One of the challenges in managing TMJ is that it often comes with comorbid chronic pain conditions–like fibromyalgia–that magnify and diversify the symptoms related to TMJ. This can increase the suffering of people with TMJ, and make it harder to get improvements in quality of life with TMJ treatment.
With a better understanding of the link between these conditions, we may be able to design more comprehensive care approaches that give better results. One proposed link between the conditions is the presence of sensitization, which is currently not treatable.
What Is Sensitization?
We talked a little bit about sensitization as a reason why it’s important to get TMJ treatment early, but a brief summary here may be useful.
In sensitization, your body begins to experience sensations as more painful than they are. In extreme forms, even normal stimuli become painful.
Sensitization can occur in two different patterns. One pattern is peripheral sensitization, where the nerves in a particular location become sensitized. The other pattern is central sensitization, where your brain becomes sensitized to stimuli that it interprets as painful.
It has been proposed that central sensitization could explain the link between TMJ, fibromyalgia, irritable bowel syndrome (IBS), and other chronic pain conditions, though there are other explanations for this link.
What Is Fibromyalgia?
We often talk about the link between TMJ and fibromyalgia, but not everyone understands what fibromyalgia is.
Truthfully, no one really knows what it is, but here’s the best explanation available. Fibromyalgia is a chronic pain condition characterized by constant or recurrent musculoskeletal pain throughout the body. People with fibromyalgia also often experience fatigue, sleep problems, memory loss, and mood disorders.
Because the pain from fibromyalgia affects so many parts of the body, central sensitization is an attractive explanation, so it would make sense if we saw more of a tendency toward central sensitization among TMJ patients who also had fibromyalgia.
Sensitization Doesn’t Link TMJ, Fibromyalgia
Researchers tried to determine whether sensitization was more likely in people with both TMJ and fibromyalgia. They looked at the level of sensitization in 168 women (100 with TMJ only, 25 with TMJ and fibromyalgia, and 43 controls with neither condition).
Sensitization was tested using exposure to painful heat. When people have become sensitized, they tend to feel a lingering effect from painful stimuli. Measuring this lingering effect shows the degree of sensitization.
Although all women experienced pain at essentially the same level, women with TMJ experienced more lingering effects of pain. But women with TMJ and fibromyalgia didn’t experience any more lingering effects than those with TMJ-only.
So sensitization definitely seems to have an important role in TMJ, but it doesn’t seem to be a critical mechanism in the link between TMJ and fibromyalgia.
Does Sensitization Make TMJ Impossible to Treat?
Although sensitization can make it harder to get good results in treating TMJ, it is still possible to reduce or eliminate pain from TMJ. Sensitization causes the body to anticipate pain and magnify sensations into pain. By reducing sensations like muscle tension in your jaw, we can still significantly reduce discomfort from TMJ. And with a team approach to TMJ, we may achieve even more favorable results.