Please watch some of my patient videos:

    Your daughter probably has airway issues in addition to TMJ from your description.
    Help is available!

  12. I’ve been suffering extreme pain and muscle spasm every day for 4 years trapezius levator and back of neck since two of my back teeth on my left side were removed after a cavity had traveled to both teeth. The actual muscle on my right jaw is bigger because of overuse probably. No one I’ve been to in my search has helped so I gave up .
    If I rest the muscles enough at night via Ativan I wake up virtually pain free
    But that is a bandaid not a cure
    The pain can be searing and burning enough to make it unbearable but when the muscles relax there is absolutely no pain
    MRI and cat scan done at the time were clear except for normal wear and tear on the neck
    Out of answers and I have a lot of childeren and 2 smalll businesses so rest is not an option
    Want to get back to living my life pain free and understanding what this all is so I don’t feel alone ??

  13. Christina,
    I can help. I am a firm believer in helping patients both with treatment and with strategies and techniques that let them treat and eliminate their pain on their own. SPG Blocks are one excellent method of decreasing pain and anxiety and self administration allows you to avoid doctor visits. They also help you get restful sleep. Neuromuscular Dentistry is one of the beth methods to create a diagnostic appliance that allows you to correct jaw issues and reset the neuromuscular system. There are many video testimonials at this link or a wide variety of issues. Different techniques are used for different types of issues and many patients have overlapping issues & treatments.

  14. Hi Dr. Shapira,
    I’ve been suffering with severe chronic pain for 7 1/2 years in my jaw, neck, back, both knees and shins along with nerve pain down my right arm. I’ve seen about 40 doctors and many had no clue at all and some say Fibromyalgia, Lupus and possibly Lyme as well as EBV, CMV, SIBO, etc. But I feel like something else is ALSO going on with my jaw alignment along with infections!! I have so many symptoms from severe joint & muscle pain, major gut issues, headaches, major muscle weakness, exhaustion, low Thyroid & adrenals, etc. The Most prominent issue is I CAN’T STAND for more than 3-4 seconds!!! I couldn’t walk before either but now I can walk 20-25 minutes as long as I walk fast! If I walk slow it’s the same sever pain in my lower back and both knees as if I try to stand. No one can understand it! Back in May 2011 I was running on the treadmill one day and the next day while working out I got a sharp stabbing pain on the outside of my leg above my knee and then I couldn’t stand and it’s been that way ever since.

    I’ve seen a very well known Chiropractor and was being adjusted 3x/day for 4+ months and every time he aligned me a few hours later I’m out of alignment again. My sacrum keeps going out constantly as well as my jaw and neck! I went to CA back in 2014 to work with a few doctors out there and they found major infection in tooth #13 where I had a root canal. The doctor numbed this area and no change happened in my body but because it was infected the tooth was removed in CA. Then he checked the gum area of tooth #1 + 2 as I had both of these teeth removed back in 2009. Although I had no pain there, they found MAJOR infection (Cavitation) in that area so I had 2 oral surgeries to clean it out. When they temporarily numb that area with Procaine ALL MY PAIN IN MY BODY DISAPPEARS!!! Within 20-30 seconds of being numb, I feel something traveling down the sides of both legs and then the unbelievable pain in both knees completely dissipates and my legs feel warm as if circulation hit my legs!! I also experience NO pain in my neck and back and could stand in his office for 1 hour straight. I can’t stand for even a few seconds as soon as the numbing wears off!! But when I’m numb I’m completely normal. I also have FULL RANGE of motion in my neck when I’m numb. When I’m not numb my neck is VERY restricted. I can’t look up or sideways for more than a few seconds and the tv & computer have to be completely eye level or my neck is a mess. I can’t even look up to talk to someone. Every morning I wake up with some jaw pain and the jaw muscles are tight, and so much neck pain and all the muscles along my spine are so tight like a chord that’s being pulled. I have to stretch my neck for 20 minutes before I can even get out of bed.

    The doctor’s and oral surgeon were trying to figure this all out. Looking back in time about 6 months after these 2 teeth were pulled in 2009, I started getting some symptoms like muscle weakness in my quads, severe menstrual cramps, heart palpitations and I was very irritated by sounds around me and sensitive to too much light and smells as if my nervous system was being irritated. A year and a half after that in May 2011, is when all the pain set in and I couldn’t stand or walk. Then more and more symptoms kept creeping up afterwards.

    At the end of my treatments in CA the holistic dentist sent me to another special dentist that deals with the trigeminal nerve because even after having the infections cleaned out from the cavitation, the pain wouldn’t go away. So they thought along with the infections maybe the trigeminal nerve was being irritated. So that dentist gave me a mouth piece to try and move my bottom jaw forward away from the trigeminal nerve. I was in more pain all over my body the second he put the mouth piece in! He had to adjust it for several days before it went back to my normal pain. I didn’t really notice any improvement. Then I went back 2 months later to move the bottom jaw even more forward again and same thing happened. More pain initially but then after several adjustments, I did see some small improvement standing with this new appliance but it only lasted 2 weeks and it was not anywhere near the same effect as when I’m numb. I didn’t like the way he was making my bottom jaw so far forward like a Neanderthal person and the positive effects wouldn’t last as I believe it would constantly have to be adjusted and I live in upstate NY and can’t fly back to CA every couple weeks.

    Lastly, I then saw another Holistic dentist in January 2017 in PA that again gave me an appliance…he said my bite has collapsed as I am missing several teeth in the back (Teeth #1,2,13,17,18,32). I noticed again a bit of improvement while standing that 1st day and I had no nerve pain down my right arm but then by the time I woke up the next day all the pain was back. The appliance broke after 30 days and he said it’s because I must be biting down really hard at night. I never went back to him as I didn’t like the way he responded when the appliance broke so quickly and he wasn’t willing to replace it.

    Sorry for such a long message!! But I found you and was hoping you can help!!! I’ve currently changed my diet 5 months ago to an almost all vegan organic diet (No gluten, eggs, dairy, soy, processed food and very little meat) and am on tons of supplements to support thyroid, adrenals, immune system and attack bad bacteria and viruses. I see some small improvements in my gut, mood, and energy but nothing is improving my standing at all!!! And no changes in my nerve pain down my arm or no changes in pain in my neck, back and knees.

    Have you ever seen any cases like this?! Have you treated any patients who can walk but have to walk fast and can’t stand at all?! How would your appliances be different? And would the appliance have to constantly be adjusted? Do you do any MRI or CT-scan of the head and neck, T-scan (to study the bite) or use EMG data (electrodes measuring muscle activity in the jaw) to fully diagnose?? Do you do DTR? Do you think I would need an appliance and then eventually implants to replace those missing teeth in the back to restore my bite permanently?

    Lastly, do you think you could help my situation of not being able to stand by re-aligning my jaw???

    THANK YOU in advance for taking the time to reply to me!!!

    Dr Shapira Resoponse:
    Shadiah Soliman

    I can help.

    You have covered a great deal of issues.
    Please view my youtube videos:

    Many of these patients experience symptoms similar to yours. We can unravel these issues.

    There are no magic cures and it takes some time to unwind these type of disorders. Most patients feel significant relief very quickly but it important to understand there are no “Magic Cures” but rather a process of recovery. After 7 1/2 years there is no return to the you of 7 1/2 years ago but the goall is to find the best quality of life moving forward. It is not possible to erase the effects of 7 1/2 years of pain. The goal is to give you significant relief ASAP and continual relief over time.

    Removing the impediments to healing allows the body to heal itself.

    I will have a team member contact you.

    Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
    Past Chair, Alliance of TMD Organizations
    Diplomat, Academy of Integrative Pain Management
    Diplomate, American Board of Dental Sleep Medicine
    Diplomate, American Board Sleep and Breathing
    Regent & Fellow, International College of CranioMandibular Orthopedics
    Board Eligible, American Academy of CranioFacial Pain
    Dental Section Editor, Sleep & Health Journal
    Member Cranio Editorial Board, Journal of Craniomandibular and Sleep Practice
    Member, American Equilibration Society
    Member, Academy of Applied Myofunctional Sciences
    Member, Academy of Cosmetic Dentistry
    Life Member, American Dental Association