Some people call temporomandibular joint disorders (called TMD or TMJ) the “great pretender” because it is so commonly misdiagnosed as other conditions. Because it’s so hard to get an accurate diagnosis, many of our patients have spent years suffering without a diagnosis. Or perhaps they have a misdiagnosis, which can be worse, because they have spent money and experienced side effects from treatments for other conditions.

In addition, many people are diagnosed with closely linked conditions and never realize that they also have TMD, which could be exacerbating their condition. Since TMD is one of what are known as chronic overlapping pain conditions (COPC), many people with TMD either have or develop multiple pain conditions that might improve with the help of an interdisciplinary team that includes a dentist.

If you think your TMD might be misdiagnosed or if you’ve been diagnosed with a related condition, neuromuscular dentist Dr. Nancy Nehawandian can help. We will perform a careful, scientific evaluation to get you an accurate diagnosis so that you can start treatment that will really help. Please call (408) 354-5600 today for an appointment at Top Down Dental in Los Gatos, serving the entire San Jose area.

Commonly Misdiagnosed Conditions

Shared symptoms are one of the leading reasons why TMD gets misdiagnosed. We see a few common misdiagnoses, including:

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

Many people are properly diagnosed with these conditions, and can often get effective treatment. But for people who think they have the condition, but find treatments don’t work for them, it’s possible they’ve been misdiagnosed.

Sinus Infection

Many people think they have a sinus infection when they actually have facial pain related to TMD. Sometimes, they even get this as a misdiagnosis from their doctor. People who find they have recurring sinus infection that doesn’t respond to antibiotics and presents mostly as facial pain or fullness likely have TMD.

Ganglion Cyst

A ganglion cyst is a fluid-filled lump that grows on your joint. They are most common on the joints of the hands and feet, but can appear on other joints, including the jaw. If you experience jaw pain and suspect a cyst, try to find the cyst, which might be as small as a pea or as much as an inch in diameter.

Meniere’s Disease

This ear disorder causes many symptoms that people experience from TMD. About 80% of TMD sufferers experience ear-related symptoms like Meniere’s disease, including ear fullness, tinnitus, vertigo, or hearing loss.

Ernest Syndrome

This outcome of jaw trauma is caused by an injury to one of the ligaments near the temporomandibular joint. There is a high degree of overlap between Ernest syndrome and TMD, but Ernest syndrome tends to be less recurrent and less likely to cause symptoms beyond the jaw.

Lyme Disease

This tick-borne illness is uncommon in California. Most people who contract this disease have traveled East, including Wisconsin, Minnesota, or the Eastern Seaboard. If you have Lyme disease, it’s likely that other joints are affected as well as your jaw. In addition, you probably developed the characteristic bull’s-eye rash and experienced a fever after being bitten by a tick.

Trigeminal Neuralgia

The trigeminal nerve is linked to TMD-related pain in several ways, so it’s not surprising that TMD might be accidentally diagnosed as trigeminal neuralgia. The type of pain can help distinguish the two conditions. Trigeminal neuralgia is more likely to be sharp, stinging pain, whereas TMD is more likely to be a dull ache from sore muscles. TMD is more likely to be set off by jaw motion or tension, whereas trigeminal neuralgia is more likely to activate if you touch your face. Nonetheless, doctors often call facial pain trigeminal neuralgia if they don’t have a good diagnosis.

Chronic Overlapping Pain Conditions

It’s bad enough that TMD is often misdiagnosed as being other conditions. Even worse is that people with TMD often suffer more than one type of painful condition. As a result, TMD has been classified as one of the chronic overlapping pain conditions (COPC). COPC are one of the leading challenges in modern medicine because they cause long-lasting pain that is often severe, even disabling. Plus, they’re difficult to treat, as they don’t respond to many treatments traditionally used for pain.

One explanation for COPC is that they’re caused by central sensitization. In this model, one chronic pain sends such constant pain signals to the brain that it begins to interpret non-pain signals as pain, amplifies pain signals, or even creates pain signals from other parts of the body.

If this is an accurate modely, timely treatment of conditions like TMD might help you avoid developing future conditions.

However, studies indicate that perhaps 75% of people with TMD report other COPCs. The COPCs most commonly reported with TMD, include:

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

Not every type of pain condition overlaps with all the others. However, people with TMD have also been diagnosed with all the above pain conditions.

Migraine

People with TMD commonly report migraine as well. These headaches affect about 30% of all TMD sufferers, and this is also one condition where we have a strong understanding of a causal link between the two conditions. TMD flare-ups may overwhelm or irritate the trigeminal nerve, which is the trigger point for migraines.

Chronic Lower Back Pain

People with chronic lower back pain are the most likely to experience other COPCs. About 30% of people with TMD report having chronic lower back pain.

IBS/IBD

IBS or IBD causes multiple abdominal symptoms, including pain, cramping. Gas, bloating, constipation, and diarrhea. The condition affects about one-quarter of all TMD sufferers (24%). Some people with IBS find fiber helps manage the condition, it is often unrelated to diet.

Fibromyalgia

Fibromyalgia is one of the most disabling COPCs. It can cause widespread pain, including pain in the legs, buttocks, arms, shoulders, and neck. People with the condition might also experience mood problems, sleep disorders, and fatigue. About 22% of people with TMD also report fibromyalgia.

Vulvodynia

Vulvodynia affects about one-sixth of TMD sufferers (17%), and it can significantly limit a person’s life activities. It causes stinging pain around the vaginal opening, and sufferers report difficulty with many activities, including having sex or simply sitting down.

Interstitial Cystitis

Interstitial cystitis is itself often misdiagnosed as a urinary tract infection (UTI) because its primary symptom is bladder pain, which ranges from mild to severe. It affects about 13% of all people with TMD.

Endometriosis

Endometriosis causes abdominal pain, irregular menses, constipation, and nausea. It’s caused by the growth of uterine lining tissue outside the uterus. About 8% of people with TMD report endometriosis.

Chronic Fatigue Syndrome

Chronic fatigue causes people to feel worn down even though they haven’t been especially active. About 8% of people with TMD report chronic fatigue syndrome.

An Interdisciplinary Approach to COPCs

COPCs are caused by a complex process that involves many systems of the body, resulting in ongoing suffering and disability. Evidence shows that these conditions benefit from interdisciplinary treatment. Building a closely knit team of professionals to treat your COPCs, including a neuromuscular dentist, can help you experience better results, including less pain and disability. As a result, you will experience a significant improvement in your quality of life.

Dr. Nancy Nehawandian has considerable experience working with other medical professionals–including doctors, chiropractors, and physical therapists–in the treatment of TMD.

Looking for Pain Relief in San Jose, CA?

If you are having trouble finding successful TMD treatment (or even successful diagnosis) in the San Jose area, Dr. Nancy Nehawandian can help. Please call

(408) 354-5600, or e-mail us to find relief.