The TMJ and Upper Cervical Spine Connection
From a chat group
Wednesday, November 14, 2007 at 12:05 PM
Stacy, et al,
Thank you for your post. I think there may still be hope, if the upper cervical spine is contributory.
I don't know much about your history or cuent symptoms other than they are related to the TMJ.
One additional proimal contributor to TMJ symptoms can be inputs from the upper cervical spine. Within the spinal cord is what is called the cervico-trigeminal nucleus. You can do a literature search on that if interested. Basically, there are connections with the upper cervical nerves (#1, sometimes #2, and perhaps less common #3), and the nucleus (the part in the brainstem and spinal cord where the nerve originates) of the nerve that supplies the jaw, TMJ, etc.
It is my belief that one of the cervical nerves that may oftentimes be over-looked, is the 3rd one. A deep inquiry into anatomy reveals that it has a very vast supply to the neck and to deeper structures of the head and neck and it even joins the nerve supply to the TMJ (5th cranial nerve) superficially/peripherally (away from the spinal region). However, at first glance in some anatomy texts or charts that show nerve supply to the skin, appear to grossly under-represent its vast connections.
I believe that this 3rd spinal nerve is very much under-diagnosed and therefore undertreated.
My own TMJD resolved after more than 30 years when I got appropriate care for my cervical spine and I no longer have atypical facial pain.
When I asked for a cervical discogram, it was significantly helpful re diagnosis and the flurosopy that is part of a discogram was very helpful (more so than x-rays, Ct scan, MRI) in visualising the pathology. Unfortunately discograms are rarely used because they only give new information 17% of the time, and medicine is geared toward the majority not the minority, etc, etc.. Every diagnostic test, be it x-ray, CT, MRI, discogram, etc has something to offer (+) but has limitations (-). Diagnostic block can be very helpful in determining if the cervical nerve roots are involved. I am NOT suggesting that any of these diagnostic tests are appropriate for you or anyone else, but if not considered previously, an inquiry with a competent health care provider may be helpful in addressing the topic.
I hope that I did justice to introducing this topic and of course it does NOT apply to all with TMJD, yet does appear to be overlooked.
I could go on but will stop here.
Best Regards,
Jerry Hesch, MHS
Wednesday, November 14, 2007 at 12:05 PM
Stacy, et al,
Thank you for your post. I think there may still be hope, if the upper cervical spine is contributory.
I don't know much about your history or cuent symptoms other than they are related to the TMJ.
One additional proimal contributor to TMJ symptoms can be inputs from the upper cervical spine. Within the spinal cord is what is called the cervico-trigeminal nucleus. You can do a literature search on that if interested. Basically, there are connections with the upper cervical nerves (#1, sometimes #2, and perhaps less common #3), and the nucleus (the part in the brainstem and spinal cord where the nerve originates) of the nerve that supplies the jaw, TMJ, etc.
It is my belief that one of the cervical nerves that may oftentimes be over-looked, is the 3rd one. A deep inquiry into anatomy reveals that it has a very vast supply to the neck and to deeper structures of the head and neck and it even joins the nerve supply to the TMJ (5th cranial nerve) superficially/peripherally (away from the spinal region). However, at first glance in some anatomy texts or charts that show nerve supply to the skin, appear to grossly under-represent its vast connections.
I believe that this 3rd spinal nerve is very much under-diagnosed and therefore undertreated.
My own TMJD resolved after more than 30 years when I got appropriate care for my cervical spine and I no longer have atypical facial pain.
When I asked for a cervical discogram, it was significantly helpful re diagnosis and the flurosopy that is part of a discogram was very helpful (more so than x-rays, Ct scan, MRI) in visualising the pathology. Unfortunately discograms are rarely used because they only give new information 17% of the time, and medicine is geared toward the majority not the minority, etc, etc.. Every diagnostic test, be it x-ray, CT, MRI, discogram, etc has something to offer (+) but has limitations (-). Diagnostic block can be very helpful in determining if the cervical nerve roots are involved. I am NOT suggesting that any of these diagnostic tests are appropriate for you or anyone else, but if not considered previously, an inquiry with a competent health care provider may be helpful in addressing the topic.
I hope that I did justice to introducing this topic and of course it does NOT apply to all with TMJD, yet does appear to be overlooked.
I could go on but will stop here.
Best Regards,
Jerry Hesch, MHS
