Last night, my no-TV-month over, we finally watched The King’s Speech. (Yes, I even banned myself from watching DVDs and yes, we are always culturally behind since we’re  too cheap and/or lazy to go out and see a movie in a theater.) Anyway, the film made me think about the effects of holding words in.

The movie implied that the king’s stuttering was largely (entirely?) psychological, caused by childhood trauma. His first nanny’s cruel treatment and his parents’ lack of affection seemed the root causes of his inability to express himself. I don’t know if there’s any evidence to support that explanation, but I enjoy the poetic logic to it. I sometimes wonder if my jaw pain, similarly, comes from biting down to trap the thoughts that I’m afraid to say aloud (for me, the result of my own nature rather than a difficult childhood).

Before W moved in with me, for instance, I overlooked the neighbors’ kids and dog running amok and burning garbage in their backyard since I wanted to get along with them. Those are the kind of problems W likes to deal with head on and I like to ignore. When it comes to people I actually care about, I am terrible at admitting there might be an issue. This wouldn’t be a problem if I could let go of the affronts I don’t talk about, but instead I might just be clenching my jaw and doing further damage to my sore temporomandibular joint a.k.a. TMJ.

The specialist said that the popping I am feeling isn’t the usual inconsequential TMJ clicking noise, either. He said it’s the whole joint dislocating and then snapping back into place as I force my mouth open. Every time I open my mouth. Yuck. Meanwhile, he said, the other side showed evidence of arthritis. So if it were repressed thoughts causing all that damage, it’d behoove me to start spewing the difficult words.

Then again, the actual roots of my problem are probably more prosaic. TMJ is thought to be caused by a number of factors including injury, how the teeth fit together, teeth grinding, clenching, posture, and stress. My diagnosis isn’t so fascinating except that so many people suffer from TMJ pain that I thought I might as well bring it up here. I’m interested in how anxiety manifests itself in the body.

When I’m looking at a drop, deciding whether or not to throw myself in that churning rapid in my canoe or staring at my to-do list, I’m apparently strengthening the one part of me that really doesn’t need a workout. And anxiety and stress cause other physiological changes to the jaw joint, causing dysfunction and pain.

That’s kind of depressing, but also from my reading, there’s good news for most TMJ sufferers. More than 90% do not need surgery and are helped by these remedies for TMJ flare-ups:

  • avoiding chewing gum and eating hard or chewy foods (like bagels)
  • avoiding activities that require a lot of opening wide or otherwise stressing the joint. (My patient leaflet mentions excessive talking and kissing, but you can also use your imagination, here).
  • placing heat or ice (or alternating between the two) for 5-10 minutes on the joint. (Use a cloth to avoid burns from the cold or heat against your skin)
  • massaging your jaw muscles (a physical therapist may even go inside your mouth to work)
  • physical therapy to work on the not only the jaw muscles but also connected muscles. They may also give strengthening exercises, help with your posture, use ultrasound on the joint, or use other treatments.
  • relaxation techniques
  • bite plates (usually created by a dentist) to prevent grinding or change the bite to relieve pressure on the jaw

For me, many of these techniques have provided some degree of relief over the years. The specialist I was seeing prescribed all of these at once, as well as therapy for my anxiety, anti-inflammatory drugs and muscle relaxants. (I was already taking an anti-depressant and an anti-anxiety medication at the time). It was probably not a bad strategy, throwing everything at the problem that had been only getting worse over some 20 years.

Strangely, however, I felt that the bite plate was making my pain worse. The longer I had it in, the more my jaw hurt, and when I took the appliance out, the pain slightly improved. It seemed to me that the bite plate was making me clench more. The specialist said this was impossible and the problem was that I wasn’t seeing my therapist often enough. (Oh, TMJ specialist: if only some extra visits to a therapist would just make the anxiety *poof* disappear.) I got annoyed and stopping seeing him, especially since his office didn’t accept insurance so it was very expensive to feel not-listened-to.

And come to think of it, I never told that doctor off the way I wanted to. Maybe that would be therapeutic.

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