By Cathleen Williams on Sunday, April 27, 2003 - 09:03 am:

Hi! I am hoping someone can help me. I have had popping in all my joints for several years. I am almost 30 now. I have also had popping in my TMJ for at least 8 years or so. I am currently seeking treatment for the TMJ disorder. I have some other symptoms associated with the TM joint. I went to my PCP to ask for a referral to a Rheumatologist, because of all the popping and the fact that my knees have started to ache a little. He said that most likely the popping was just my ligaments popping over the joint and was nothing to worry about. My TMJ specialist said that it sounds like I am hypermobile, but I have never dislocated anything and am not double jointed. When I move my joints certain ways, all of my joints pop. My back and neck do too. Sometimes when I walk one or the other of my hips will pop. Sometimes just a couple times, sometimes many times until I change my stride, stop walking, etc. I am wondering if I could truly be hypermobile, and if so, if this could be the cause of my TMJ problems? IF loose ligaments is the cause of my TMJ problems, can it even be "fixed" by a splint allowing the ligament to tighten back up, or will the ligament most likely just loosen back up again allowing the disc to slip back out? Any ideas?

Thanks for any help.

By starrdark on Thursday, May 01, 2003 - 05:45 pm:

Hello, Cathleen; what you're experiencing does not sound like hypermobility. It's likely you would have a history of dislocations, sprained ankles, etc., if you were hypermobile or had EDS. As to whether loose ligaments can be "fixed" by a splint, oh, how we all wish that were posible!

By Margareth S on Friday, May 02, 2003 - 08:28 am:

Does this popping hurt?

Margareth S

By Cathleen Williams on Friday, May 02, 2003 - 12:11 pm:

Hi Starrdark and Margareth,

Thank you both for replying. I had almost given up on a reply. First of all, the popping itself doesn't hurt. Sometimes my knees ache, but it doesn't really seem to be associated with the popping. Also, once in awhile when my hip is popping it aches for a minute. I do have aches in my back and recently have had a little trouble with what feels like my sciatic nerve once in awhile. As for the TMJD. I saw my TMJD dentist again and I apparently do have a lax ligament (or more than one) in that joint. When I open all the way, my ligament allows my condyle to come out of socket. He is going to start me on a neuromuscular splint (I have symptoms that he thinks are referred from the facial muscles), a soft food diet, and exercises to "strengthen the muscles that make it HARDER for me to open my mouth". I am not too optimistic about this tightening up the ligament, as I don't know if that is possible. I am praying, though. Also, I most likely have a displaced disc on at least the left side (as per all this popping and clicking). He also thinks I have some fibrous or scar tissue in the joint on the left side and inflammation. (From a test that listens to the joints.) He did mention prolotherapy as an option if this doesn't work for the ligament. I don't want to have to go that route if I don't have to. Do either of you have experience with Prolo?My muscular test showed that when I stand the facial muscles are working twice as hard as when I sit. He thinks there may be a postural/skeletal component to my problems. I am not sure which doctor to see about that, but am hoping to see someone while the splint therapy is underway.

All the noise in my joints makes both my PCP and the TMJD dentist think it is the ligaments they are hearing. If the ligaments are "popping" over the joints, doesn't that mean they are probably too loose, or not necessarily? What doctor is best to see for all this, an orthapedic surgeon, osteopath, or what? By the way, how are you both doing?

Thanks for all the help.

Cathleen

By Ian on Saturday, May 03, 2003 - 04:29 pm:

Cathleen

Much of what you write is associated with hyper mobility. This is typical "I saw my TMJD dentist again and I apparently do have a lax ligament (or more than one) in that joint" and this is why the joint has such movement. His suggestion about building up muscle strength will control the joint better and will not "tighten up the ligament" - the two are quite different.

"If the ligaments are "popping" over the joints, doesn't that mean they are probably too loose, or not necessarily?" - Yes, this usually goes with "loose joints" but I am confused because you state that you are not "double jointed" and do not suffer uncontrolled dislocations except for the jaw joint.

By Cathleen Williams on Sunday, May 04, 2003 - 11:00 am:

Ian,

I don't understand it much myself. I have a popping in all my joints. Sometimes with bending them, turning them, etc. My hips sometimes pop when I walk, but none of my joints seems to dislocate. At least, I don't think so. I would guess that I would know. I wouldn't even know I had a problem at all if it wasn't for the popping. I have, however, recently started to have some aching in my knees-and my back, etc aches at times. My PCP thinks that problem in my knees is a little scar tissue on the cartilage under the kneecap. This is certainly a possibility, but sometimes it hurts in areas that are not anywhere near my kneecap. I am hoping to get a referral to an orthopedic surgeon or an osteopath soon. I am not too sure he will give me one, however, since I have already seen him for this once. He said the ligaments popping over the joints was not a problem. As for the jaw joint, I didn't realize it was hyperextending at all. I haven't actually dislocated it, as in it getting stuck, and I pray that will never happen. I only found out about this when the dentist did x-rays of the jaw joints. Would you recommend Prolotherapy for strengthening and tightening ligaments? I am hoping I won't need it, but am not sure.

Thanks for the help.

By Az on Monday, May 05, 2003 - 05:52 pm:

Hi was just wondering who says you are not double jointed you or a specialist? I only ask because until I was diagnosed with HMS I would of said the only joint of mine that was double jointed was my thumbs as I didnt realise how hyper extended the rest of my body was because this was normal to me. Also a friend of mine has Marfans and the only body part of his that seem to hyperextend are his spine and arms and he would never claim to be hypermobile, he thought he was just very flexible. Anyway just a thought
Az

By Cathleen Williams on Tuesday, May 06, 2003 - 06:10 am:

Az,

You bring up a good point. I am the one who thinks I am not double-jointed. A doctor has never told me I was, but has never really looked for it either. I guess I always assumed someone who was double-jointed could "pop" out of the joint and all those other "tricks". I have never been able to do that. I would like to see a doctor about this and the overall alignment of my skeleton/posture. I don't look like I have a problem (with the posture, etc.), but I would like to be sure. The trick is trying to get my PCP to refer me to anyone. If I could get a referral, what type of Dr. should I see for the lax ligaments and the postural/skeletal alignment? Thanks.

Cathleen

By Ian on Tuesday, May 06, 2003 - 05:58 pm:

Hello Cathleen

About the dislocation thing! When a person has hyper mobility of the joints then they can get much greater angular movement from the joints because of "stretchy" ligaments. Normally, the surrounding muscles will stop unintentional dislocation but if the muscles have inadequate tone then unintentional dislocation can occur. Often, in this case, the muscles go into spasm and tighten up and it is difficult to get the joint to reseat properly.

It could very easily be that your jaw is at the stage where it dislocates and pops back without the muscle spasm because this is common to you.

On the sports field someone may get carried off because the shoulder has dislocated but if you go to a contortionist performance the girl will often dislocate her shoulder and pop it back into the socket without pain or problems. The shoulder, because of the shape of the joint is very easy to do controlled dislocations. And when the joint reseats it does so with a distinct popping sound.

Ian (mercedes_nz@yahoo.com)

By Az on Tuesday, May 06, 2003 - 11:21 pm:

Cathleen you would be best getting a refferal to see a rhumatologist for diagnosis. I am the same age as yourself and I didnt have subluxions until after a failed pregnancy (subluxion Caused from relaxin hormone) but none were real servere until 10 months ago and now I sublux at the drop of a hat. For realignment of your skeleton I would suggest seeing a chiropractor. You will be best seeing if you have HMS before visiting a chiro as you should need to be treated in a different manner to someone without HMS.
Good luck
Az

By Cathleen on Wednesday, May 07, 2003 - 12:37 pm:

Ian and Az,

Thank you both so much for the information. I appreciate the insight and the advice. Part of the treatment for my TMJ problem is going to be working the muscles that make it "harder" to open my mouth. My dentist says that certain exercises will hopefully keep those muscles strong and keep me from dislocating. I just got my splint today (for my bottom teeth) and am hopeful that I will eventually get relief from some of the TMJD symptoms I have. I'm keeping my fingers crossed. Do either of you have an opinion on osteopaths? My dentist says that osteopaths, in his opinion, would be best qualified to diagnose a possible skeletal problem. He had told me before, though, that a Rheumatologist would be best to diagnose the lax ligaments.

Thanks so much for your help. I hope you are both doing well.

Cathleen

By Az on Wednesday, May 07, 2003 - 11:47 pm:

All I can say is you get good doctors and bad, but if you go to either specialist your G.P should of forwarded a letter saying what he suspects (Hopefully he does) and this should be what the specialist looks for to either diagnose or rule out. I was wondering about the problem you are having with your TMJ have you had your wisdom teeth removed yet? My jaws stopped subluxing as often when I had mine removed.
Az

By Cathleen on Thursday, May 08, 2003 - 10:08 am:

Az,

No, I still have my wisdom teeth and have been told they don't need to come out unless they get decayed or cause me problems. That is interesting that yours got better. I don't seem to have a problem unless I open too wide and luckily I haven't ever gotten locked. Infact, I never knew I was opening too far. How does it help the ligament to not have your wisdom teeth? Also, I have heard of people getting TMJD AFTER having their wisdom teeth out, so I am a little wary of that.

Thanks,
Cathleen

By Az on Friday, May 09, 2003 - 12:19 am:

I would think after having all four wisdom teeth out there is enough room in the mouth and the wisdom teeth arent crammed in pushing your jaws out of place. I did however have to have mine removed as two were lying flat and one slanted this also caused my teeth to start pushing too close together as well as the jaw subluxing. If you do ever decide to have yours removed do NOT have them all removed at the same time. Learn from this idiots mistake that you cannot eat with holes in each side of your gums *Sigh*

By Cathleen on Friday, May 09, 2003 - 10:25 am:

Az,

Thanks. It would be hard to convince the surgeon to just do two at a time, I guess. Personally, I would think the less number of times they have to force your jaw open the better. However, I can also see having your jaw open a long time being a problem. All my teeth fit so I am not sure if that would help me. I am so glad it has helped you, though. Thanks. How is your jaw now?

Cathleen

By Az on Friday, May 09, 2003 - 11:45 pm:

Well if your wisdom teeth arent causing the problem then you are right having them removed will cause more problems that it solves. My jaw hurts like hell, but thats because Im a tooth gritter and grinder. It not only hurts the jaw, it causes nasty migraines and tooth ache, but I havent been able to find a way to stop doing it. I even had a guard made for my lower teeth, but I couldnt get on with it. So im stuck with this annoying habit.
Az

By Cathleen on Saturday, May 10, 2003 - 08:23 am:

Az,

Sorry to hear about your jaw. I am trying a splint now and have noticed myself clenching on it at night. I never noticed myself clenching before. I guess I did at some point, though. I don't know if this splint is going to help. Since I have been wearing it, I have been getting a little popping in the RIGHT joint when I chew soft food and sometimes a little pop when I close. This really bothers me, because up until now all my popping has been in my LEFT joint only. The doctor says everything is fine, but it bothers me. Hopefully, I am not pulling the disc out on that side as well. Unfortunately, I don't get to see him for almost 2 more weeks. I just pray I am not making myself worse. Do you know if your TMJ troubles are just muscular, or if there is any internal derangement going on?

Hope you feel better,
Cathleen

By Az on Saturday, May 10, 2003 - 10:27 pm:

Lol me internally deranged???? oh yeah but thats not what you asked was it? I dont know whats going on with my jaw and Im not going to my dentists unless I really have to cos they dont have an alternative to local anestetic (SP) and im not in the mood for more pain, besides I hate having to sit there with my mouth open wide and my jaws aching. Its just something im tolerating like the HMS and athralgia.
As for your right side jaw popping is it just popping or does it hurt? its quiet natural for joints to pop its only if it hurts its a problem. With you having trouble with your left side you will of been using the right more so this is most likely why its aching now. Same if you had twisted your left ankle you would of been putting more pressure on the right side to take the weight off the right ankle thus causing the origional unaffected part extra stress. Just keep having your TMJ checked regular.
Az

By Cathleen on Sunday, May 11, 2003 - 09:10 am:

Az,

Thanks again for the reply. None of my popping has ever hurt--in and of itself. It is the symptoms supposedly referred from the muscles that are giving me trouble. However, the popping/clunking seems to be a sign of displacement of the disc on my left side. My concern is that we thought my right side was fine, as I had no popping and can open all the way. Now, with the splint, it is popping some and I DON'T LIKE IT!!!

The internal derangement joke was cute!! I know what you mean about not wanting anymore dental work, the idea isn't appealing to me, either. I have also noticed I almost feel "bruised" when I touch the TMJ on the right side. At least it is right in front of my ear. I don't know. I will just wait until I see my specialist again, but I hope I don't have more problems before then.

I hope you are doing better.

Thanks again.