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Tinnitus, Facial Pain, TMD, donald tanebaum, tinnitius doctor

Tinnitus, Facial Pain and TMD – Are They Related?

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: October 17, 2013

It is not uncommon to see patients that present with facial or jaw pains that are not associated with disease, injury or illness of any type. These patients, typically women between the age of 18-55, relate that their pains came on without specific events, emerging spontaneously upon awakening one morning after a fatiguing day or associated with a routine meal, for example. As all medical and dental investigations are unrevealing, answers are searched for and often prompt comments like “there is nothing wrong.”

Over the course of the last several years I have also seen numerous patients present with the same historical account, but instead of suffering with pain they complain of debilitating ear ringing, humming, buzzing and whooshing sounds. For these patients the onset of their ear complaints (often lumped under the term tinnitus) also started for no good reason and prompted multiple tests which were all normal.

So what is going on with these two patient groups that are plagued with symptoms that have no specific origin. How to ease their suffering? From my perspective, the pain and ear noises (tinnitus) represent a specific type of sensory disorder that typically occurs after prolonged periods of challenging life circumstances and emotional distress. In short, these patients consistently relate that they have lost control over their daily existence. As a result, the human brain is upset, and an upset human brain loses its ability to regulate nerve function, muscle tone, heart and breathing rates, and hormonal regulation. The end result is something called sensitization…when normal stimuli are perceived by the brain as noxious (like putting a shirt on after a sunburn).

For the patient with tinnitus, I believe that everyday normal sounds are interpreted as noxious and patients describe their symptoms with variable choices of language, such as humming, ringing, buzzing, hissing, whooshing, and “fullness.” For the patient with facial pain any type of superficial stimulation (a hug, chewing, yawning, or speaking too much) prompts the sensation and experience of pain.

The good news is that with time (months or years) the majority of these patients improve (at times the relief occurs for “no good reason” the same way the symptoms emerged. The key is for these patients to avoid unnecessary and unproven treatments, particularly if surgical explorations are involved. The most useful treatments involve strategies to quiet the mind and body. Programs like the Stop and Breathe Program advocated by Susan Ginsberg have provided relief for patients along with Transcendental Meditation, Biofeedback, Autogenic Training, and Progressive Muscle Relaxation to name just a few. The use of medications like Clonazepam and/or supplements can also be found to be helpful. And, periodic assessments with pain doctors and audiologists are always advised.


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