TMJ Pain Without Internal Derangement/DJD
Most TMJ pain is associated with either a displacement of the disk in the joint referred to as internal derangement or as a form of arthritis referred to as degenerative joint disease. However, there are circumstances in which the pain is localized to the TMJ without evidence of myofacial pain syndrome, internal derangement, or degenerative joint disease. The particular patients are likely progressing toward ID or DJD but are not yet there. It is important to make this distinction in order to create a proper treatment plan. In such circumstances the priority is to identify any precipitating factors which may be rectified before the process progresses to ID or DJD. In addition, conservative treatment modalities can be utilized as well as careful observation to identify any progression and intervene to prevent further damage if possible.
It is important to make this distinction rather than make the common mistake of lumping these patients into the myofacial pain syndrome (MPS) category. As MPS is a very different process, it is likely that treatments directed at MPS would be ineffective. In addition, if a MPS diagnosis is established, the practitioner will not be monitoring the patient for progression into ID or DJD. This diagnostic subtleties reinforce our centers dedication to making an accurate diagnosis.