Dr Magaziner - TMJ Jaw Pain and Headaches

TMJ and Headaches

Category: Blog

A new study shows how stem cells can repair the cartilage and bone damage associated with TMJ related pain.
A paper published in the medical journal Stem Cells International says that stem cells can help TMJ patients by forming cartilage and bone in osteoarthritis damaged temporomandibular joints. In the paper, temporomandibular joint osteoarthritis is described as a degenerative disease, characterized by progressive cartilage degradation, subchondral bone remodeling (this is the bone under the cartilage trying to repair itself), synovitis (inflammation of the synovial tissue of the joint), and chronic pain.

Can Stem Cells Help?

In recent years, stem cell-based therapy has raised much attention as an alternative approach towards tissue repair and regeneration. Mesenchymal stem cells, derived from the bone marrow, synovium, and even umbilical cord, play a role as seed cells for the cartilage regeneration of temporomandibular joint osteoarthritis.
Mesenchymal stem cells possess multilineage differentiation potential, including chondrogenic differentiation as well as osteogenic differentiation. This means that the stem cells can convert themselves into the building blocks of cartilage and bone.
The study concludes that: “Given the limited self-healing potentials of avascular cartilage, little effective therapy is available for the repair of normal TMJ tissues in osteoarthritis disease. Although the conventional nonsurgical or surgical treatments can relieve the joint pain to some extent, they cannot completely restore the TMJ function and reverse disease progression. Mesenchymal stem cells. . . may provide an alternative treatment for the cartilage degradation in TMJ osteoarthritis.”1

More about TMJ and What It Is

TMJ is a condition we have treated effectively for many years. But sometimes patients with TMJ present more than jaw pain.
Many cases of jaw and facial pain and headache unresponsive to traditional measures such as analgesics, night guards, bite plates, or antibiotics for sinusitis can be traced to the occiput, cervical facet joints, cervical interspinous ligaments, and the trapezium.
Patients should be fully evaluated by a physical examination including, but not limited, to the strength of the arm and hands, the integrity of the cranial nerves, sensory nerves and deep tendon reflexes, and range of motion of the neck. Furthermore, careful evaluation of the cervical facets, occiput, interspinous ligaments, and trapezium should be performed by a physician skilled in diagnosis and treatment of such injuries. Injury in the latter regions caused either by trauma, overuse, or degeneration is often responsible for causing headaches, jaw aches, and facial pain.
Cervicocranial syndrome (Barre-Lieou syndrome) can also occur from injury to the cervical facet joints. This syndrome is often manifest by a variety of findings such as vertigo, tinnitus, visual blurring, nasal stuffiness, and facial numbness.
Radiological studies such as plain radiographs and MRI may be useful in some cases of referred head, face, and jaw pain but often diagnose incidental findings that do not contribute to a patient’s pain syndrome. Findings such as degenerative disc disease, herniated cervical discs, or spinal arthritis may be incidental, as a significant percentage of the population (over 60% in some studies) demonstrate similar findings and remain asymptomatic. The author strongly believes that a careful physical examination with clinical correlation is paramount to diagnosis and treatment of referred pain problems and can help to spare the patient from the cost and inconvenience of further diagnostic studies, treatments, and unnecessary medications.

Current Treatments

Treatment of referred pain should be directed to correcting the source of the problem. While analgesics, antidepressants, and anti-inflammatory drugs can help to temporarily eliminate chronic pain, they do not cure the underlying pain problem.
In those with injury to the cervical facet joints, interspinous ligaments, trapezium, or occiput will likely benefit or be cured by Prolotherapy and PRP injections.
Prolotherapy and PRP injections, placed directly into the fibro-osseous junction trigger the immune system to permanently rebuild and reorganize collagen tissue, thus regrowing damaged tendons and ligaments. Once this process is completed, the integrity of the joint is restored, and the patient’s chronic pain should be alleviated.
Prolotherapy and PRP injections are the only documented treatment to restore joint, ligament, and tendon damage without surgery and can permanently cure the origin of referred facial, temporal, and jaw pain.
To learn more about TMJ pain, and treatments that may help, please contact us at drmagaziner.com.  Our office in Cherry Hill, New Jersey can take care of all your questions and existing pain issues.
REFERENCES:
1 Cui, D., Li, H., Xu, X., Ye, L., Zhou, X., Zheng, L., & Zhou, Y. (2017). Mesenchymal Stem Cells for Cartilage Regeneration of TMJ Osteoarthritis. Stem Cells International2017, 5979741. http://doi.org/10.1155/2017/5979741
Refai H, Altahhan O, Elsharkawy R. The efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2011 Dec;69(12):2962-70. Epub 2011 Jul 16.