COPING SKILLS
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Jaw Exercise

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by Jane Uitti

I have a very rare deep, stabbing ear pain type of TN called "nervus intermedius neuralgia" (named after the nervus intermedius, which is the nerve running between the 7th and 8th nerves) or "geniculate neuralgia." Actually, it's not on the 5th nerve at all most likely, but on the 7th-8th nerve complex. I've had 2 MVD's with Peter Jannetta, MD, University of Pittsburgh Medical Center, where he did remove compressions from 5 and 7, and pain returned after both of them, despite the fact that during the second surgery he sectioned (cut) the nervus intermedius.

I also have moderate TMJ (temporal mandibular joint disorder with joint clicking etc.) on the TN side, and have noticed that the TMJ is tighter when I'm having a TN attack. I have been doing some exercises for the TMJ, and during my last TN attack I did one of these exercises that stopped the TN cold in its tracks. However, I haven't had a subsequent attack as of this date (6/00) so I can't say that this has helped more than the one time.

During my last attack I tried something I'd never tried before, a TMJ jaw joint exercise, involving a very gentle hand resistance under my chin while slowly opening my mouth, and gentle hand resistance above my chin (below my lower lip) while slowly closing my mouth. I did both of these movements twice, slowly, taking maybe a minute in all....and the TN went away completely, miraculously, from a  "level 8" pain level to absolutely no pain, and that attack was finished. This has never happened before.

This made me wonder if my own TN pain might be precipitated by a jaw joint muscle spasm, and if somehow those TMJ "resistance" exercises may have immediately released the spasm. .I wonder if the TMJ muscle spasm causes the TN pain, and relief of the TMJ muscle spasm relieves the TN pain.

I continue to do this "gentle resistance" exercise daily, and while I've felt the TN looming in the background at times, I haven't had another full-blown attack in four months. If I do, I'll try this exercise again, of course, to see if it works again.

Jane Uitti