Feldenkrais and TMJ: The Mayo Clinic Gets It Wrong.

About 30 minutes ago, I read a statement on the Mayo Clinic website that noted:

“Severe TMJ disorders may need to be treated with dental or surgical interventions.” (From: Mayo Clinic)

That’s a simple statement that few would take issue with. And it seems to meet the unconscious expectations that many of us have, such as “Long term pain in body means surgery may be necessary.” As I have written previously on this blog, there is a great deal of research to suggest that pain symptoms do not always have a structural cause and it has been demonstrated that many people with defined “causes” do not necessarily have pain symptoms (See: Think Your Pain Symptoms Are Caused By a Structural Problem?)

However, the Mayo Clinic’s assertions are somewhat shocking because in the case of TMJ problems, there isn’t any reliable evidence that surgery or dental implants work for TMJ pain. Research organizations such as the NIH have repeatedly stressed that there is little evidence supporting surgery. For example,

“There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery.” (From: NIH)

If you want more detail, I did a post about TMJ and Dental devices on my blog that promotes my Feldenkrais TMJ program. For those of you who do Feldenkrais-related work or are interested in doing so, using Feldenkrais for TMJ meets all of the suggested requirements put out by the NIH and NIDCR. Namely, that treatments should be

1) Conservative and reversible

2) Customized to a client’s special needs.

And treatments that can cause permanent changes in the bite or jaw should be avoided.

Even more to the point: “Simple self-care practices such as relaxation techniques, stress reduction, and biofeedback are often effective in easing TMJ symptoms.”




6 thoughts on “Feldenkrais and TMJ: The Mayo Clinic Gets It Wrong.

  1. John Quinn

    Ryan,

    Funny you should bring up this TMJ thang now. I had an steady ATM and FI client had to drop out this past summer due to her buying an house with her husband and two kids

    This must have been stressful for her and demanding of more work in their business. About a month ago she called me after this long summer and winter absence, complaining that she was having ‘Jaw problems’.. and requested some new FIs from me.

    In the first FI visit she ‘presented with an swollen left side of her face and jaw.

    TMJ cases often happen to People who grind their teeth at night when sleeping, To counter- act the teeth grinding most dentists will immediately prescribe an TOOTHGAURD to be worm in the mouth when sleeping . The Dental patients are told not to sleep without it. After having worn said Tooothgaurd for some time she had developed some severe pain in some upper left teeth and said pain radiated to her left ear, and her left face was markedly swollen.

    In the first meeting I did some general and pelvic FI work and then some very gentle face work ala Gindler, Feldenkrais, Berenger and myself.

    A week later we met again. She said that she felt better after the FI including her face, but she said her her face developed an soreness, later. This was alarming to me.

    After two more FIs weekly, with her face still being swollen and her tooth pain increasing so that she could hardly eat, I advised the client to see her general practitioner (MD) right away and ask him if there were some infection. Her dentist had såid he should see an TMJ specialist.:}}

    A week later she sent me the following note:

    Hi John-

    Hope this finds you well.

    I wanted to update you on how my jaw’s been feeling.

    Last week I saw an Ear, Nose, Throat Dr who said my ears were clear–so he recommended seeing an oral surgeon.

    I went to an oral surgeon, the head of oral surgery at (such and such big)sic
    Hospital, who did some tests (palpating muscles around jaw etc) and diagnosed classic TMJ Disorder. Tendinitis of the jaw muscles.

    I am supposed to wear my mouth guard at all times except eating (hard to do), eat only soft foods for 3 months, put warm compresses on my jaw 3x a day, and take an prescription strength Naproxen (Aleve), and a muscle relaxer at night. I have a follow up appointment a week from Friday. Not sure how long I can take the medication, but it does seem to help the pain.

    {I had asked her to keep me informed re this Medical Oral Surgical treatment.}

    This evening I received this note:…..

    No worries, John. I’m going for a follow-up appt next Friday, so will let you know how it goes.

    The medication is relieving some pain; I’m wearing the nightguard, and sleeping well as a result of taking the muscle relaxer.

    Hope to see you over the summer.

    {I guess some times we need an oral surgeon, as well as a hole in the head.}

    Certainly the pain must be treated, before anything else can be done.

    Perhaps when the pain goes away, better things can be done. I’m not stupid at face work neither. I have been doing it since the sixties (that’s the 1960’s), when I studied Gindler work. Maybe I’ll learn it to you sometime.

    I downloaded your materials too. Thanks. This TMJ stuff is a horrible affliction.

    I knew a lady once i the 911 trauma area, who used to wake up screaming from her Night Gaurd.

    This is an factual, confidential, report.
    best wishes,
    John Quinn

    (We would welcome further advise that FM practitioners and others might have re this matter and the TMJ syndrome.)

  2. Ryan Nagy

    Thanks John. I don’t think there is a shred of evidence that “tooth guard” work. They are one of those many “common sense” ideas based on a mechanical view of the body…that aren’t worth a damn.

    Anyway, thanks for keeping me posted. Testimonials are great. I sometimes forget how powerful the work is until a client reminds me by sending an email saying that they aren’t getting surgery because Feldenkrais “cured” them.

    cheers!!! – Ryan

  3. John Quinn

    Ryan,

    Actually, it is a pretty stupit idea that immobilizing the mouth at night during sleep time can curtail teeth grinding, admitably an serious problem, both physically and, you should excuse the expression, mentally. There are a lot of tough jaws in our society (and in others’?). From whence comes this twisted form of aggression, teeth grinding? Are we trying to chew ourselves to death?

    Of course, if the dentists and the oral surgeons and the TMJ specialists are all there to close the proverbial barn door a little too late, well there’s a lot of gold in them thar nightgaurds. And if infection and disfigurement and unbearable pain follow hard upon, well it keeps the industry going and pains must needs pills.

    It is the grinding must be caught at the pass. Of course some grinders don’t even know they are grinding. When I was studying Gindler and Stanislovski (the Method), avant de la deluge, we were interested in faces and visages, and we could spot hard jaws coming down de road.There’s the time for intervention.

    For who would fardels bear? The whips and scorns of time? The proud man’s contumely? The law’s delay?

    I don’t hear any sage Feldenkrais advise. Cats got your tongues? At least say # 23 or something. Is there some kind of boycott going on…the unkindest cut of all?

    Tch, tch, tch…

    John Quinn
    GCFP, BFL(T). SOUNDER SLEEP, AEA, SAG, AFTRA, QDE (Qualified Designated Entity, Ret.)

  4. nagster Post author

    Hi John – I don’t have much to say about specific ATMS (other than what is in my product) but I am exploring the idea of adding some more and I am digging into the Alexander Yanai series. I may post more ATM’s later.

    I am fascinated by the fact that I still habitually push my tongue into my teeth and that I am rarely aware of doing so. It seems to me – I think – that it contributes to some stress and discomfort in my mouth. I may need to invent or adapt some ATM’s to deal with it….

    cheers! – Ryan

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