Temporomandibular joint (TMJ) dysfunction disorder
Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.
The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.
TMJ disorder has three types:
- Pain or discomfort in the muscles controlling the TMJ.
- Dislocation or injury to the jawbone.
- Arthritis of the TMJ.
Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.
Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.
Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck
Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw
Urgency: Primary care doctor
Pseudotumor cerebri, also called 'idiopathic intracranial hypertension' is a condition caused by pressure building inside the skull. The exact cause of this increase in pressure is often unknown. Symptoms include headaches, pain behind the eyes and changes in vision.
You should visit your primary care physician within the next 2 days to confirm a diagnosis and discuss treatment options for managing symptoms.
Myofascial pain syndrome
Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.
The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.
This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.
Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.
Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.
Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.
Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.
Meniere's disease is a disorder of the inner ear that affects balance and hearing.
Meniere's disease is due to an abnormality in the inner ear that results in low levels of fluid, thus interfering with the sense of balance. The abnormality may be hereditary or it could be from allergies, autoimmune disease, or other illness.
Symptoms usually affect only one ear and include severe attacks of vertigo, or the sensation of spinning; tinnitus, or ringing in the ear; pressure inside the ear; and increasing deafness. These symptoms are unpredictable and can come and go without warning.
Meniere's disease is progressive and will not go away on its own. It can lead to a severe loss of hearing and balance, and so a medical provider should be seen at the earliest symptoms.
Diagnosis is made through patient history; physical examination; hearing tests; and balance tests.
There is no cure for Meniere's disease, but it can be treated with motion sickness and anti-nausea medicines, hearing aids, and occasionally surgery.
Top Symptoms: nausea, ringing in the ears, vertigo (extreme dizziness), ear fullness/pressure, brief fainting episode
Symptoms that always occur with meniere's disease: dizziness: at least 2 episodes
Urgency: Primary care doctor
Iron deficiency anemia
Iron deficiency anemia means that the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.
The condition is caused by:
- Acute blood loss through injury, surgery, or childbirth.
- Chronic blood loss through an ulcer, overuse of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs,) or heavy menstrual periods.
- Inability to absorb dietary iron due to intestinal surgery or disease, or interference from certain medications.
- A diet low in iron-supplying foods.
Symptoms include fatigue, shortness of breath, lack of endurance, and chest pain with rapid and irregular heartbeat.
If not treated, iron deficiency anemia can lead to heart disease because the heart has to pump extra blood to get enough oxygen to the tissues. Developmental problems in children can also occur.
Diagnosis is made through physical examination and blood tests.
Treatment includes a diet higher in iron-rich foods, such as red meat and dark green leafy vegetables, along with iron supplements. Severe cases may require hospitalization for blood transfusion and/or intravenous iron therapy.
Inner ear infection (labyrinthitis)
An inner ear infection, also called labyrinthitis, affects the delicate bony structures deep within the ear.
Labyrinthitis usually follows a viral infection such as the common cold, influenza, mumps, or the measles. In rare cases, usually in young children, it can be caused by bacteria.
Risk factors include a middle ear infection; meningitis; or any autoimmune disorder.
Symptoms include vertigo, where the person feels that the world is spinning around them; nausea and vomiting; some loss of hearing; ear pain, sometimes with drainage from the ear canal; and ringing in the ears (tinnitus.)
Viral symptoms may at least partially resolve on their own, but treatment can rule out a more serious condition as well as address the pain and discomfort. Bacterial labyrinthitis is often more serious and can cause permanent hearing loss.
Diagnosis is made through patient history, physical examination, and sometimes a hearing test.
Treatment for viral labyrinthitis includes rest, fluids, and over-the-counter pain relievers. Antibiotics will be prescribed for bacterial labyrinthitis.
Hypertensive crisis, also called malignant hypertension, means there has been a sudden increase in blood pressure to dangerously high levels. Any reading higher than 180/120 is enough to cause serious health problems.
High blood pressure, or hypertension, can be due to stress, poor diet, lack of exercise, obesity, sleep apnea, or use of illegal drugs. Untreated hypertension can lead to a hypertensive crisis.
Symptoms of dangerously high blood pressure can include chest pain, severe headache, blurred vision, nausea and vomiting, shortness of breath, and blacking out.
Blood pressure at these high readings, with these symptoms, can damage blood vessels and cause a stroke. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and blood pressure measurement.
Treatment involves oral medication to reduce the blood pressure. Hospitalization is usually not required unless the medication is not effective, in which case intravenous medicine will be used.
The best prevention involves proper use of blood pressure medication along with lifestyle changes to reduce stress and improve physical fitness.
Ear wax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum, which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside. Ear wax buildup has nothing to do with poor hygiene, and it is not possible to prevent a build-up by washing.
You should go to a retail clinic to be treated. You should NOT try removing the wax with cotton swabs, because you run the risk of pushing the ear wax further into the ear canal, and potentially damaging the ear canal or eardrum. A variety of ear drops exist that can be bought at the pharmacy, such as Debrox, Murine, and Cerumenex. You may also use other remedies such as mineral oil, baby oil, or glycerin ear drops instead of brand-name drops.
Top Symptoms: dizziness, dry cough, ear canal pain, ear fullness/pressure, ringing in the ears
Symptoms that never occur with earwax blockage: swollen ear, fever
Urgency: Phone call or in-person visit
Cholesteatoma (a non-cancerous growth in the ear)
Cholesteatoma is a type of skin growth located in the ear, behind the eardrum. While it can be present from birth, it is usually caused by an ear infection. Symptoms include dizziness, hearing loss and pressure in the affected ear, and discharge from the affected ear.
You should consider visiting a medical professional in the next week or two to discuss your symptoms. Cholesteatoma can be evaluated with a review of your symptoms and an ear exam. Imaging such as a CT scan may be performed to rule out other conditions. Once diagnosed, it can be treated with ear cleaning, antibiotics, and eardrops. Surgery to remove the growth may be needed in some cases.
Top Symptoms: ear fullness/pressure, ringing in the ears, pain in one ear canal, vertigo (extreme dizziness), hearing loss in one ear
Urgency: Primary care doctor
Carotid artery dissection
A carotid artery dissection is the tearing of the walls of the carotid arteries, which deliver blood to the brain from the aorta. This is a medical emergency.
Call 911 immediately. Diagnosis is done by CT or MRI, and treatment involves anti-clotting medication for at least 3-6 months. Surgery may be necessary for those who can't get this medication.