Pain Management and Rehabilitation: The TMJ Connection

Dr. Shapira Blog, TMJ 0 Comments

Pain Management, Integrative Pain Management, Rehabilitation Institute all have to deal with a wild card, the Joker or TMJ Disorders.

The Trigeminal Nerve is the largest input into the brain of the body. After amplification in the Reticular Activating System it accounts for over halh of al input to the brain In addition to the Somatosensory input of the trigeminal nerve to the brain there is also Sympathetic and Parasympathetic Autonomic Input.

Thje complexity of treating and correcting TMJ issues and trigeminal pain is daunting for physicians and is usually best dealt with by a neuromuscular trained dentist. The reason for this is that while there are only two jaw joints they each have 2 compartments that act like seperate joints and they are connected but except for opening or protruding the jaw all other motions require the right and left TMJoints to work in different ways. This is also complicated incredible du to the presence of teeth. Each tooth has thousands of nerves and there are at least 29 different neurorecptors in the periodontal ligament (PDL).

Each tooth is actual a joint, a movable joint between teeth and bone that has at least 29 different types of nervous receptors. The trigeminal nerves instantly relay information to the brain. A great deal of this information is propriceptive in nature. Trying to adequately treat chronic pain while ignoring half the input to the brain is foolish. A neuromuscular Evaluation may lead to finding answers that would otherwise be missed as in these two patients express in videos:


Over 100 additional videos available at: https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/videos

The Trigeminal nerve is responsible for Trigeminal Neuralgia, the Suicide Disease. It is also involved in every single headache type including Migraine, all of the Autonomic Cephalgias, Tension Headache, Chronic Daily Headache, muscle contraction headaches. Sinus headaches, contact headaches, atypical facial pain and TMD.

All treatment of chronic head and neck pain should include trained neuromuscular dentists, ideally extremely well versed in sleep disorders and pain management.

The Trigeminal nerve is actually part of the brain, the cell bodies residing in brain ganglia. The Sphenopalatine Ganglion is the largest Parasympathetic Ganglion of the head. All patients with headaches should have a trial SPG Block to evaluate response. There are both Sympathetic and parasympathetic fibers passing thru the SPG.

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