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Forum Name: Rheumatology Topics

Question: Head pain...Fibro or DDD?


 4PtSake - Sat Jul 30, 2005 3:39 am

I am confused about jaw and face pain I have been experiencing and would appreciate any input or suggestions on what is most likely causing it and how to ease it. I was diagnosed years ago with fibromyalgia and more recently with advanced degenerative disc disease, stenosis and spondylosis...mostly in C5-6 area. Lately I have been having trouble with pain in the area of the TM joint and into the jaw (almost down to my chin) on the left side and it is usually accompanied by pain in my temple, ear, behind the eye, sometimes the sinus, and the base of my skull (sometimes extending down my neck and/or up the back of my head). It seems to be mostly on the left but occassionally it effects both sides more or less equally. There are times when Tylenol or Ibuprofin will help take the edge off (and sometimes a heat pack) and other times when it won't even touch it...even after 3 or 4 doses. It usually lasts a day or two then disappears for a week or two and comes back. It's beginning to drive me to distraction because I can't think or concentrate and when I bend over (which I do frequently at work) it only makes it worse. I've read that TMJ problems are common in people with fibro but it's only been a problem since my neck became symptomatic...about the last 7 months. Could it be a combination of both the fibro and the neck issues or is it most likely one or the other? Or none of the above?
Sincerely,
Aimee B.
 Jackie E. Pool, LPN - Sat Jul 30, 2005 6:52 pm

User avatar You maybe experiencing Myofascial Pain, common in patients with Fibromyalgia Syndrome.
The main feature of this condition is pain arising from a distinct portion of the muscle, which is called a trigger point. Stimulation of the trigger point by pressure or by stretching the muscle produces pain.Tthe pain may be felt in an area that is some distance from the trigger point. Myofascial pain may originate in muscles anywhere in the body, including the back, neck, extremities, head and face. Other symptoms of myofascial pain include intermittent numbness, muscle tightness, pins and needles sensations, tingling, or hypersensitivity.

Temporomandibular Joint Disorder, TMJ, This is one of the most commonly used joints in the body. (It moves every time you chew, talk or use your mouth at all.) The displacement creates a painful pressure and stretching of the associated sensory nerves. You might have TMJ if you feel like your jaw is locking or clicking, if you have a problem opening your mouth fully or if you have frequent headaches or pains in your neck.

As you can see, your pain may be caused from either of these disorders. You should make an appointment with your dentist to rule out TMJ.

There are some things you can do for pain while waiting to see your doctor/dentist.

Local cooling of the muscle to reduce pain, place ice pack at base of neck.Leave on 15 min. Off 15. If cooling does not work for you, try heating pad, 15 on and 15 off.

Gentle Range of Motion to all upper extremities. Roll neck gently from side to side
.
Continue to take the OTC pain meds.
 4PtSake - Sun Jul 31, 2005 1:35 pm

Thank you so much Nurse2 for the response and the information.

I actually have talked to my dentist about it and he didn't seem to think it was anything to worry about. I have had clicking on occassion, as well as feeling I can't open my mouth very wide, in the past but not so much with the recent onset of more extensive symptoms...so, from what you say, I'm assuming it's more likely MFP?! Unfornately, my neck problems became symptomatic due to a fall at work so dealing with the situation becomes rather complicated. I do have an appointment with my regular Dr. for a physical in a couple of weeks so I may ask him for his input too. If he thinks it's more likely to be connected to MFP after examination then I can contact workmans comp about getting someone in the system to see me. If he thinks it's more likely TMJ then I can call my dentist and talk to him again.

One additional question...could a trigger point in the area of the neck or shoulders also cause dizziness? Seems like when my head and face symptoms kick up I tend to get dizzy much more easily...not a good thing when you bend over a lot on the job.

Thanks again for the information and for your time...it's appreciated. Have a great week.
Aimee
 Jackie E. Pool, LPN - Sun Jul 31, 2005 10:55 pm

User avatar Here is a list of Fibromyalgia signs and symptoms. I thought they might be helpful to you.

. PAIN- in the muscle: often described as aching, burning, throbbing, gnawing, shooting, tingling.
Almost always exacerbated by exercise and may or may not be present at rest.
Can be migratory and differing from day to day.

2. FATIGUE- From feeling tired to exhausted and requiring rest periods during the day.

3. SLEEP DISTURBANCE- not being able to fall asleep and or able to stay asleep. Unrefreshing
sleep patterns " feels like I haven't slept."

4. PARESTHESIA- numbness or tingling. ( non dermatomal)

5. DEPRESSION- most often reactive as with chronic pain condition.

6. ANXIETY- may include panic attacks.

7. PERSONALITY CHANGES- usually a worsening of a previous tendency.

8. MOOD SWINGS

9. SUBJECTIVE SWELLING OF EXTREMITIES- i.e. feels swollen but no-one can find anything.

10. HEADACHES- tension and or migraine.

11. COGNITIVE FUNCTION PROBLEMS: calculation difficulties, memory disturbances, spatial
disorientation, difficulty with concentration, short
term memory loss.

12. FREQUENT UNUSUAL NIGHTMARES- or being unable to dream.

13. DYSTONIA- stiff muscles due to involuntary contracture. Difficulty in moving
tongue to speak.

14. FREQUENTLY SAYING WRONG WORDS

15. BURNING SENSATIONS

16. LIGHT HEADEDNESS- "Fibro Fog", spaced out, cloudy.

17. MORNING STIFFNESS

18. EASY BRUISING

19. MILD BUTTERFLY RASH- (LUPUS TYPE) May be photo sensitive.

20. NEUROGENIC INFLAMMATION- rashes, may be severe itching. NI causes the symptoms and
signs of Dermatographia.

21. DISEQUILIBRIUM- Vertigo

22. MUSCLE WEAKNESS- variable with no "objective" abnormality to formal testing.

23. SCIATICA- like pain

24. PHOTOPHOBIA- Intolerance of bright lights.

25. ALTERATION OF TASTE, SMELL and HEARING.

26. LOW FREQUENCY, SENSORINEURAL HEARING LOSS.

27. DECRESED PAINFUL SOUND THRESHOLD.

28. TINNITUS- ringing in the ears.

29. OCCASIONAL EXAGGERATED NYSTAGMUS- involuntary rapid movementof the eye ball.

30. CHANGES IN VISUAL ACUITY- impaired function of the smooth muscle used for focus as well
as skeletal muscles for tracking.

31. INTOLERANCE OF ALCOHOL

32. ENHANCEMENT OF MEDICATION SIDE EFFECTS

33. INTOLERANCE OF PREVIOUSLY TOLERATED MEDICATIONS

34. WEIGHT CHANGES- usually gained due to the lack of exercise through pain and or tricyclic
antidepressants

35. RESTLESS LEGS

36. HEIGHTENED AWARENESS- of symptoms of HYPOGLYCEMIA 9 when blood sugar falls)

37. POSSIBLE CARBOHYDRATE INTOLERANCE

38. SYMPTOMS OF IRRITABLE BOWEL SYNDROME (I.B.S.)

39. HEARTBURN- secondary to I.B.S.

40. SUB-NORMAL TEMPERATURE

41. NIGHT SWEATS.

42. SENSITIVE TO TEMPERATURE EXTREMES

43. HEART PALPITATIONS

44. BREATHING DIFFICULTIES

45. HEART MURMUR-Mitral Valve Prolapse appears to be more symptomatic in FM than normal.

46. IMPOTENCE- reactive and occasionally.

47. SEVERE PREMENSTRUAL SYNDROME

48. FREQUENT VAGINAL YEAST INFECTIONS.

49. MUSCLE SPASM- twitching.

50. NON-CARDIAC CHEST PAIN- which may simulate cardiac disorder.

51. PELVIC PAIN.

52. ABDOMINAL WALL PAIN.

53. DRY EYES AND MOUTH.

54. TEMPOROMANDIBULAR JOINT DISORDER- usually due to abnormal muscle tone.

55. RAYNAUD'S- like symptoms.

56. CARPAL TUNNEL SYNDROME-possible related condition.

57. HAIR LOSS-secondary to psychological stress from FM.

58. VULVODYNIA- Vulvar discomfort or pain, burning, stinging and irritation.

59. PLANTAR ARCH-or heel pain. Exacerbated in FM.

This list of symptoms has been correlated by the Arthritis Foundation S.A.
 4PtSake - Mon Aug 01, 2005 1:28 am

Nurse2,
Wow! I've seen lots of symptom lists related to FM but I think that is the most complete one and I can say I relate to so many of them. There are a few of the symptoms I have been experiencing for years but had no idea they might be related to the fibro. The Arthritis Foundation website has come up during some of my google searches and I've checked it out before but I must have missed the list somehow.
Thank you so much for your help, suggestions, and the information.
Have a wonderful and safe week.
Aimee

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