What is it that I do in treating TM Disorder?

I use two “state of the art” protocols (Eastern and western medicine) in treatment of Muscle –nerve disorder of head and neck.

To start with, muscle spasms of head, neck muscles, including the trapezius muscle located as low as mid-back area; along with one’s habit of tooth grinding and/or clenching of teeth cause the following symptoms to occur:

Tension headache, migraine, neck pain, jaw pain, sinusitis (clogged nose), throat disorder, deep pain behind eye, dizziness, ear sensitivity, ear ringing, Numbness, or tingling of the fingers, and other symptoms involving stress and tension of upper body.

I combine medical acutherapy technology (protocol #1) and the latest dental orthotic technology (protocol #2) in most cases to successfully treat disorder by removing or reducing these symptoms via relieving muscle tightness, relieving pressure on nerves and arteries, and increasing blood flow to muscles and joint areas.

This unique treatment is safe, non-invasive, painless, and completely drug free. The only contra-indication for protocol #1 is if you have a pace maker inserted.

I find that the symptom most complained about is the recurrence of tension headache and migraine (not to negate the severity of other symptoms of course). For the migraine headache, over the counter drugs relieve the pain temporarily. Pain surfaces again and again, however, because drugs work to relieve the symptoms, but fail to solve the cause of the headache.

In order for the treatment for tension headache, migraine, or neck pain with limited range of motion, or any of the symptoms mentioned to be be successful, grinding or clenching dysfunction must be addressed by the placement of a muscle-nerve orthotic (NTI appliance).

This unique treatment, a combination of the latest medical technology of combining electrical acutherapy and the dental orthotic technology, works to solve this problem.

The “first” protocol I use in treatment of TMD:

ETPS Neuromechanical therapy, a unique hybrid therapy combining the best of osteopathy, acupuncture, and trigger point therapy and myofascial release

HOW DOES ETPS WORK?

ETPS starts with an overall structural / mechanical body analysis looking for areas of nerve impingement, trigger point locations and acupuncture sites. All these sites are then integrated into protocols in order to reduce the impingement and relieve the pain.

The “trigger point” refers to a hyperirritable spot in muscle which manifests as a nodule (knot), which is painful on compression, and which can give rise to characteristic referred pain to other areas of the body. The original trigger point location, or “the primary trigger point”, relays pain to remote areas, or “satellite trigger points” having the same characteristics as the referring primary points. If these satellite trigger points are not treated within a period of time they often turn into primary trigger points. But worst of all, if not addressed over a prolonged period of time the trigger points sometimes sit deep within the muscles and lay dormant at times, ready to explode when least expected. Under trigger point conditions, these effected muscles have been negatively educated and, if the trigger point presence continues over time with treatment, the more difficult it becomes to treat and re-educate the muscles back to normal condition.

To ensure an effective and successful treatment, I:

• follow the basic laws of electro-physiology and their relationships with the temporomandibular pain disorder (TMD) and disease process.

• familiarize myself with the patient’s anatomical location of acutherapy points known
  as “distal, parasympathetic, emotional, influential, spinal points” all used for ETPS protocol development.

• analyze each treatment as to how I develop and apply ETPS protocol. 

• apply ETPS non-invasively with concentrated direct current (DC) stimulation, often producing positive therapeutic results in minutes.
  In addition, ETPS point stimulation can be used to quickly treat multiple areas at one sitting.       

Description of DIRECT CURRENT Electrical Point Stimulation (ETPS) as opposed to other modalities (tens units) that may be

 confused with Point Stimulation.

WARNING !    (this technical stuff may sound like it’s for Geeks only

                 ...but if you’re like me, read on)

 First, the ETPS point stimulator:

• emits Direct Current only

• Is Mono-phasic (waves either above the horizontal line or below the horizontal line)

• is electrically therapeutically efficient, effective, yielding energy through a concentrated point rather than a ball (LASER units), or traditional TENS units which use 2”x 2” delivery pads and require 32,000 times more voltage to deliver the same amplitude (current) as the ETPS.

• being monophasic, the unit has a polarity switch (+) or (-) to determine the polarity of its sole point.

• uses an extremely low pulse frequency of current (never more than 4 pps or Hz) while producing a square wave (monophasic, not bi-phasic) at a much higher ATP (Accumulated Total Power) than all other electrical stimulation devices… all these factors give point stimulation the advantage.

 Do not confuse ETPS with:

• bi-phasic electro-therapy devices (waves spike and go above and below horizontal line on the graft diagram). The presence of bi-phasic waves found in traditional “TENS” units do not influence blood circulation…rendering it less effective than a point stimulation unit.

• “ball” type tips emitting laser. (not as effective long term)

• Devices using Alternating Current (not effective long term)

• the Traditional Tens units using “alternating currents” that feel stronger due to higher amplitudes but produce little or no “Accumulative Total Power”…. Again. not as effective as the ETPS unit.

The ATP factor mentioned above is the amplitude x pulse width, and represents the amount of electrical (or healing) energy that enters the body. The higher the ATP factor, the greater the pain relief (healing response) experienced by the patient. ETPS has a much greater pulse width at lower (& safer) amplitude producing an extremely high ATP factor, which explains the superior benefits of its use.

What are the ETPS Therapy Responses I look for?

     ETPS Therapy works on several different physiological principles:

1. Body circulation response. Increasing or decreasing of circulation (called “Chi” in Eastern Therapies).

2. Autonomic / parasympathetic response. Comprised of the sympathetic and parasympathetic nervous systems, the Autonomic Nervous System covers over 90% of the body and is the medium for chronic pain. The proper point stimulation of parasympathetic “gates” can have a “calming effect” on the body, providing the suffering patient immediate and long lasting relief from pain, anxiety, and insomnia. A patient’s pain patterns may be correlated with known nerve pathways (Dermatomes), and then via use of our Point Stimulator, we are able to work on corresponding primary and satellite trigger points and acupressure points.

3. Endorphin response. Endorphins, or neurotransmitters, found in the brain, have pain-relieving properties similar to morphine. There are three major types of endorphins: beta endorphins, found primarily in the pituitary gland. Endorphins interact with opiate receptor neurons to reduce the intensity of pain: among individuals afflicted with chronic pain disorders, endorphins are often found in high numbers. Many painkilling drugs, such as morphine and codeine, act like endorphins and actually activate opiate receptors. Besides behaving as a pain regulator, endorphins are also thought to be connected to physiological processes including euphoric feelings, appetite modulation, and the release of sex hormones. Prolonged, continuous exercise contributes to an increased production and release of endorphins, resulting in a sense of euphoria that has been popularly labeled “runner’s high.”
   Endorphins may be released through concentrated, low frequency ETPS stimulation. Endorphins are similar to morphine, but are thousands of times stronger and are not harmful to the patient. ETPS stimulation of neural points can excite the pituitary to release endorphins, which inturn release ACTH and hydro-cortisols for tissue repair.

4. Myofascial release. It is now accepted that chronic pain is always caused by muscle contracture. Relaxing contracted muscles relieves impingement of nerves, reduces the heightened sensitivity of pathways, and improves patient’s neck and jaw range of motion.

5. Application of “Concentrated Micro-current Stimulation” (CMS) non-invasively duplicates the “De Chi” of traditional acupuncture therapy. (Including nociception, endorphin, histamine and energetic responses), but does so in a fraction of the time. CMS can also relax contracted muscle tissue responsible for existing nerve impingements. This fast application permits the concurrent treatment and assessment of soft tissue pain, effectively determining the root causes of pain, saving time and effort.

6. ETPS affects cumulatively. The number of applications over a period of time varies dependent upon many factors. Patients seek treatment after years of suffering and, in many incidences unsuccessful past treatment history. Remember, the muscles must be re-educated. Whether it’s two, five, or ten or more treatments over an extended period of time, success is based on the subjective feelings of the patient relative to the decrease in pain symptoms. Rate of success is extremely high. If patient is suffering from an acute disorder (3 months or less) success comes rapidly. If the disorder has been chronic (over three months to years), success will take longer.

7. ETPS in its healing of wound and its elimination of contraction at muscle spasm sites as well as at joint areas at the initial stages of treatment prepares the patient in many cases for the use of a specific muscle-nerve mouth orthotic which will maintain what we have accomplished with the ETPS application.

    

    

   AFFIRMATION OF “DIRECT CURRENT” TREATMENT

    FOR DAMAGED TISSUE

The treatment of Direct Current in its healing of wound was given a substantial write up in the “NEW ENGLAND JOURNAL OF MEDICINE,” Jan.18^th, 2007, 356:3, pp 303, in the article entitled “Wound Healing with Electrical Potential.” This review discusses the wonderful affects of Direct Current on wound and inflamed areas of human tissue…. Of course from a “Western medical perspective” it is explained in terms of chemical cellular changes

                                                                   … which leads us to:

                 The “second” protocol I use to treat TMD:

     I use the “NTI” orthotic appliance (www.nti-tss.com/mx3/#E) that targets clenching and/or grinding of teeth.

     If the patient has already received ETPS therapy, it makes the job of the orthotic much easier. Via ETPS application, I remove the muscle spasms and heal the wounded areas in preparation for the orthotic, which then works much more quickly and effectively. In cases of muscle disorder, the Orthotic is now placed in position to maintain and continue the re-education of muscles initiated by the application of ETPS.

     I construct a customized orthotic appliance (day and night orthotics) for each patient. Appliances are very small, clear plastic devices and are placed over the front teeth so that the back teeth do not touch each other.

Some facts about the orthotic I use:

The NTI-tss orthotic is the only FDA (USA Food & Drug Administration) approved device for prophylactic treatment of migraine. (FDA 510(k) #K01 0876). The FDA indication is that use of this orthotic is the most effective way to prevent and treat migraine pain.

The NTI-tss system prevents the clenching of upper and lower back teeth. This, in turn, prevents the powerful temple muscles from contracting with full intensity while the patient is asleep, thereby reducing the neuromuscular component of the migraine attacks.

In clinical trials reviewed by the FDA, 82% of medically diagnosed migraine sufferers had a 77% average reduction of migraine pain attacks within the first eight weeks of use of a NTI type appliance.

Pilar note: “FDA studies did not include the supportive protocol of ETPS which if used, may have raised the percentage of success…. such as I have experienced in my practice.”