DIAGNOSIS:
Diagnosis of acute pain is easy and clear because a particular body part has gone wrong. However, the diagnosis of chronic pain and TMJ disorders are difficult because there is often a disconnect between the source of the pain and the pain experience. It is difficult to assess pain objectively, to adjust to the condition, and often times the best measure of chronic pain intensity is the patient's word.
Finding out the true source of pain is critically important and is the key factor for the treatment. Such, multiple diagnostic procedures are developed: medical-dental history, clinical examination, dental examination (intra-oral and extra-oral), occlusion analysis, jaw and neck range of motion, cranial nerve screening, skeletal morphology and posture evaluation, muscle palpation, bio-mechanical functional test, TM joint x-ray, MRI, electro-diagnostics (jaw joint vibration analysis, jaw tracking analysis), listening to the jaw joint sound, diagnostic splint, orthopedic jaw casts, diagnostic photograph, TMJ scale, diagnostic anesthetic block, etc.
However, even all these modern diagnostic procedures and observation, often times, do not necessarily provide doctors an accurate diagnostic information or clear treatment protocol. Often times, objective clinical assessment and evaluation of the relationship between pain/dysfunction and TMJ is very important. If the patient responds positively during assessment and evaluation session, it enables practitioners to create and implement a treatment protocol with confidence, and accept a successful treatment outcome. If you have an incorrect diagnosis and treat it accordingly, your pain and dysfunctions will not go away. Further, you very well may end up traveling from office to office in an attempt to find out causative factors and relieve the pain.
The following is one of a typical patient's experiences when dealing with TMJ disorders:
"I am a 45 year old female. I found your website while I was searching on google for some diagnosis for all my problems. I know I have TMJ as my jaw has been popping and clicking for as long as I can remember. I have been having headaches, neck pain, shoulder pain, arm pain, tingling in my arms and hands, teeth pain, etc. off and on for years. Every couple of years my neck will 'go out' and I will go to a chiropractor for a few weeks. I started going to a chiropractor last October for neck pain and headaches. This time I got worse instead of getting better. I started getting severe headaches, severe tingling in my arms and hands and twitching in my right hand. I was referred to an orthopaedic doctor. I have had several MRI's (brain, neck and lumbar). I have pinched nerves and bulging discs in my neck. I was referred to a neurologist because my doctor wanted to rule out MS. After testing by the neurologist, it was determined I didn't have MS and was turned back over to my orthopaedic doctor. He sent me to a pain specialist to get a steroid shot in my neck hoping it would relieve my headaches enough so I could go through physical therapy for my neck. We waited two weeks after the injection to see if it was going to help with my headaches. I did get some relief. Some days I didn't have a headache at all (which for me is extremely rare). I started physical therapy about 3 weeks ago. After the third session, I woke up the following day with the worst headache of my life that lasted for almost two days. I called my doctor and he discontinued physical therapy and decided it is time for me to go to an orthopaedic surgeon for another opinion. I have another appointment for another injection in another part of my neck. I told my doctor that I am ready for surgery if it will help ease my pain. I don't know how much more I can deal with. As I sit here typing this email, I have a fairly severe headache (I woke up with it this morning), my arms are tingling and my shoulders and neck hurt. Please send me any information you can.
Sincerely,"
Dr. Kim uniquely developed a simple on-site assessment and diagnostic program, which enabled him to identify the true source of pain and dysfunction objectively, and whether the symptoms are related with TMJ disorders, and whether the symptoms can be improved with treatment or not.