Ear and Jaw Discomfort: Possible TMJ Disorders

Q: Ear and Jaw Discomfort: Possible TMJ Disorders

Hello： If you have symptoms such as left joint tenderness due to malocclusion or misalignment, it may not be directly related to the ear symptoms you mentioned. <br>I recommend that you consult with the oral surgery department at a medical center for a detailed evaluation. <br>Wi

Discomfort near the temporomandibular joint and the ear?

Hello Doctor: About two to three months ago, I suddenly felt a significant discomfort in my left ear.
It wasn't pain, but more like a pressure and swelling sensation similar to having water in my ear.
Since it was a holiday, I went to a pharmacy and asked the pharmacist for some medication (he suggested it might be antibiotics/anti-inflammatory drugs).
After taking them for about four to five days without improvement, I began to feel tightness and dizziness extending to the left side of my neck and head, as well as a slight feeling of nasal congestion on the left side.
I then visited an ENT specialist at the hospital.
The doctor examined me and said there were no signs of inflammation in my ear or nasal cavity.
Hearing and ear pressure tests were also normal.
Since the discomfort was unilateral, he recommended that I see a neurologist.

The neurologist conducted an outpatient examination and ordered an EEG, which showed no abnormalities.
He suggested it might be temporomandibular joint (TMJ) inflammation and prescribed a week’s worth of muscle relaxants and pain relievers, advising that if there was no improvement, I could see a neurosurgeon.
After more than half a month with persistent symptoms, I consulted a neurosurgeon.
After an outpatient examination, the doctor stated that there were no issues with my neurological reflexes.
Since the discomfort was concentrated around my ear and neck, he recommended that I see an infectious disease specialist.
The infectious disease doctor performed a physical examination (to check for tumors) and said that everything looked and felt normal.
He advised me to monitor my body temperature.
I measured it several times at home, and it fluctuated between 37 to 37.6 degrees Celsius (oral temperature), which is slightly higher than usual but still within normal range.
During the outpatient visit, I also asked the doctor if it could be TMJ arthritis, but he confidently told me that if I could open my mouth, it was unlikely.
Currently, my symptoms are as follows:
1.
The left side of my ear and the area connecting to my neck feels very tight, and my left ear still has a sensation similar to having water in it.
Sometimes, especially when I feel particularly uncomfortable, I experience dizziness.
2.
I have no difficulty opening and closing my mouth, and there is no pain when I do so.
However, I feel weaker when chewing, and drinking through a straw causes pain in my left cheek.
3.
When I touch the area where my ear connects to my cheek (the joint that moves when I open and close my mouth), I feel significant pain on the left side, while I have to apply pressure on the right side to feel slight discomfort.
4.
According to my dental records, all my wisdom teeth have been extracted, so it shouldn't be an issue with wisdom tooth inflammation.
However, I had a root canal treatment on my right molar years ago, and I usually chew on the left side.
I also have some dental alignment issues.
Could these symptoms be caused by TMJ arthritis?
I have been uncomfortable for nearly three months and have seen several specialists without finding a cause, so I apologize for the lengthy description.
Thank you, Doctor, for taking the time to read this.

Miss Yang, 30~39 year old female. Ask Date: 2016/11/08

Dr. Lin Jiayong reply Dentistry

Hello: If you have symptoms such as left joint tenderness due to malocclusion or misalignment, it may not be directly related to the ear symptoms you mentioned.
I recommend that you consult with the oral surgery department at a medical center for a detailed evaluation.
Wishing you safety and good health.

Reply Date: 2016/11/08

More Info

Hello! Thank you for sharing your concerns regarding the discomfort you're experiencing in your left ear and jaw area. Based on your description, it seems that you may be dealing with a condition related to the temporomandibular joint (TMJ), which can often lead to symptoms that affect both the jaw and the ear.

TMJ disorders are quite common and can manifest in various ways, including pain, discomfort, and a sensation of fullness or pressure in the ear. The TMJ connects the jawbone to the skull and is located just in front of the ear. When there are issues with this joint, it can lead to referred pain in the ear, neck, and even the head. This is likely why you're experiencing a sensation similar to having water in your ear, as well as tightness in the neck and head.

Your symptoms, such as the feeling of pressure in the ear, tightness in the neck, and discomfort when chewing, align with common TMJ disorder presentations. The fact that you have tenderness in the area where the jaw connects to the skull further supports this possibility. Additionally, the history of using one side of your mouth more (due to previous dental work) can contribute to imbalances in jaw function, leading to increased strain on the TMJ.

It's also worth noting that TMJ disorders can be exacerbated by stress, teeth grinding (bruxism), or jaw clenching, which can occur unconsciously, especially during sleep. This can lead to muscle tension and inflammation around the joint, causing pain and discomfort.

Given that you've already consulted multiple specialists without a definitive diagnosis, it may be beneficial to focus on conservative management strategies for TMJ disorders. Here are some recommendations:
1. Physical Therapy: A physical therapist specializing in TMJ disorders can provide exercises to strengthen the jaw muscles and improve flexibility. They may also use modalities like ultrasound or heat to reduce inflammation.

2. Jaw Exercises: Gentle stretching and relaxation exercises for the jaw can help alleviate tension. Avoiding hard or chewy foods can also reduce strain on the joint.

3. Stress Management: Since stress can exacerbate TMJ symptoms, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

4. Dental Evaluation: A dentist specializing in TMJ disorders can assess your bite and jaw alignment. They may recommend a night guard to prevent teeth grinding or clenching during sleep.

5. Medication: Over-the-counter anti-inflammatory medications, such as ibuprofen, can help reduce pain and swelling. Muscle relaxants may also be prescribed for short-term relief.

6. Follow-Up: If symptoms persist despite conservative treatment, further evaluation by an oral and maxillofacial surgeon may be warranted to explore other treatment options, including injections or surgical interventions.

It's essential to continue communicating with your healthcare providers about your symptoms and any changes you experience. Keeping a symptom diary may help identify triggers and patterns that could be useful for your doctors.

In conclusion, while TMJ disorders can be complex and frustrating, many patients find relief through a combination of conservative treatments and lifestyle adjustments. I encourage you to pursue these options and remain proactive in your healthcare journey. If you have any further questions or concerns, please feel free to reach out. Wishing you the best in finding relief and improving your quality of life!

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