Hi Docs
Thanks for everything you do, it’s much appreciated.
I was hoping you could point me in the right direction.
Male. 50. 84kg 37" waist. Currently in Sydney Australia lockdown which limits my options somewhat.
I’ve been getting a minor catching in my left TMJ on and off for a little while. I might be talking or eating and I’d get a sudden pain then it was gone. Didn’t think too much of it, and didn’t worry. Thanks to BBM I’m quite familiar with the biopsychosocial model of pain so I generally don’t catastrophize, but also understand that sometimes pain is worth investigating.
29th June towards the end of dinner the pain suddenly came on and got progressively worse. Was too painful to bite down. Next morning trying to eat an apple was still far too painful. The pain would be an ache from the TMJ down the side of the jaw.
It was definitely not a tooth or gum related pain. No paresthesia.
The following 2 weeks pain settled a little but a mild ache persisted. Chewing was still painful to varying degrees, but always less than the first time. I’ve palpated everywhere I can around the inside and outside and nothing is painful to the touch or pressure. Unless eating, I can only reliably reproduce the pain (but to a lower level) when clenching my jaw shut.
15th July saw a dentist who took x-rays and checked some jaw movements. Told me he couldn’t see anything related to the pain. We discussed the possibility of bruxism and to the best of my knowledge I don’t grind my teeth at all (my partner does and wears a splint, but she has never noticed me doing so). Ended up with suggesting it’s probably a muscle strain and it can take a while to settle and if it’s not better in 1-2 months to make another appointment.
23rd July (today) during lunch chewing pain was almost as bad as initially. Got a phone consult with a local GP who suggested I try ibuprofen 400mg 3x/day, suggested an MRI, and also gave me a referral to an oral and maxillofacial surgeon.
I’m ok with the anti-inflammatory, but I feel that at this stage an MRI is probably unnecessary, and jumping to a surgeon might be skipping ahead a step or two (dozen!)
So far my approach has been to treat it like any other loading issue and avoid overworking the area, but also haven’t tried to avoid using the left side altogether. Since it hasn’t settled, I’m guessing I haven’t reduced loading enough.
Any general idea what my next steps should be?
Mostly I’m worried if there’s anything that’s not at all on my radar that needs to be ruled out.