Stress and the response to it is a fact of life. It is a blessing in times of danger

and an aggravation when it isn’t controlled. Actually I don’t think stress can be controlled but the severity and length of our response to it can be. I have regular visits from patients who are sure they have an ear infection because of how badly their ear hurts. More women than men visit for this problem. The ear examination is often normal but the examination of their Temporomandibular Joint (TMJ) is not.

TMJ disorders are the second most common cause of facial pain after tooth aches. They were first recognized in the medical literature in 1934 and since then our understanding and knowledge of this problem has greatly expanded. There are multiple causes and as many treatments.

Usually the more minor TMJ muscle disorder is diagnosed. It does not require any significant therapy and usually lasts less than 2 weeks. The other more serious articular TMJ disorder is more difficult to diagnose and more long lasting in its discomfort and effects. You may want to ask the questions at the end of this article to your doctor if you need evaluation for this problem.

What does stress have to do with an ear ache?

Grinding, biting, clenching and chewing compulsively can lead to the muscular TMJ disorder. The patient as mentioned previously will often present to the office with “ear pain” but with normal hearing and no prior illness. Often they are not aware of their problem with stress until they discuss it with their doctor or dentist. If they are aware, they usually don’t connect their earache to their stress.

Where am I going with this discussion?

The stress response can be ameliorated by cognitive behavioral therapy. A change in eating as was discussed Monday, along with appropriate exercise for the fitness level, and a change in sleep routine all can help you to lessen the effect and response to stress.

How is it done?

O.K. First you have to be sure that all you have is the TMJ muscle disorder. Your doctor should be able to do that for you. Then you treat the physical problem with jaw rest, medication like ibuprofen can be helpful, so is ice or heat and massage. Sometimes you need a visit to the dentist for a guard that is usually worn at night but may be required all day. You have to quit gum for a while, chewy foods and chewing on things like pencils.

Then you need to address the issues that underlay the problem. There is a list of significant stressors that is on a page of my blog. You need to visit and look at that or one like it to help you think about the things that stress you. You might need a professional counselor for a while, or you could go to someone like me - a wellness coach.

What are you going to do for my stress?

Good question to ask someone like me. First I would need to collect some data. There are 4 pages for clients (not posts) listed on the right column of my blog. The last one is entitled Stress and Relaxation History .

Fill out that one and the ones above it and lets talk some. Because I have a medical background I am able to direct you into more medical care, counseling or stress reduction techniques. It usually takes an hour to review the historical information and then I study that and we talk again about ways to relax, and to decrease your response to stress.

Who has had stress-related pain and what were the results of your treatment? Has anyone used a wellness coach to help you with stress, behavior change or to improve any aspect of your health? Let me hear about your experiences. Look forward to your comments.

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