Chicago eye pain

Chicago Eye Pain: Pain Behind The Eye is Usually Associated with TMJ (TMD) and MPD

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Eye Pain can be related to medical issues.  If you are experiencing Eye Pain, Behind the Eye pain or flashing lights in your eye your first stop should be at an ophthalmologist to rule out both eye issues and intracranial issues in the brain.

The good new is that most eye pain and behind the eyes pain is actually referred Myofascial Pain and a dentist trained in Orofacial Pain, Craniofacial Pain and especially Neuromuscular Dentistry can probably help you out.  A small percentage of the time it can be a sinus infection but studies have shown most patients with sinus pain DO NOT HAVE AN Infection.

The Trigeminal Nerve is usually the mediator of most chronic head and neck pain including all types of headaches and migraines.  The Trigeminal Nerve goes to the teeth, gums, periodontal ligaments, dental pulps, jaw muscles, jaw joints, lining of the sinuses and control the blood flow to the anterior two thirds of the meninges of the brain.

Myofascial Pain in the head and neck is usually related to jaw function.

There is an excellent website (www.triggerpoints.net) that details the patterns of referred myofascial pain.

The Sphenopalatine Ganglion is the largest parasympathetic ganglion of the head and it has significant input from sympathetic nerves.  It is located on the Maxillary branch of the Trigeminal Nerve.

Eye and retro-orbital pain  pain and headaches are usually also influenced by the autonomic nervous system.

Neuromuscular Dentists are the most equipped to deal with problems from these structures.  The ULF-TENS works trigeminally innervated muscles as well as on the Sphenopalatine Ganglion.  These are the primary mediators of myofascial pain that refers to the head.  The TENS also works on facial muscles thru the facial nerve.

Sphenopalatine Ganglion Blocks can turn off retro-orbital and eye pain from myofascial sources.  They can also be used to prevent and mitigate migraines, cluster headaches and TMJ disorders.

There are numerous videos on youtube of my patients responding to SPG Blocks, Neuromuscular Treatment and direct treatment of Myofascial pain with trigger point injection and Travell Spray and Stretch Techniques.

Biomed Res Int. 2018 Jul 9;2018:2694517

Correlations between the Visual Apparatus and Dental Occlusion: A Literature Review.

The development of visual functions takes place in the first months of postnatal life and is completed around the one year of age. In this period, the maturation of the retina and the visual pathways occur, and binocular bonds are established at the level of the visual cortex. During this phase and then for a few years, a certain plasticity of the visual functions remains, which seem therefore susceptible to change both in a pejorative sense (by pathogens) and in an improving sense (for example, by therapeutic measures). This plasticity involves also the oculomotor system. Due to this plasticity, many researchers believe that there are some functional correlations between the visual and the stomatognathic apparatus. But the scientific evidence of this statement has not been clarified yet.

Aim:

The purpose of this review is therefore to analyze the clinical data in this field and finally establish their level of evidence. Studies have been collected from the main databases, based on keywords.

Results:

The results showed a middle level of evidence since most of the data derive from case-control studies and cross-sectional studies.

Conclusions:

The level of evidence allows establishing that there is a correlation between ocular disorders (myopia, hyperopia, astigmatism, exophoria, and an unphysiological gait due to ocular convergence defects) and dental occlusion, but it is not possible to establish the cause-effect relationship. Future studies should be aimed at establishing higher levels of evidence (prospective, controlled, and randomized studies).

Another study by Monaco explains the association between occlusion and ocular disorders.  Intriguing neurophysiological connection:

 

“Clinical experience in dental practice claims that mandibular latero-deviation is connected both to eye dominance and to defects of ocular convergence. The trigeminal nerve is the largest and most complex of the twelve cranial nerves. The trigeminal system represents the connection between somitic structures and those derived from the branchial arches, collecting the proprioception from both somitic structures and oculomotor muscles. The intermedius nucleus of the medulla is a small perihypoglossal brainstem nucleus, which acts to integrate information from the head and neck and relays it on to the nucleus of the solitary tract where autonomic responses are generated”

 

Eye Pain, Swelling and Twitching

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Has eye pain, swelling or twitching just become too much of a strain?

tmj-eye-painDo you sometimes feel a ‘stabbing’ sensation behind your eyes or do they swell up or twitch unexpectedly making it difficult to concentrate on everyday things? Have you tried everything to relieve these painful sensations and haven’t yet come up with a solution?

When you have ruled out organic causes of eye pain with your ophthalmologist it is likely your pain is related to jaw, muscle  and TMJ function.

These sorts of symptoms could be due to a dental problem related to your jaw and neck muscles and your temporomandibular joint (TMJ). These  are  the joints that act like a hinges on both sides of your face. These joints allow you to speak, chew and yawn, amongst other things.

Some problems with the joint can lead to referred pain behind the eyes and the eyebrow area via the Trigeminal Nerve.  The TMJoints  are some of the most complicated joints in your body.  Each TMJ joint is actually two joints in one, a ball and socket joint and a sliding joint.  The entire ball and socket portion can slide forward and back as well as side to side.

The nerve that just might be behind your eye pain

If your bite is not properly lined up, you have what is often called a ‘bad bite’. This can cause friction or uncoordinated motion in one or both of your  (TMJ) TMJoints.

If it stopped right there you would probably never know about it, but unfortunately a nerve runs right past the joints, called the trigeminal nerve.  The Trigeminal Nerve goes to the teeth, the jaw muscles, the jaw joints as well as to the sinuses especially directly behind the eye.  Retro-orbital or behind the eye pain is mediated by the Trigeminal Nerve. This nerve is responsible for passing the message about friction through to the brain and somehow the message is transferred right on through to the eyes as well. The result is that you feel pain behind the eyes and sometimes they cause swelling and twitching because of the pain.

The trigeminal nerve is a cranial nerve, or actually made up directly of brain cells. The impulses of the trigeminal nerve ultimate are more than 50% of all input to the brain after they are amplified in the reticular activating system.  This is similar to music coming out of an amplifier at a concert.  Good input can be amazing but bad input is intolerable noise.  In this example the bad input or noise is what patients percieve as pain. What we call eye pain is nociceptive input perceived as eye pain.  The pain is absolutely real but the cause is often different than expected.  This is called refered eye pain.  Pain that is perceived in the eye but is actually from elsewhere.

These eye pain symptoms are common in the disorder known as temporomandibular disorder or TMD.  Myofacial Pain and Dysfunction (MPD) refers to the pain coming from trigger points in the muscles.  90-95% of all pain is actually muscular in origin.  The muscles work overtime to protect us from problems.  When they are overworked we have myofascial pain and TMD, both repetitive strain disorders.  More commonly known repetive strain disorders include carpal tunnel and tennis elbow.

There are many other symptoms  of TMD and MPD as well so it’s not surprising that it’s hard to work out exactly what is behind all these varied pains and sensations.  Physiologic dentists are experts in understanding patterns of referred pain in the head and neck .

The ‘bad bite’ that causes the problem in the TMJ is actually a poor alignment of the upper and lower teeth. When they don’t match up properly it puts extra pressure on the jaw and the muscles are used incorrectly causing repetitive strain injuries  like a chain reaction.  These problems affect head position posture and the body as a whole. The bad bite affects the muscles and the TMJ (TMJoints) which triggers the trigeminal nerve causing referred pain that eventually makes your eyes hurt.

The swelling around the eyes and dark circles under the eyes are actually secondary results of unhealthy muscles blocking normal drainage creating venous back-ups.  The dark area under the eyes is due to blood that is not receiving enough oxygen.

Dental treatment may be pain resolution

By now you will be wondering if anything can be done to help relieve the symptoms of eye pain, swelling and twitching. Fortunately, we might be able to provide a solution through the use of a diagnostic physiologic orthotic placed in your mouth that realigns your bite and allows your healing.  The orthotic is used to eliminate the impediments to healing. Doctors who allow the body to heal understand the process of health far better than those who promise magic cures.

An ultra low frequency TENS machine (MYOMONITOR) is used to create minute electrical impulses to stimulate your jaw and neck muscles so they  relax and the jaw and TMJ joint takes up a better position. This makes it easier for a dentist who specializes in physiologic treatment of TMJ and other jaw disorders to pinpoint where your bite should be.  Once the bite is idealized postural changes occur in the neck and throughout the entire body.  The diagnostic orthotic is corrected to reflect these postural changes.

When your bite is kept in the correct place then your TMJoints and jaw muscles will not be triggering the trigeminal nerve and resultant  pain will not be referred to  your face and neck. Effective dental treatment may eliminate or improve your eye pain and allow you to reclaim your normal life.

It may be time to seek TMJ relief

tmj-reliefYou shouldn’t miss out on enjoying life because eye pain is distracting you and painkillers have become a way of life. As it is possible that your TMJ is causing your eye pain, then it may be time for you to take the next step.

A diagnosis of TMD will be required, and we will need to make a thorough examination and eliminate any other potential causes of your eye pain. From there, we can determine what the best step would be for you. TMJ relief may be possible if you have bad bite and it can be realigned successfully.