Expert: Dr. Kristina Conner - 6/13/2006

Question
For the past 6 months, I have been developing TMJ that has been getting progressively worse.  I know that it is stress related (work, moving, trying to get pregnant).  In addition to grinding my teeth at night (I do wear a nightguard now), I also find myself tensing my jaw during the day especially when I am concentrating on something at work.  As a result my jaw area is constantly sore and pops when I open my mouth wide.  My PCP has given me prescriptions for muscle relaxers and pain medicine, but I want to avoid taking drugs, especially since I am trying to get pregnant.  Do you have any recommendations?

Answer
Jen,
Thanks for your question.  TMJ is really a catch-all term for a variety of problems, but I can point you in a few directions that may help.  
First, your stress level needs to be addressed, by whatever means you can--life changes, stress management, counseling, exercise, or therapies like massage.  That's a recommendation for overall health as well as treating your TMJ, and having a healthy pregnancy.  I strongly encourage you to find ways to deal with your stress that is not harmful to the body.  
The night guard can help, but really doesn't stop the cause of the problem, so is only a stop-gap measure.  Since there is such a link between TMJ and chronic neck/ upper back pain, I suggest trying massage (whole body or self massage for the head, face and neck), chiropractic or other joint manipulation, stretching, therapeutic ultrasound, or any combination of these.  Make sure your desk is set up ergonmically so that does not make things worse.  Take frequent breaks to stretch, re focus your eyes, and un-tense during the day.  
Another thing to look at is your dental health; tooth decay or gum disease can cause inflammation in the area that can lead to or exacerbate symptoms of TMJ.  Replacing metal fillings sometimes helps, because this can be a constant irritation, too.   
Lots of water is important, while keeping caffeine drinks and alcohol to a minimum.  A whole foods diet is also supportive for the body under times of stress.  Finally, supplements that can help include magnesium ( a natural muscle relaxant, taken orally or in a bath of Epsom salts), valerian (for sleep and muscle relaxation), and passion flower, kava kava, lemon balm, and chamomile for relaxation.  Take one or a combination of these before bed helps relax your body and mind so you can sleep without clenching.  This will often relieve the pain during the day, also.  Magnesium and the herbs except valerian can be taken during the day, too.  B vitamins are depleted when you are under stress, and are also helpful for TMJ.  White willow bark, corydalis, and jamaican dogwood are all natural pain relievers.  Homeopathic remedies are often helpful, and are chosen according to your symptoms (stores that sell them will have a guide to choosing the right one).  
I hope that gives you some areas to start with and find some help.  Good luck in your search.  
Dr. Conner