The human jaw is a very important part of human anatomy and within it, the mandible or the lower jaw is very important as it is the movable part which helps you chew and enables you to open or close the mouth. The lower jaw is connected to the skull via the TMJ or the Temporo-mandibular joint. It works like a hinge which slides as and when required to allow movement of the jaw. TMJ disorder can be quite painful and limit you from normal activities and cause disruptions in your daily life.
Causes of TMJ-
The TMJ works as a movable joint where the bone area in contact with each other is covered by cartilage and a small shock absorbing soft disk separates the two cartilages. The disk enables the movements to be smooth. Any changes in this arrangement will usually result in pain. The primary causes for TMJ disorders could be summed up as follows –
Misalignment – If the TMJ moves out of alignment due to underlying factors, it will cause pain and the inability to move the joint.
Erosion of the cartilage or the disk – If the cartilage or the disk separating them erodes, then TMJ disorders might occur.
Arthritis – Just as arthritis affects knees, wrists, elbows and finger joints, it could cause TMJ disorders as well.
Impact – One of the most common causes of TMJ disorders, this may occur due to injuries sustained from forceful impacts.
Pain or tenderness around the jaws.
You may experience pain on either or both sides of the temporo-mandibular joint.
Even if you don’t have pain in the specific joint, you may have an aching facial pain.
The most common and typical symptom of TMJ is of pain while chewing. Your pain may progressively get worse over time if you have a deteriorating condition.
Pain in and around the ears may also be a symptom of TMJ disorders.
Difficulty in opening or closing your jaw either due to stiffness, pain or both.
Treatments vary between various methods and approaches and the severity of the pain or condition and the underlying causes. Some of the options are:
Oral Medications – Pain killers, muscle relaxants and anti–inflammatory medications are usually prescribed to reduce pain while the jaw may be healing or for underlying causes that may result in pain.
Physical Therapies – This is another common method wherein the doctors may use a device to keep the jaw stiff or stop them from moving in a particular way in which it causes pain. Mouth guards or oral splints are such devices. Dislocation may have to be corrected by physical pressure and setting the bone back into the joint as well.
Surgery – In certain cases, surgery may also be required to correct chronic pain, especially wherein the underlying condition may keep causing problems. If you wish to discuss about any specific problem, you can consult a Dentist.
When is your pain chronic?
Your pain is chronic if it last for more than a period of six months. Chronic pain is a long-term pain whose nature can vary from mild to excruciating, and it may trouble you either continuously or at short and regular intervals. Chronic pain is so dangerous that it does not only cause discomfort and inconvenience but also robs you entirely of your capacity to work for a long time.
Chronic pain can occur in a number of organs of the human body like head, joints, back, shoulders, neck etc. In fact, pain in any part of your body can turn into chronic pain. Here are a few symptoms that can help you identify if what you are going through is, in fact, chronic pain:
- persistent and severe body pain
- burning sensation accompanied by the body pain
- fatigue and sleeplessness
- weak immune system
- stiff and sore joints
The 4 types of chronic pain disorders that you should be aware of are:
1. Nociceptive pain
The pain that affects the soft tissues of the body such as the skin and the muscles or the organs that have sensory nerves present in them is called nociceptive pain. The sensory nerves, known as nociceptors can detect the stimuli of pain and send information to the brain and the spinal cord for interpretation. The pain could be either somatic (originating in the outer body) or visceral (originating in the internal organs).
2. Neuropathic pain
Related Tip: Why does PAIN occur? Understand the Mechanism of Pain
Rekha is 32 years old, she has a succesful career, a lovable husband and two wonderful kids. She has a few helpful friends and a supportive family. She also got promoted at work 6 months ago. Yet for the past few months she has been finding it a little difficult to fall asleep at night, she dreads daybreak and wished she could sleep for a bit more time. She fights through the tiredness as everything she once enjoyed seems grey and non rewarding. She stopped following her favorite tv show and hasn’t been talking to her friends as much. She has been unable to focus on work and it takes her longer than usual to complete her tasks. The food she once loved seems drab and unappealing. There is no more color to festivals and functions, and smiling becomes an effort. She worried about the future and feels helpless as her life spirals down a eternal dark staircase.
Rekhas husband has noticed this and is supportive as he can be, telling her that she needs to snap out of whatever that she is going through. Not that she wouldnt want to snap out of it. People around her have been trying to cheer her up, suggesting everything that they feel would make her feel better! But no, the shadow of depression follows her around and makes her feel that her life is not worth living anymore.
What are the numbers ?
Depression is difficult, depression is dark and depression is dangerous. Studies have reported numbers ranging from 1 in 10 to 1 in 30. An article in the Indian express on feb 15,2016 was titled “with 36% of India depressed, we must end the taboo around mental health”
Depression was reported to be higher in females, in the age-group of 40-49 years and among those residing in urban metros. Equally high rates were reported among the elderly.Depression and suicides are closely linked, with upto 15% of depressed individuals attempting suicide. With around a lakh and 30000 people ending their lives by suicide every year, and atleast 10 times as much attempting suicide, this 15 percent starts looking like a very large number.
What causes depression
Contrary to popular belief, depression does not necessarily stem from a weakness in one's "mind" or from ones poor ability to cope with the stressors of life. This Depression like every other illness stems from complex interactions between biological, psychological and social factors. Like one cannot "think away" a fever, it is impossible to "think away" depression.
Genetic studies have demonstrated a concordance rate for mood disorders in identical twins of 70 to 90 percent. Implying a strong role of inherited factors in depressive illness. Alterations in hormonal regulation and sleep architecture can also lead to depression.
At the base of the illness there are abnormalities at the synaptic level in the neuronal networks in the pre-frontal cortex (a region in the brain). The pre-frontal cortex holds and processes information in regard to ones personality, memory, decision making, motivation and complex cognitive tasks. These processes are encoded in the form of synapses or interneuronal connections. The neurons communicate via electrochemical processes called neurotransmission. Current knowledge implicates a imbalance in serotonin, dopamine and noradrenaline (neurotransmitters) and or an abnormal number of their receptors in the synapses in causing depression. Most anti depressants increase serotonin concentrations at the synaptic level so as to improve mood and cognition.
Low levels of serotonin have also been observed in those who attempt suicide.
What are the symptoms of depression? How is it diagnosed ?
Symptoms of depression include persistent low mood, easy fatiguability and a lack of interest in things that were previously pleasurable. Physical symptoms such as changes in sleep patterns, changes in appetite and weight and decreased interest in sex may also occur. Further a loss of self confidence, undue feelings of guilt, emotional lability and thoughts about self harm are also common.
The safest thing to do, if one is experiencing such symtoms is to seek professional help.
The Psychiatrist or Psychologist will be able to make a diagnosis based of Criteria set forth by the world health organization. They may suggest laboratory investigations to rule out physical illnesses such as anemia and thyroid dysfunction that mimic depression and will offer appropriate treatment measures.
Depression tends to occur in episodes with each episode lasting from 6 months to two years with an average of 8 months. Untreated depression tends to leave behind residual symptoms that include fatigue, anhedonia, long lasting sleep disturbances, poor productivity and a propensity to recur. 60% of those who develop a depressive episode, develop another Thus earlier and effective treatment will improve prognosis and will decrease the long term morbidity.
Effective treatment strategies are available for the management of depression. Based on the severity of illness and the nature of symptoms, you health care provider may prescribe either behavioral changes, psychotherapy or biological therapy. You do not have to go at it alone. Help is available for all those who seek it !
Depression is nothing to be afraid of, and certainly nothing to be guilty or ashamed of. With the right intervention from qualified experts, depression can be managed effectively.
You can find a lot more information about mental health and mental illness at our stigma breaking.
More than 17 crores (14%) of Indian population needs mental health intervention. Still, one out of ten people utilizes the professional help for mental health problems. There is a huge gap between the services needed urgently and services available to reduce burden.
Other facts about mental health disorders:
Lack of awareness, Stigma, and Discrimination are the biggest hurdle against patients and families for seeking mental health care.
Some of the causes of nail disorders include the following:
· Infections such as paronychia warts and green nail syndrome
· Internal diseases such as certain lung diseases, which can cause yellow nail syndrome)
· Structural problems such as an ingrown toenail
· Birth deformities such as pachyonychia congenital
With aging, nails become dry and brittle and flat or concave instead of convex. They may develop ridges along their length. Nail color may change to yellow or gray. Brittle nails may split.
Toenails require special attention in older people and in people with diabetes or peripheral vascular disease. Such people may have poor sensation in their feet, which increases the risk of injury when they try to trim their nails.