Temporomandibular joint disorders (called TMD or TMJ) are notoriously hard to diagnose. Many people with TMD go years seeking a diagnosis of their condition, often receiving three or four misdiagnoses before accurately identifying the true cause of their suffering. Some misdiagnoses are common because of overlapping symptoms. 

Of course, another significant problem with TMD is that it rarely exists in isolation. Most people with TMD experience multiple conditions that complicate their treatment and increase their suffering. These chronic overlapping pain conditions (COPC) are best treated with an interdisciplinary team including a dentist. 

At Firouzian Dentistry, Columbus, OH neuromuscular dentist Dr. Mike Firouzian can help patients get an accurate diagnosis and effective, nonsurgical treatment for their condition. Please call (614) 848-5001 today for an appointment.

Misdiagnosed Conditions

Because of shared symptoms, TMD is commonly misdiagnosed as other conditions. Some of the more common misdiagnoses we see include:

  • Meniere’s disease
  • Sinus infection
  • Ernest syndrome
  • Ganglion cyst
  • Trigeminal neuralgia
  • Lyme disease

All of these are real conditions that need to be properly diagnosed and treated, but if you’re not responding to recommended treatments, you might be misdiagnosed.

Meniere’s Disease

Meniere’s disease is an ear disorder that often triggers vertigo, tinnitus, ear fullness, and hearing loss. TMD can also cause these symptoms, but is distinct with the addition of jaw-related symptoms, facial pain, and headaches.

Sinus Infection

It might seem incredible, but sometimes doctors misdiagnose TMD-related facial pain as sinusitis. In fact, some people think they have recurring sinus infections, when what they’re actually experiencing is periodic TMD flare ups.

Ernest Syndrome

This is an injury to one of the ligaments near the temporomandibular joint. Ernest syndrome is very similar to TMD, but it tends to be more temporary and less recurrent. It takes detailed measurements to differentiate the two conditions.

Ganglion Cyst

Ganglion cysts are fluid-filled lumps near your joints. These usually occur on your hands or feet, but they can appear on your jaw joints, too. These mostly cause jaw pain, and can be distinguished by finding the cyst, which ranges from pea-sized to an inch in diameter.

Trigeminal Neuralgia

Trigeminal neuralgia is when branches of the trigeminal nerve send pain signals to the brain. The pain is severe, sharp, and typically caused by any touch to the face outside the mouth. It can also cause pain with jaw motion. Treatments for trigeminal neuralgia can be serious and may have complications, so it’s important to get a second opinion whenever you get this diagnosis. Facial pain with an uncertain cause is often lumped into this category, but careful diagnosis can distinguish them.

Lyme Disease

Lyme disease is a tick-borne illness that affects your joints, including the jaw joints. Columbus is in a relatively low-risk area for Lyme disease, but if you travelled to the Eastern Seaboard, Wisconsin, or Minnesota, your risk is higher. People who get Lyme disease often develop the characteristic “bullseye” rash, but it’s easy to miss that, depending on the location of the bite. More helpful is the onset of fever-like symptoms, which come with Lyme disease. Lyme disease also tends to affect more than just the jaw joint.

Chronic Overlapping Pain Conditions

In addition to being confused with other conditions, TMD is one of the chronic overlapping pain conditions (COPC). COPC cause long-lasting pain, are difficult to treat, and people with one either have or will develop others. This may be because of central sensitization, where the body receives so many pain signals from one type of chronic pain that it amplifies, prioritizes, or even creates pain signals from other parts of the body.

If this model is correct, it’s important to treat these conditions quickly to avoid central sensitization, which can lead to numerous additional problems.
About three-quarters (75%) of people with TMD experience other COPCs. The most common COPC are:

  • Migraine
  • Chronic lower back pain
  • Irritable bowel syndrome/disorder (IBS/IBD)
  • Fibromyalgia
  • Vulvodynia
  • Interstitial cystitis
  • Endometriosis
  • Chronic fatigue syndrome

Although not all COPCs overlap, they all overlap with TMD.

Migraine

Migraine is very common in people with TMD, affecting almost a third of all sufferers (30%). People with TMD are more likely to develop migraine in the future, and TMD treatment has been shown to lead to reductions in migraine frequency and intensity.

Chronic Lower Back Pain

Chronic lower back pain has the most overlap with other conditions, and it affects about 30% of sufferers with TMD.

IBS/IBD

IBS or IBD was among the first pain conditions to be linked to TMD, affecting nearly one-quarter of all people with TMD (24%). IBS causes abdominal pain, cramping, bloating, gas, diarrhea, and constipation. Although fiber can help manage the condition, symptoms aren’t always related to diet.

Fibromyalgia

Fibromyalgia causes some of the most widespread pain of any COPC, including pain in the neck, shoulders, arms, buttocks, and legs. It also comes with fatigue, sleep problems, and mood disorders. It affects about 22% of all people with TMD.

Vulvodynia

Vulvodynia causes burning, stinging pain around the vaginal opening. It can affect many aspects of life, making it hard to do many things, from having sex to simply sitting down. About 17% of TMD sufferers experience vulvodynia.

Interstitial Cystitis

Interstitial cystitis is a painful bladder syndrome affecting about 13% of all people with TMD. It can cause different levels of bladder pain, from mild to severe. This can be misdiagnosed as a urinary tract infection (UTI).

Endometriosis

Endometriosis is when uterine lining tissue grows outside the uterus. It causes pain, irregular menses, nausea, or constipation. It affects about 8% of all TMD sufferers.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is when a person feels fatigued despite little or no physical exertion. It affects about 8% of all people with TMD.

An Interdisciplinary Approach to COPCs

We have increasing evidence that the most effective way to manage and/or treat COPCs is with an interdisciplinary approach. A team of professionals from diverse disciplines can contribute to improving your long-term quality of life. A skilled neuromuscular dentist can be an invaluable addition to this treatment team if you have TMD.

Dr. Mike Firouzian has extensive experience treating TMD successfully and understands how to work well with a team of professionals to help you get the best possible results.

Looking for Pain Relief in Columbus, OH?

If you are suffering from, or suspect that  you are suffering from TMD in Columbus, OH, we can help. Please call (614) 848-5001 today for an appointment with Dr. Firouzian at Firouzian Dentistry.