Ask Dr. Dennis

dr dennis steigerwaldOne of the confounding elements of temporomandibular disorder (TMD) is the wide variety of potentially debilitating symptoms produced. This is especially problematic because the temporomandibular joint (TMJ), while rich in proprioceptors, has no nociceptors (pain receptors) on it’s load bearing surfaces.

This means that a TMD patient can present to any doctor with any combination of the following symptoms (a partial list) with little or no reported jaw pain: headache, neck pain and stiffness, multiple forms of ear symptoms, upper shoulder muscle pain, upper quarter pain including arm and hand pain/paraesthesia, dizziness, phantom tooth pain, tinnitus and more.

The solutions to this diagnostic nightmare will be discussed on this blog. These solutions are covered in depth on and video demonstrations of diagnostic and treatment procedures are available in DVD form: TMD Training System.

This blog is set up to provide information about the symptoms, examination, diagnosis and treatment of TMD, answer questions such as the one below and to provide a forum for you to express your opinions and experiences (comment section on each page/post). All discussion is welcome.

This is an example of the type of TMD problem doctors frequently encounter:
Your patient’s predominant symptoms do NOT include jaw pain, clicking or locking but are specifically:
- Frequent, moderate to severe headaches
- Pain, muscle hypertonicity and stiffness in the neck which may or may not restrict head and neck movement
- Intermittent dizziness
1. How would you know if this patient had an inflamed TMJ that was producing these symptoms when the TMJ is NOT an area of complaint ?
2. Do you think that their inflamed TMJ would have to be on the same side as the pain and cervical muscle hypertonicity ?


Ask Dr. Dennis — 7 Comments

  1. Hello, Dennis.
    I saw Scott last week. He told me that you are still working and by this, I see
    that you REALLY are working!
    Congratulations on a great site!
    I’d love to chat when you have a minute. Please let me know when that might
    be and I will call you.

    Best regards,
    Sandra (Sandra Coulson)

  2. Hi Dennis, hope this finds Jackie and yourself well. Have been practicing in San Quintin, Mexico now for 2 1/2 years including numerous patients with TMJD. Thanks so much for your instructional expertise.

    TMJD here in Mx. is just as prevalent as it is in the USA, epidemic and totally beyond the ability of most practitioners, be they MD, DC, DO or DDS.

    I have treated a General Surgeon with the problem and he immediately referred his daughter, also another success story.

    Naturally many cases are extrinsic trauma, ie vehicular collisions but in Mx. intrinsic trauma is more prevalent, ie stress related bruxism. This is not dominated by an individuals economic status down here, as stress appears to have no boundaries or limitations.

    I have been able to relieve patients TMJD symptomatology in 3-5 visits for the most part. It is amazing how quickly patients achieve normalcy when they pay for their own professional fee’s.

    Therapeutic’s pertaining to Chiropractic treatment of TMJD is the future of chiropractic. I cannot get the DDS population to listen to me in Mx at this point. They have no clue even though I have handed them the info. They have no clue but patients are screaming in pain and I am getting incredible results.

    (Brian Bruck, DC)

  3. The chiropractic approaches to TMD vary from the simplistic, to the scary, to the scientific. Dr. Steigerwald’s approach, developed over decades of practice starting in the 1970’s, working hand in hand with dentists, oral surgeons and neuroligists, is still by far the brightest example of the later. Every chiropractor needs to understand TMD and there is no better way to do this then becoming familiar with Dr. Steigerwald’s work.


    John Maher, DC

  4. Dr Steigerwald is a legend in TMJ, who lives at ground zero for Lyme disease. The standard for testing for the bacteria causing Lyme (Borrelia Burgdorferi) came from Shelter Island. Possibly Dr Dennis’ yard!
    The TM joint has many characteristics, both in form and function, that make it unique in the human body, and understanding those unique properties can be the difference between misery and joy to the patient, AND their family.
    The Lyme spirochete can affect joints, and how the two interact is a black hole at this time. We need more clinical information, research, and sharing of ideas, and Dr Steigerwald is the man to make that happen.
    Mike D Maddox DC
    Austin TX

    • Dr.Maddox,
      Thanks for the kind words. We will soon have a Lyme section within the “Chronic Pain” section of the blog. That section will deal with many co-morbid conditions that confound TMD diagnosis. I would love to see you contibute with comments there as I know you have extensive experience personally and professionaly. Thanks again.
      Dr. Dennis

  5. I was impressed with your website and the doctors comments.I sawn you had a seminar tape on tmj. I have tmj and have been frustrated over the years treating it. Is muscle testing part of your analysis? I am afraid I could never get it to work. How esoteric a system is it? And how difficult to lear and time to apply. I work doing primary medical care so time is limited. Tim Callaghan

    • Dear Dr. Callaghan,
      Thanks for the kind words. This is an important topic and, as you probably know, TMD is NOT a dental disorder!
      Nothing esoteric and no muscle testing, just an intelligent interpretation of the findings from simple, standard tests. Once you learn what the findings mean the whole exam (except the case history) can be done in 5 minutes! I guarantee you will like and find useful the information in the DVD/workbook package (never had a return or complaint). You can order here:
      ps: Make sure to read the research paper pdf. on the website about headache, neck pain and TMD.
      All the best,

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