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Dr.Sumanth
Dr.Sumanth,
Category: Medical
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I'm looking for a diagnosis. I have been to several general

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I'm looking for a diagnosis. I have been to several general practitioners and I've been told a number of things, including; Muscle spasm, tmj, tmd and trigeminal neuralgia...all by different doctors.
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have been prescribed valume and diazapan with the intention of presenting the "spasm"
JA: Anything else in your medical history you think the Doctor should know?
Customer: I have had tonsilitis quite a bit in recent years. My glands are typically quite swollen, but otherwise, I'm 22 years of age, male and I train in the gym 6 days a week.
JA: Any recent injuries? How long have you been dealing with the swelling?
Customer: Spread and location of pain or twitch or visible muscle spasm?Gradual onset beginning in the marked point inferior to the mandible and anywhere between the digastric muscle, mylo-hyoideus and the stylo-hyoideus (between the anterior and posterior belly) and progressing down the sternocleidomastoid right across to the upper trapezius. Similarly, the pain begins at the epicenter (directly superior to the digastric tendon within the first 20 minutes) before progressing after 40 minutes to the "debilitation phase" (Can no longer speak, swallow and has effectively come to its most painful).Type of pain:
- Stabbing, spreading, constant
- However, after 4 hours of holding my chin in my hands while sitting in A&E in Bristol two years ago, I found that the pain had slightly subsided, until I'd eventually realized this and attempted speaking, only to relapse the "spasm".
-It doesn't feel like an electric shock, more like a stabbing or torn muscle. I don't explicitly recall any throbbing.
-Pain increased by yawning, chewing, clenching of teeth, movement of neck, head, and cannot move left arm above the head without significantly aggravating the area.
-No numbness. No pins and needles.Frequency:
- In five years, it's occurred four times, and with each time spanning longer and with more pain. Recovery has also been significantly longer with each consecutive occurrence.
- In between the events, I pay very close attention to the early signs of the spasm. It's difficult to describe but the because the pain is so gradual, if not paying attention to tenseness in the area, it can often go without realizing. Now, I experience all these little triggers, including twitching, tightness, sore if pressed/palpated firm enough and up until last Sunday, I would just sit there and breathe - praying it wouldn't go off.
Hello,

I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.

I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.

Thank you!
Customer: replied 12 days ago.
Please continue searching!

Hi...Welcome to Just Answer. I am Dr. Sumanth Amperayani and I am here to help you today. I have 15 years of experience in the field of Medicine at a tertiary care referral hospital. I will do my level best to alleviate your health concern. I am currently reviewing your question. I will be back in a moment to guide you further.

If you see a premium phone call request I suggest you ignore it - as the premium request of phone call was a system generated prompt and was not initiated by me. I would be glad to continue here please.

Kind regards - Dr. Sumanth Amperayani

Customer: replied 12 days ago.
Thank you!

Hello...I understand your concern.

Usually as a physician I take a lot of medical history before pointing out towards a diagnosis, but I am glad that you have given all possible necessary information please.

By what you say I feel that this is temporomandibular joint disorder.

 

Lock jaw is used for tetanus and we don't see this serious bacterial infection now a days.

 

Temporomandibular joint disorders are problems with the jaw joint and the muscles around it. The jaw joint, called the "temporomandibular joint," is located in front of the ear where the jawbone connects to your head. To feel the joint, place your finger on your cheek just in front of your ear and then open and close your mouth.

 

TMJ disorders can be caused by many problems, including arthritis. Sometimes TMJ is due to a combination of stress, jaw clenching, teeth grinding, and other things that strain the jaw joint and the muscles around it. Some people with TMJ also have anxiety, depression, or an increased awareness of pain.

 

The main symptom of TMJ is a dull pain on just 1 side of the face, near the ear. Sometimes the pain also affects the ear, jaw, or back of the neck. Some people have headaches with TMJ. The pain of TMJ is typically constant, but may come and go. It is usually worse with jaw movement. People with TMJ might hear a clicking or popping sound or have a "crunchy feeling" in the joint when they open and close their mouth.

 

Your doctor might order a special X-ray called a "panoramic radiography of the jaw." This can show the TMJ shape and bone structure, the teeth, and the sinuses. (Your sinuses are hollow areas in the bones of your face.) This test can look for other things that can cause jaw pain.

 

No single treatment for TMJ works for everyone. Most of the time, medicines and simple lifestyle changes can help. Most patients get better over time, even without treatment, so patience is important.

 

Treatment options include -

1. Self care and understanding of disorder.

2. Pain killer medications like NSAIDs.

3. Devices – These are called "bite plates" or "occlusal splints." They fit in your mouth and keep you from grinding your teeth at night.

 

I sincerely hope that I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen (this is the only way we professionals get credited for our time and professional effort). We can continue here until you are satisfied, simply use the reply box and let me know.

A bonus is highly appreciated....Thank you!".

If you are happy with my interaction and guidance, next time if you have any health concern, you can approach me directly at the following link please -

https://www.justanswer.com/medical/expert-drsumanth/?rpt=3800

Kind regards - Dr. Sumanth Amperayani

Customer: replied 12 days ago.
And the significantly painful spasms which are absolutely debilitating? Are you sure they're not nerve related? And, I've looked at TMJ and TMD but found that to be more associated with the jaw itself rather than the digastric area where the spasm usually occurs. Also, spasms typically just last a few minutes. This lasts for hours and takes days to recover from.
Customer: replied 12 days ago.
Also, I don't want to be relying NSAIDs and I'm trying to ultimately determine if it's a muscular issue as I'm aware the trigeminal nerve beaches to the same area. I wonder does having swollen glands have an effect. Specifically, the submandibular gland.
Customer: replied 12 days ago.
Didn't mean to request call

I have already requested you to ignore the system generated phone call request in my introductory statement itself please!

Customer: replied 12 days ago.
Yes, it was accidental.

Don't worry - I do not see any phone call request please.

Any inflammation in the region can cause the local regional lymph nodes to get inflamed please.

But your other symptoms including spam is again suggestive of TMJ please.
Dr.Sumanth,
Category: Medical
Satisfied Customers: 6801
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I am happy that my interaction was helpful for you. In future you can opt me as your favorite medical expert so that you can ask me a question directly. I will be happy to help anytime.
Kind regards - Dr Sumanth Amperayani