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Fibromyalgia already causes widespread pain — if you've developed TMD, a condition that causes jaw pain, but also sometimes ear pain, shoulder pain, neck pain, and headaches as well, what can you do to seek relief?

What is fibromyalgia?

Fibromyalgia, a "functional pain disorder", is characterized by widespread pain, "tender points" that are a particular source of agony, fatigue, difficulty getting to sleep or staying asleep, and cognitive changes — not being able to think clearly and frequently losing things, for instance. The condition, which strikes somewhere between two and seven percent of people all across the globe and is much more common in females and middle-aged people, is also linked to some other ailments. People with fibromyalgia are more likely than others to also be diagnosed with migraines and irritable bowel syndrome, to name two examples. Temporomandibular Disorder is another condition that can co-exist with fibromyalgia. 

What is Temporomandibular Disorder (TMD)?

TMD, which stands for Temporomandibular Disorder, might be better known to you by its older name — Temporomandibular Joint Dysfunction, or TMJ for short. Whatever you call it, it's a problem that makes gives you jaw pain, because something's with the muscle, joint, or both that normally allow you to move your jaw normally. 

TMD can develop gradually or hit you out of (seemingly) nowhere, and though there are some known risk factors — arthritis, a previous injury in the area, a history of grinding your teeth, being female, being aged 20 to 40, and plain old genetics — your doctor may never find out what exactly was behind your TMD. They will, however, be able to recognize its symptoms and make sure that you receive a correct diagnosis.

The following signs will allow your doctor to come to the conclusion that you are suffering from TMD:

  • Pain, discomfort, and soreness — not just in your jaw, where you'd expect it, but also often in your face, ear, neck, and shoulders — all areas surrounding the joint in question. Your pain is likely to reach a peak when you do things you've taken for granted until now; speaking, chewing, and even yawning can cause severe discomfort. 
  • Your jaw may not be able to open as widely as before, or you may find it impossible to close your mouth after opening it wide. Sudden jaw movements may leave you feeling that something is "out of place" as well. 
  • Eating and speaking may now be accompanied by discomforting, tell-tale, "popping" noises, which are also sometimes painful. 
  • Given all this, you can additionally expect your facial muscles to feel overworked — like you've just sung a five-hour opera, or something — and to swell up
TMD may be unilateral — on one side — or affect both sides of your jaw. Accompanying symptoms that may not immediately seem related to the condition can include severe headaches, neckaches, earaches, and toothaches. Some people also feel dizzy, and suffer from tinnitus (ringing in the ears). 

What do fibromyalgia and temporomandibular disorder have in common?

Quite a lot, actually:

Research has been undertaken to further explore the connection between the two, because it's not uncommon for people with fibromyalgia to also have Temporomandibular Disorder. It's well-known that fibromyalgia involves a severely-lowered pain threshold. This is why even gentle touch can lead to severe discomfort in fibromyalgia sufferers. It is currently thought that this problem originates in the brain. The heightened sensitivity to pain stimuli seen in people with fibromyalgia may likewise make them more prone to TMD. It is also possible that the two conditions can share a common cause, whether neurological, physical, or psychological. 

What can you do to treat Temporomandibular Disorder?

The symptoms of Temporomandibular Disorder do clear up on their own after a while in some patients, but should your TMD become chronic, you have some options. 

Simple treatments you're mostly able to work on without a doctor's help — so-called "conservative management" — include steering clear of chewing gum, trying not to open your mouth too widely under any circumstances, and relying on soft foods that do not need much chewing. Think soups and mashed potatoes. You can also try drinking through a straw. Ice packs, which should reduce the inflammation, and over-the-counter painkillers that also act as anti-inflammatories ("NSAIDs"; these include ibuprofen and naproxen) will also offer you short-term relief. 

Since high-stress levels are known to aggravate TMD, working on reducing your stress is a conservative management technique that is more likely to have a long-term effect. Whether this means combating the impact of existing stressors, through meditation, exercise, or even prayer if that works for you, or working on removing stressors, by looking for a job that suits you better, changing your college major, reducing contact with relatives that cause you stress is for you to work out. 

If conservative treatments do not work, your healthcare provider may suggest more aggressive solutions. Wearing a mouth guard at night prevents you from grinding your teeth and allows you to relax the affected muscles more easily. In extreme cases, surgery becomes an option. You will be reassessed to see whether your symptoms could instead be caused by another condition, like osteoarthritis, first, however. 

Are some TMD treatments incompatible with fibromyalgia treatment plans?

Temporomandibular Disorder treatments do not usually present a problem in relation to either your fibromyalgia or any medications and other treatments you are using for it. It is, however, possible that:

  • The use of ice packs will induce pain because you suffer from fibromyalgia
  • Surgery, which is already a last-resort option in people with TMD, will pose specific challenges for you, both in recovery and possibly in relation to the anesthesia you need for an operation

Keep in mind that fibromyalgia sufferers are less straightforward TMD patients than people who only have Temporomandibular Disorder. Not only will the cause of your TMD be harder to pinpoint, your condition will also be more challenging to manage, not least because you will experience the pain associated with Temporomandibular Disorder even more heavily than other patients. 

It is also important to note that medications virtually always come with dosage restrictions, contraindications (reasons for which you can't take them), and interactions with other medications. This is why any person with multiple medical conditions for which multiple medications are prescribed by different doctors should always either make sure that the doctors liaise with each other, or inform the other doctor about the medications they are about to start taking. A multidisciplinary team in which both or all of your healthcare providers are in touch and in consensus is best. This also applies to surgery for TMD!

Treatments that will offer symptom relief from both your conditions at once do exist. Research has shown, for instance, that meditation, restorative yoga, and breathing techniques (especially diaphragmatic breathing) help many fibromyalgia patients manage their pain better. There is no reason these techniques cannot also help you with your TMD-related pain. 

Temporomandibular Disorder and fibromyalgia both have a close relationship with stress, too. At best, stress makes the symptoms worse, and at worst, it can directly lead to the onset of both conditions. In addition to lifestyle changes that reduce stress, massage therapy and even psychotherapy can help you relieve some tension. 

Even some medications, namely those that boost your pain threshold by increasing your endorphin and serotonin levels, can simultaneously play a role in managing TMD and fibromyalgia. Finally, botox injections appear to be promising in combination with controlled jaw exercises. 

In conclusion, a dual diagnosis of Temporomandibular Disorder and fibromyalgia poses some special challenges. A good, multidisciplinary healthcare team and a patient like you — one who is willing to inform themselves and do whatever it takes to reduce symptoms — will ensure that those challenges are met in the most productive possible way. 

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