The Treatment of Modern Western - Biblio.nhat-nam.ru

76TEMPOROMANDIBULAR JOINTSYNDROMETemporomandibular joint syndrome (TMJ) refers to pain inthe temporomandibular joint region with possible swelling,limited range of motion, muscle spasms, earaches, bruxism,facial asymmetry, clicking or popping noises, and, occasionally,tinnitus. Common causes of TMJ pain include blows tothe jaw, overstretching as a result of dental or surgical procedures,and excessive grinding or clenching of the teeth. Mostforms of arthritis can involve the TMJ, and the TMJ isinvolved in more than 50% of cases of rheumatoid arthritis.Up to 25 million Americans experience some form of TMJ,with women seemingly at greater risk.The current Western medical treatment of TMJ consists of acombination of dental and medical approaches. Theseinclude the use of anti-inflammatory drugs, a soft diet, hotcompresses, and intra-oral splints. Permanent dental correctionsand removable protheses may also be recommended.Surgical correction is necessary in 5-10% of patients. WhenTMJ is primarily related to muscular tension, biofeedbackand other stress management techniques may be recommended.CHINESE DISEASE CATEGORIZATION: Bruxism iscalled nie chi, gnashing of teeth, or nie he, clenching of teeth,while jaw pain is categorized as mian tong. Earaches are calleder tong, tinnitus is er ming, and facial swelling is mian fu.DISEASE CAUSES: External injury, external contraction ofwind evils, internal damage by the seven affects, habitualbodily vacuity, and wormsDISEASE MECHANISMS: If external wind cold or windheat evils invade the exterior and lodge in the channels andvessels of the face, the flow of qi and blood there will beinhibited. Because there is lack of free flow, there will bepain. Pain in the face is especially likely if wind evils combinewith phlegm internally engendered due to spleen vacuity. Inaddition, spleen vacuity is the root of defensive qi insecuritywhich allows external evils to invade. If, due to faulty diet,over-thinking, worry and anxiety, too little exercise, loss orconsumption of the blood due to menstruation, gestation, orlactation, or due to aging, the spleen becomes vacuous andweak, the spleen and lung qi may not move and transportfluids. Hence swelling in the face may occur. If the spleenfails to engender sufficient blood to nourish the sinews, thesinews may contract. In addition, blood may fail to motherthe qi, with blood vacuity internally engendering liver wind.Either of these causes may result in spasms and contraction.Further, emotional stress and upset may cause depressiveheat or fire. Because of the inter-relationships between theliver, stomach, and heart, depressive heat may manifest in theheart and/or stomach, especially if the stomach is hot due toover-eating hot, spicy, fatty foods or alcohol. Both the heartand stomach channels connect with the mouth. If this heatfollows the channels upward to the face, it may cause burningpain. Liver blood-kidney yin vacuity either due to aging,enduring disease, drug use, or excessive taxation and stirring,may fail to nourish the sea of marrow, thus giving rise to tinnitusand dizziness. In addition, liver blood vacuity failing toadequately nourish the sinews may lead to difficulty openingand closing the mouth. Blood stasis may be engenderedlocally due to any of several factors. These include qi vacuitynot stirring or propelling the blood, enduring qi stagnationdue to liver depression, or enduring lodgment of evil qi inthe channels and vessels of the face. Because spleen qi andliver depression typically go hand in hand, most cases ofTMJ have at their root a liver-spleen disharmony. This is alsoeasily complicated by food stagnation. Although it is possiblefor external injury to cause blood stasis locally in theregion of the face, this is not such a common cause of TMJin the Western patients who come for treatment by acupuncturistsand practitioners of Chinese medicine.