Temporomandibular joint disorder (TMJ) causes pain or tenderness around the back of the jaw in the region of the joint. One in thirty Americans suffer with TMJ, it is somewhat more common in women than men. It is more common in people with fibromyalgia or chronic fatigue syndrome than it is in the general population.
Although the association of TMJ and fibromyalgia or chronic fatigue syndrome is clear, the cause or link is not known. When TMJ occurs first, it’s possible that the pain could contribute to the development of central sensitization – which is believed to be a key component of chronic ailments like fibromyalgia and chronic fatigue syndrome.
Treatment includes alleviation of local abnormalities with anti-inflammatory medications, dental interventions, physical therapy, and treatment of the central pain component (similar to phantom limb or CRPS) by amelioration of the abnormally disinhibited representation of pain. In our clinic that might include a treatment cycle with the combination of infused ketamine and concurrent transcranial magnetic stimulation (TMS).