Dear Ask The Doctor: A few years ago someone elbowed the side of my face (accidentally he slipped) and every since then my ears both feel like they have a bone stuck inside underneath them (more right then left but left hurts more) and whenever i move my jaw it cracks and sometimes (very rarely) when im eating it feels like it cuts my ear and it hurts so bad i cant even move my mouth for hours. Is there any way to fix this?
Your description most likely corresponds to a Temporo Mandibular Disorder (TMD), or temporomandibular joint syndrome, this is the most common cause of facial pain after toothache. Temporomandibular disorder is a commonly seen condition in primary care and dentistry practice, as many as 75% of the people in the United States population will at some time have some of the signs and symptoms of TMD. Problems in this area can cause head and neck pain, a jaw that is locked in position or difficult to open, problems biting, and popping/cracking sounds when you bite. The causes are various: grinding the teeth (bruxism), clenching the jaw, punch to the jaw (like in your case), osteoarthritis or degenerative joint diseases, and other joint diseases. Most temporomandibular disorders (TMDs) are self-limiting and do not get worse. Simple treatment, involving self-care practices, rehabilitation aimed at eliminating muscle spasms, and restoring correct coordination, is all that is required. Nonsteroidal anti-inflammatory medications (NSAIDs) should be used on a short-term, regular basis and not on an as needed basis, eat soft food, apply warm compresses on the area of pain. Home therapy includes mandible (lower jaw) movements, such as opening and closing the jaw from side to side. Try this after a warm compress is applied for 20 minutes. The lower jaw movements should be repeated three to five times a day, five minutes continuously each time, for about two to four weeks. On the other hand, treatment of chronic TMD can be difficult and the condition is best managed by a team approach; a primary care physician, a dentist, a physiotherapist, a psychologist, a pharmacologist, and in small number of cases, a surgeon. The different modalities include patient education and self-care practices, medication, physical therapy, splints, psychological counseling, relaxation techniques, biofeedback, hypnotherapy, acupuncture, and arthrocentesis. Arthroscopic surgery is indicated in the following: internal derangements, adhesions, fibrosis, and degenerative joint diseases.