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Eye Pain, Swelling and Twitching

Dr. Shapira Blog 32 Comments

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.

Patient Testimonials: TMJ, Orofacial Pain and Sleep Disorders

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Dear Dr. Shapira,
I wanted to thank you for taking my sense of fatigue seriously and trying to help me overcome it. You noticed things that sent me to a surgeon to stop my snoring and fashioned a mouth guard for me. This is in addition to other tips you have given me.

I appreciate you asking for my recent blood tests and analyzing them. You even went a step further and contacted my internist. She suggested, as did you, I see an endocrinologist. I have an appointment next month and will request you receive a copy of the results.

Again, thank you for caring.

– Bonnie S.


Dr. Shapira, or as I like to call him, Ira, is an angel in every sense of the word; blessed with a great brain and a greater heart and his hands work pretty good, too. His top qualities are that he provides great results, he’s an expert, and he is creative. I will never forget his devotion to one client he met with for eighteen months, on a weekly basis, at Rush Pres St. Luke’s who still has never received a bill for all services provided. May God bless you and yours always.

– Patrice C.


My longtime acupuncturist recommended Dr. Ira Shapira as an expert on Sleep Apnea when I shared with her my frustrations with my CPAP. Less than three months later, (and a sleep study to prove it), I am cured of my moderate condition of sleep apnea. Dr. Shapira created an oral appliance that is easy to sleep with and maintain. I am so relieved, feeling much better, significantly fewer headaches and more energy I would recommend Dr. Shapira to anyone. His knowledge of dentistry goes well beyond the norm. Anyone that suffers from TMJ and or sleep disorders should have a consult.

– Karen G.


I saw Dr Shapira for TMJ problems and chronic Migraines. I wore a plastic appliance for several months. All of my issues with jaw locking and clicking resolved as did my daily headaches and chronic migraines. I no longer have dark circles under my eyes either.
I could not afford a full mouth reconstruction but have been wearing a permanent appliance for several years on my bottom teeth..Expensive but worth it.
I did have 10 veneers done and now have killer smile, partially because I am no longer in chronic pain.

K.C.

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I have been a patient for over 15 yrs. When I came to Dr. Shapira I was in very bad TMJ pain. He and his staff worked with me for hours and when I left that day the pain was gone. I continued treatment until my bite was fully corrected and not only that but thanks to Dr Shapira’s talent in cosmetic dentistry, my teeth look more beautiful then they ever have. Dr Shapira and the staff continue to gain education on the most innovative ways to help people look and feel good. The staff there are very kind and I always so cared for when I go for my appointments.

Michelle H.

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I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.I received TMJ treatments from Dr. Shapira and I was pleased with the results. I had terrible migraines as well as smaller headaches for as long as I could remember and they dissipated upon receiving treatment. I would recommend Dr. Shapira to anyone with TMJ.

– Christopher J.


I was referred to Dr. Shapira for TMJ issues almost 30 years ago. Not only did the TMJ treatment plan resolve my issues but, over the years, I’ve also received excellent dental care and had some cosmetic work done, which I am very pleased with. Dr. Shapira has a real passion for what he does, and that passion has brought him vast knowledge and expertise. I trust him completely. Also, Barb has been my hygienist over those 30 years and I am completely pleased and satisfied with her skills and commitment to keeping my teeth and gums in the best condition possible. I’ve had Dr. Amidei a few times over the years when Dr. Shapira was not available and those interactions led me to believe that he is of the same top caliber as the rest of the Delany Dental Care staff.

– MK


Rating: 5.0 5.0 stars,
By: Charlene Bown
On: Google, 05/11/2018
Comment: I cannot imagine my dental work ever being done by any other dentist than Dr. Shapira!! I have been seeing higm for several years to help correct my sleep apnea. I cannot tolerate CPap so Dr. Shapira created an oral device that has literally been saving my life!!! I am a high risk patient and absolutely swear that I might not even be here if it weren’t for this incredible Doctor! He knows more about medicine from all different perspectives than most of my doctors and has exceptional skill in the practice of dentistry!! I truly believe this man is also a philosopher, a practitioner in natural remedies and has become a very special person in my life. Don’t even bother seeing any other dentist cause after you have seen Dr. Shapira you will be horribly disappointed!! I highly recommend Delany Dental for a real experience in what dentistry should be and rarely is!!!

I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MEK


I am so grateful for Think Better Life and Dr. Shapira. I have been suffering from TMJ for 10+ years and have been to countless dentists who all have told me that I am “fine.” Dr. Shapira was the first dentist to actually listen to my pain, thoroughly examine me, and talk me through my options. My first meeting with him lasted over an hour! Dr. Shapira is not only a great dentist, he is an incredible human being: kind, compassionate, and sincere. After only a month, I am already beginning to feel relief from my chronic headaches and facial pain. It is a feeling I honestly didn’t know was possible. Think Better Life is a warm, caring, and friendly office. Dr. Shapira and his entire staff have are truly competent and hospitable!

Laila N.


When I came to Doctor Shapira I was at the end of my road with severe TMJ pain. I went to many doctors and somehow no one could solve my problem. After many months of research I found Dr. Shapira’s website. I was hesitant to make the appointment due to the distance I would have to drive and feeling hopeless, but after being astonished from watching all the testimonials on his website I thought it was worth a shot.

At the first visit I could instantly tell he had superior knowledge about my issues than other doctors I met with previously. He was open and honest about my condition, the long treatment plan, and the high cost of care. Although this information was intimidating, I finally knew what the saying meant “health is wealth”, life is not worth living in constant pain and discomfort. Therefore, I decided to proceed with his treatment plan.

1 year later I can honestly say that it has been the best money I have ever spent. I am about ~80% better and I will hopefully continue to improve over time. The constant clicking and popping of my jaw is gone, I have normal range of motion again, and most importantly I am mostly pain free.

Not only is Dr. Shapira one of the best and most knowledgeable practitioners I have encountered, he treats you like family and is honestly one of the most interesting people I have ever met. I never leave his office without learning a fun new fact. He truly cares about his patients and work. You can tell he loves what he does. I can’t recommend him enough if you have TMJ pain/issues.

BRITTANY B.


I’ve been seeing Dr Shapira since 1998. In college I developed severe TMJ symptoms where I could no longer open my mouth more than an inch. I saw numerous specialists all over the state, visited top hospitals including the Mayo clinic. My family spent a lot of money and I got no relief from my symptoms. It wasn’t until my mom called the TMJ association in Texas and got Dr Shapira’s name. I was skeptical when I had my first appointment at Delany Dental Care but I was told it’d be a long road to recovery but I’d eventually be pain free. Within the first month of treatment, I noticed the headaches lessened. A few months later I could open my mouth further and within a year I had many days were I was able to forget about TMJ. This practice gave me my life back. While I still have some symptoms a few days a year, I am overall pain free. I was told though once you have TMJ as severe as my case; it would be something that I would have to deal with for the rest of my life but for the most part; most days I will not even know I have it.

– MK


Dr. Shapira has been treating me for TMJ. We started with an oral appliance to relax the jaw and make a better bite. Then we went to a DNA Appliance. I have been pain free since almost day one. Now I can’t wait to see the results of the DNA which will reshape my jaw so I won’t need an appliance in the future. Dr Shapira is a miracle worker. His staff is Awesome as well!

Suzan B.


Very Caring and professional staff! Most definitely the best dentists I have ever been to. After an orthodontic mistake that left me disfigured and with a few less teeth, I was feeling very sad and hopeless. I decided to check out restorative dentistry. They basically pointed out everything and how your jaw can affect your entire body. The doctors were very kind, considering I was in tears. They were completely understanding. They also specialize in sleep dentistry. They did a sleep study on me and I got to choose where I could have it done. They will definitely get my business in the future.

– Marty S


Terrific place for Dental and TMJ healing…I’ve been a patient for 13 years. Not only did they fix my cavities very well, but the incredible relief from my jaw problems was unexpected. My jaw would sometimes lock up on one side, and Dr. Ira discovered that my bite was misaligned. I had the painless TENS treatment, wore a plastic appliance made for my mouth (like a retainer), and then my jaw was fixed, my bite was fixed, and my jaw pain was gone!!
Better still, this treatment apparently also aligned my sinuses, because my life-long sinus congestion disappeared. AND, I no longer require a small shim my right shoe for which I had long ago been diagnosed as having needed “because” one leg was longer than the other — which is no longer the case! Alignment works! This is a great place to get healed for life!!

– Marty S


I have going to this practice for 23 yrs. with Dr. Mark Amidei as my dentist and Dr. Ira Shapira for my Sleep Apnea.
I can not say enough about their staff, friendly and professional.
I enjoy going to the dentist.
A+ all around. Do yourself a favor and look no more, call and make an appointment. You will not be disappointed.
I began working with Dr. Shapira several months ago regarding a case of debilitating TMJ. He uses innovative technology to measure jaw movement, ensuring that his splint treatment is precise. He also works with patients to help them understand and treat the muscular component of TMJ (something not offered by the four previous dentists I had seen for my condition). Dr. Shapira works in conjunction with Dr. Mark Freund of Natural Care Chiropractic for TMJ cases; together they are relentless in finding a solution for their patients. I have been particularly impressed that both doctors continually seek out further education and knowledge in their respective fields. I cannot recommend their work enough!

– DS


I don’t know where my health would be without Dr. Shapira. I have been a TMJ patient for 20 years. I had no idea that TMJ treatment can effect your sinus, sleep, and migraine health as well. Dr. Shapira has been a lifesaver for me more times than I can count. This past January we started DNA treatment which stands for Day and Night Appliance. The improvement I’m already feeling is incredible! I wear this new, comfortable appliance 12 hours a day-basically after dinner and while I sleep. It is expanding my upper and lower jaw which is going to correct my TMJ, open my breathing passages, and greatly improve my allergy and chronic sinus infections. It’s mind-blowing how all of my medical issues are inter-twined with what Dr. Shapira treats. He is always on the cusp of the newest technology and treatments and many of his treatments offer instant relief. Dr. Shapira and his staff treat everyone like family. You couldn’t be in wiser or better hands.

Barbara K


I have been a patient of Dr Shapira and Dr Amidei for the past 24 years. My husband, myself and our three sons are all patients here and I cannot speak highly enough about everyone there! Dr Shapira diagnosed me with TMJ issues about 15 years ago and I have worn a night guard appliance from him ever since. I noticed a remarkable difference within a few nights of starting the appliance and have never had any uncomfortable issues with TMJ since then. Both doctors have seen all three of our sons since they were toddlers. Barb, one of their hygienists, has been treating our entire family these past 24 years and she is the absolute best.
Two years ago, Dr Shapira helped me with the decision to get porcelein veneers and I am thrilled with the results! The level of expertise he has, the wealth of knowledge that both doctors have, the kindness and care that everyone there displays – honestly, there is no place I would rather go and I have recommended many friends to this practice.
You can really tell that at Delany Dental Care, everyone there is treated like they are part of their family. Everyone there makes you feel like you are as important to them as members of their own family. I highly recommend this practice to anyone looking for themselves or their entire family to be treated! You cannot go wrong with choosing Delany Dental!

– DS

100+ VIDEO TESTIMONIALS https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/videos…

TMJ Surgery

Dr. Shapira TMJ is a painful condition 0 Comments

Think twice about non-emergency TMJ surgery

tmj-surgeryTMJ is a painful condition, and there are a variety of treatment options. While surgery is one of them, going under the knife comes with risks. That’s why dentists typically only suggest TMJ surgery as a last resort for patients who tried other TMJ treatment without success.

Surgical procedures use unique methods of supporting the jaw and cartilage and removing the factors that cause pain and discomfort. Before choosing surgery, your doctor will talk with you about the risks and rewards, and some potential TMJ surgery risks include problems swallowing, difficulty talking and issues with eating.

TMJ treatment comes in three distinct phases

Phase 1

This phase is all about relieving pain and restoring physiological health to your jaw. Typical treatments include:

  • relaxing your jaw muscles with a TENS machine
  • a diagnostic physiologic orthotic sometimes called a bite splint to correct jaw function
  • practicing simple exercises
  • changing your behavior (putting and end to habits like nighttime teeth grinding, jaw clenching and pencil gnawing).
  • This is the most important phase of treatment.  The orthotic is utilized to correct the jaw position so the muscles and nerves can function ideally. This will properly load the TMJoints to prevent damage.   This is the DIAGNOSTIC Phase of treatment.  This is a preview for the patient as to what can be accomplished during phase 2 treatment.   Do not proceed to phase two treatment unless you are happy with the results of phase 1.

Phase 2

The objective of phase 2 treatment is to bring longer-term stabilization to your jaw. This involves the use of:

These treatments straighten, replace, repair or rebuild teeth in order to stabilize your bite in a balanced, healthy position.

Phase 3

It’s only when none of the aforementioned, less-invasive treatments help, that surgery should be considered an option.

Though temporomandibular joint (TMJ) surgery is a last resort, some patients find that they cannot improve their symptoms with the use of other remedies. Surgeries can involve:

  • an arthroscopic procedure
  • arthrocentesis
  • microsurgery
  • open surgery

tmj-location

Arthocentesis is the least invasive procedure to the TMJ.  It involves washing out the joint and removing adhesions.  It is often done with hydraulic pumping movements   While this is listed in Phase three it can also be considered a phase 1 treatment for some joint issues.  Dr Shapira does arthocentesis on awake patients in his office.  Other patients are referred to Oral Surgeons to have the procedure done with OV sedation.

With an arthroscopic procedure, the dentist will insert needles straight into the infected joint and use enough saline or another liquid to force the jaw open and loosen the cartilage.   Microsurgery uses tools and equipment that let the doctor repair damaged cartilage inside your mouth.

Open surgery surgery is a much more complex and dangerous surgery.  It is usually best avoided.

Is surgery right for you?

The effects of TMJ surgery on patients before and after varies from person to person. The popping or clicking noise that you might hear generally dissipates after a surgical procedure, but some patients still experience headaches, muscle pain and other symptoms.

Before committing to surgery, it’s important to weigh the pros and cons of all TMJ treatments carefully. It’s also critical to involve a dentist like Dr. Shapira, one who understands the principles of physiologic dentistry. If you have questions and concerns about the treatments for TMJ, please come in for a consultation.

TMJ Pain and Sleep

Dr. Shapira Jaw Problems, Sleep Problems, TMJ Pain and Sleep 0 Comments

TMJ Pain and Sleep: Why do I have trouble sleeping?

tmj-pain-and-sleepDo you find trouble sleeping and at the same time have jaw pain? A lot of Americans suffer from one sleep disorder or another but the most common is something called sleep apnea. Sleep apnea occurs when the airways become blocked and you find that you keep waking up as your body reacts to the lack of oxygen.

There are other reasons that can help to stop you sleeping well and these are related to your temporomandibular joint (TMJ). The jaw joints that connect the lower jaw to the skull are the TMJ Joints.  When they do not function smoothly you may hear clicking, popping or grinding noises in your joints or experience mild to severe pain when using your jaw.  This is the part of the face that allows you to move your jaws up, down or sideways.  When the TMJ is not working you may experience locking of your jaws or experience pain with movement.

If your ‘bite’ becomes misaligned you might experience symptoms such as face, ear, neck and jaw pain, because a ‘bad bite’ can affect your TMJ. A problem with the TMJ may then also cause snoring and sleep problems.  Your bite and your two TMJ joints act like a three-legged stool, if the legs are even the stool is stable.  If one or more of the joints or the bite is not correct you will have instability resulting in problems.  Muscle pain, neck pain and headache are some of the most common results of instability.

A jaw joint disorder could be causing your sleep problems

If you have a problem with your TMJ, then the pain could cause a TMJ related sleep disorder. The link between your TMJ and some sleep disorders like sleep apnea is crystal  clear, but just the jaw pain may still prevent you from getting a proper night’s sleep.

TMJ problems are often caused by a misaligned bite, which can put your tongue in the wrong place so that it readily blocks your airways. If you snore a lot and cannot sleep because of your TMJ, you do need to find a remedy because it could lead to more serious health issues, including heart disease and high blood pressure. A sleep disorder is more than a lack of sleep as it is a warning that further health problems are possible if treatment does not start.

The National Heart Lung and Blood Institute of the NIH published a report on “THE CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS”  I  wrote a paper for Cranio Journal titled “TMJ, The Great Imposter has a Co-coconspirator Poor Sleep”   I  was requested to write the editorial for Cranio by Riley Lunn, the editor and owner when the Journal  changed it’s name from  the Journal for Craniomandibular Practice to the Journal for Craniomandibular Practice and Sleep.

Sleep problems can cause a multitude of pain Disorders including Fibromyalgia

It does not matter if jaw pain or airway problems are causing your disturbed sleep.  Once you sleep is disturbed it creates a host of new problems with widespread muscle pain.  There is a very specific sleep finding in Fibromyalgia, Alpha Intrusion into Delta Sleep or in simple English you wake or have disturbed deep sleep.  Studies have shown that many patients have Fibromyalgia symptoms if you disturb their sleep.  The disruption in sleep also alters our endocrine system affecting insulin resistance, cortisol levels, growth hormone, adrenal function, sexual hormones and thyroid hormone.  All of these factors can increase the pain and dysfunction associated with TemporoMandibular Disorders.

Dental treatments for your jaw problems and sleep disorder

This may be the right time to consider dentistry to correct the TMJ problem and any sleeping disorders, too. We will first ensure that no other health problems are causing your TMJ problem and any other sleep disorders. The first test we might use is an ultra low-frequency electronic device which will relax the muscles in your face.  Many patients have comorbid conditions or health problems that contribute to their TMJ disorder but there are also many patients who experience a host of medical problems because of their TMJ disorder.   One study showed that patients with TMJ disorders have a 300% increase in spending in every field of medicine.

If your TMJ is the culprit, then a special orthotic appliance is put in place which prevents the bite misalignment. If teeth grinding (bruxism) seems to be the main reason for the TMJ disorder, fitting a night guard is quite likely. This is a custom-made mouthpiece that you will wear when you sleep. These treatments can lead to less pain and better breathing.  Many patient who grind their teeth have sleep apnea and the bruxism helps to stiffen and open their airways.  Sometimes, a troublesome behavior can have both  positive and negative  consequences.  It is extremely important that patients with sleep problems and/or TMJ problems always see an expert in both fields.

Dr Shapira is a Diplomat of the American Board of Dental Sleep Medicine, A Diplomat of the Ameican Academy of Pain Management and a Felllow of the International College of CranioMandibular Orthopedics.

Stop the pain and get back to sleep

If you have been experiencing jaw pain and find it hard to get to sleep you may have a problem with your TMJ which could be helped by physiologic dentistry combined with Dental Sleep Medicine. We will need to make a thorough examination and eliminate other possible causes of the pain and any sleeping problems you have been experiencing. By utilizing advanced clinical and diagnostic protocols available in modern dentistry techniques, Dr. Shapira will be able to help you find a night filled with better sleep and a reduction or elimination of your daytime pain.