All posts in TMJ (Temporomandibular Joint)

Chiropractic & Sports Medicine

Chiropractic manipulation does not reposition a vertebra from a misaligned position to an aligned position. Rather, it is likely that manipulation breaks up adhesions present in the joints of the spine, which improves movement asymmetries and/or stimulates mechanoreceptors – thereby reducing spinal muscle excitability, enhancing proprioception and reducing pain.

While manipulation has been proven effective for the management of acute low back pain, a prospective placebo-controlled study by Senna and Machaly demonstrates that long-term chronic low back pain sufferers respond best to maintenance manipulations performed bimonthly for up to nine months. The authors suggest the occasional (Chiropractic) manipulations may allow for the “early treatment of any emerging problem, thus preventing future episodes of low back pain.”

My sports medicine and chronic pain therapy approach of using the DMS (vibration, percussion), EnPuls (radial shockwave), Piezowave (acoustic shockwave) and massage  in conjunction with chiropractic enhances the breaking up of disruptive and painful scar tissue.

  1. Tullberg T, Blomberg S, Branth B, et al. Manipulation does not alter the position of the sacroiliac joint: a roentgenstereophotogrammetric analysis. Spine, 1998;23:1124-1128.
  2. Cramer G, Tuck N, Knudsen J, et al. Effects of side-posture positioning anti-posture adjusting on the lumbar zygopophyseal joints as evaluated by magnetic resonance imaging: a before and after study with randomization. J Manip Phys Ther, 2000;23:380.
  3. Nansel DD, Peneff A, Quitoriano J. Effectiveness of upper versus lower cervical adjustments with respect to the amelioration of passive rotational versus lateral-flexion end-range asymmetries in otherwise asymptomatic subjects. J Manip Phys Ther, 1992;15:99-105.
  4. Nansel D, Waldorf T, Cooperstein R. Time course effect of cervical spinal adjustments on lumbar paraspinal muscle tone: evidence for facilitation of intersegmental tonic neck reflexes. J Manip Phys Ther, 1993;16:91-95.
  5. Lehman GJ, McGill SM. Spinal manipulation causes variable spine kinematic and trunk muscle electromyographic responses. Clin Biomech, 2001;16:293-9.
  6. Childs JD, Fritz JM, Flynn TW, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med, 2004;141:920-928.
  7. Cleland J, Fritz J, Whitman J, et al. The use of a lumbar spinal manipulation technique by physical therapists in patients who satisfy a clinical prediction rule: a case series. J Orthop Sports Phys Ther, 2006;36:209-214.
  8. Senna M, Machaly S. Does maintenance spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcomes? Spine, 2011 Aug 15; 36(18):1427-37.
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My approach to chronic pain, muscle pain, joint pain, and  weight loss

Chiropractic. The goal of this treatment is to significantly decrease symptoms such as pain, tightness, stiffness, soreness, aches, and improve athletic performance, mobility, and your ability to perform general activities.

Laser. Evidence for the effectiveness of laser is strong. Patients feel the relief especially for knee pain and TMJ pain

Shockwave therapy. This form of medical treatment is acknowledged as a means for enhancing scar tissue mobility and breaking up muscle tightness and muscle and joint adhesions. It is also helpful for chronic pain reduction and improved mobility. It helps osteoarthritic symptoms with improved functional mobility and quality of life.

Along with laser, Deep Muscle Stimulator (DMS), shockwave therapy is effective for pain control of osteoarthritis of the knee, neck pain, low back pain, and increasing mobility.

Deep Muscle Stimulator Massage. Followed by hands on therapy, DMS is the most commonly utilized treatment in my office. Patients feel better after this type of massage than receiving a regular hand massage. They have significant improvements in pain, stiffness, and physical function.

Dietary supplements. I use a variety of products from Metagenics, Xymogen, Designs for Heath, and Standard Process for joint pain, arthritis, inflammation, and weight loss.

Widening the integrative approach to treatment

There is emerging evidence that integrating multiple conventional and alternative therapies such as chiropractic, exercise, laser, shockwave, DMS, lymph therapy provide the best results for patients.

If you are a person who still has pain and diminished mobility who has already explored other therapies and doctors but have been disappointed, I would like the opportunity for you and I to meet. I continuously evaluate the increasing body of evidence in support of new therapies, and I am confident in offering my patients a wider range of choices than standard chiropractic care.

Call 310-444-9393 for an appointment

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Chronic Pain, Foot Pain, Hip Pain, Inflammation, Neck Pain, Shoulder Pain, & TMJ Pain

If you have any of the above, have you tried Pneumatic Lymphatic Pump Therapy?

One of the most neglected systems of the body is the Lymphatic system. An innovative treatment for chronic pain, foot pain, hip pain, inflammation, neck pain, shoulder pain, & TMJ pain is Lymph Drainage Therapy (DLT). In my office I use state of the art technology called LymphaTouch for DLT. Benefits of the LympaTouch Pump Therapy include reduction in limb circumference, pain, increase in range of motion, scar mobility and improved functioning of the immune system. The immune system is stimulated through increased lymph flow. The additional flow carries more antigens to the lymph nodes, thereby increasing antibody/antigen contact. This has been found to help with chronic or subacute inflammatory processes — chronic fatigue syndrome, autoimmune disease, bronchitis, sinusitis, tonsillitis, laryngitis, arthritis, acne and eczema.

Call 310-444-9393 to schedule an appointment

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Pain Relief with PiezoWave Shock Wave Therapy

We are the first office in Los Angeles to offer the PiezoWave therapy. The PiezoWave machine supplies an acoustic wave used to target tissues at varying depths (0 to 20 mm). It is a very focused, precise, deep tissue therapy. The device locates myofascial trigger points in the muscles. These are hyper-irritable spots located in a taut band of skeletal muscle. They generate pain, both locally and in referred pain patterns, and often accompany chronic musculoskeletal disorders. PiezoWave is being used for regional pain, especially in the neck, shoulders, low back and hip areas. If you know you have tension headaches, temporomandibular joint pain, decreased range of motion in the legs, and low back pain, even if you have tried other therapies like laser I would suggest a trial of PiezoWave.

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Laser Treatments

Laser therapy has been around for a long time but it is considered cutting edge treatment for musculoskeletal injuries and pain.
Laser therapy stimulates cellular activity, expediting the healing processes to reduce inflammation and repair damaged tissue. 

You can feel the warm deep tissue penetration. This deep heat significantly increases the body’s cellular production of ATP (Adenosine-triphosphate) to reduce inflammation and heal the inflamed area.

Here are some of the benefits of using the deep tissue penetration that laser provides safely and effectively:

Healing and pain relief with no side effects, drug interaction effects, or invasive surgery.

Treats acute and chronic conditions as well as post surgical pain.

Pain relief is often felt immediately.

Most laser treatments take only 10-20 minutes.

Are you a potential candidate?

  • If you have pain that is of musculo-skeletal origin, laser therapy may be for you:
    This includes sports injuries, back and neck pain, any joint pain (knee, shoulder, ankle, etc), bursitis, tendonitis, tennis elbow, contusions, strains and sprains, carpal tunnel syndrome, chondromalacia patellae, arthritis, fibromyalgia, heel spurs, plantar fascitis, migraine headaches, neck pain/whiplash, nerve root pain, postoperative pain, repetitive stress injuries, TM joint pain and more.
  • If you have the wound that is slow to heal and has been resistant to treatment, you may be a candidate for laser therapy. This includes slow healing fractures, as well as soft tissue injuries and ulcers.
  • If you have multiple trigger points (sore spots in the muscles) that do not go away, you may be a candidate for laser therapy. This includes areas associated with fibromyalgia.
  • If you have had Prolotherapy or PRP, and wish to accelerate the response of healing, you may be a candidate for laser therapy. This includes any area that has been treated with Prolotherapy/PRP injections.
  • If you need Prolotherapy or PRP therapy but are afraid of needles, you may be a candidate for laser therapy.
  • Laser therapy stimulates the same areas that Prolotherapy targets. It does it without needles, but requires a lot more time and repeated treatments to gain the result that can be gotten from Prolotherapy and laser together.

Feel free to call me directly at 310-473-2911 or call my cell phone at 310-339-0442

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General Nutrition for TM Disorders

EC Matrixx™ 3-6 capsules daily with food. EC Matrixx is a mechanism-specific formula designed to support healthy connective tissues by supporting the extracellular matrix, a key structural component of connective tissues such as tendons, ligaments, and cartilage. Features berberine and tetrahydro iso-alpha acids (THIAA), which have been shown in laboratory research to influence MMP-13, an enzyme involved in the maintenance of connective tissue structure. 

          THIAA has also been shown to beneficially influence multiple cellular signaling processes related to connective tissue health. 

          Supports biochemical processes that influence the health of the extracellular matrix.

Chondro-Relief Intensive Care — 3-6 capsules daily with food. Joint & soft tissue support with MSM, Green Lipped Mussel, Hyaluronic Acid and ASU.

Inflavonoid Intensive Care — 3-9 tablets daily with meals. For relief of minor pain.

E-Complex 1:1 — 2-4 softgels daily. 1:1 ratio of alpha and gamma tocopheryls.

 

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Do I Have Temporomandibular Joint (TMJ) Disorder?

TMJ is a collective term for a broad range of disorders displaying a variety of signs – radiating pain in the face, neck, or shoulders; limited movement or locking of the jaw; painful clicking or grating when opening or closing the mouth; and a significant change in the way the upper and lower teeth fit together. Other common symptoms include headaches, earaches, dizziness, hearing problems, and difficulty swallowing.

The Jaw Symptom Questionnaire consists of the following questions:

? Does it hurt when you open wide to yawn?
? Does it hurt when you chew or use the
jaws?
? Does it hurt when you’re not chewing or
using the jaws?
? Is your pain worse upon waking?
? Do you have pain in front of the ear, or
earaches?
? Do you have jaw muscle or cheek pain?
? Do you have pain in the temples?
? Do you have pain or soreness in the teeth?
? Do your jaws make noise so that it
bothers you or others?
? Do you find it difficult to open your mouth
wide?
? Does your jaw ever get stuck/lock as you
open it?
? Does your jaw ever lock open so that you
cannot close it?
? Is your bite uncomfortable?

In my experience if a patient answers more than three of the above questions they will benefit by education, an anti-inflammatory home care program including dietary changes, nutritional supplements, heat or ice applications, avoidance of mechanically stressful activities, and resting the jaw (practice the “lips apart and jaws relaxed” procedure).

In office treatment that I provide include: warm laser, soft-tissue therapy and specific muscle massage. I also train clients in corrective exercise therapy.

General Nutrition for TM Disorders

• EC Matrixx™ is a mechanism-specific formula designed to support healthy connective tissues by supporting the extracellular matrix, a key structural component of connective tissues such as tendons, ligaments, and cartilage. Features berberine and tetrahydro iso-alpha acids (THIAA), which have been shown in laboratory research to influence MMP-13, an enzyme involved in the maintenance of connective tissue structure.
THIAA has also been shown to beneficially influence multiple cellular signaling processes related to connective tissue health.
Supports biochemical processes that influence the health of the extracellular
matrix.
• Chondro-Relief Intensive Care — 3-6 capsules daily with food. Joint & soft tissue support with MSM, Green Lipped Mussel, Hyaluronic Acid and ASU.
• Inflavonoid Intensive Care — 3-9 tablets daily with meals. For relief of minor pain.
• E-Complex 1:1 — 2-4 softgels daily. 1:1 ratio of alpha and gamma tocopheryls.

Order at www.DrJeffreyTucker.meta-ehealth.com

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LASER TREATMENT

Dr. Tucker says “One of the major goals of my treatment is to increase the blood flow and oxygen content to the tissues and that helps to reduce pain”. Cells and tissues that have a poor blood supply and low oxygen content as a result of inflammation, swelling/edema, and injury have been shown to have a significantly higher response to warm laser therapy than normal healthy structures.
Applicable conditions of laser therapy
1. Low back pain
2. Wound healing
3. Dermatological conditions
4. Temporo-mandibular Joint Dysfunction
5. Frontal and maxillary sinus inflammation
6. Rotator Cuff injuries
7. Epicondylitis (elbow pain)
8. Small joints of the hands
9. Trigeminal Neuralgia
10. Bell’s Palsy
11. Neck pain

Laser is used for sports injury, back problems, neurological conditions, wound/post surgical healing, fracture healing, Carpal Tunnel Syndrome, soft tissue therapy, wounds, burns, arthritis, strains, tendonitis, temporary increase in local blood circulation, relief of minor muscle & joint aches, pain & stiffness, relaxation of muscles, & muscle spasms.

Laser therapy has been shown to: stimulate cell growth; increase cell metabolism; improve cell regeneration; produce an anti-inflammatory response; produce an edema (swelling) reduction; reduce fibrous (scar) tissue formation; stimulate nerve function; reduce the production of substance P (a pain producing chemical); stimulate long-term production of nitric oxide; decrease the formation of bradikynin, histamine and acetylcholine (painful chemicals); and stimulate the production of endorphins. Dr. Tucker finds “These responses are responsible for the pain-relieving effects often observed in patients treated with laser therapy”.
Tucker says, “Laser therapy influence the cells at the molecular level to improve healing”. The result is rapid regeneration, normalization and healing of damaged cellular tissue. This painless warm light therapy is a trigger for improving metabolism.
Dr. Tucker uses class IV laser therapy approved by the FDA with the highest wavelength for deeper penetration. Penetration is paramount in order to stimulate deep musculoskeletal, vascular, lymphatic and neurological structures.
He uses the top healing and pain reduction modalities available today. Dr. Tucker’s unique treatments not only include laser therapy, he also uses the Deep Muscle Stimulator (DMS), exercise therapy and First Line Therapy nutritional recommendations.
“The most common musculoskeletal conditions I treat are neck pain and low-back pain”. The most common generators of pain in the cervical regions are the zygapophyseal joints of the neck in acute (traumatic) and chronic neck pain conditions. Several authors have reported the most common tissue of pain origin in the low back to be the outer layer of the disc. Given that the depth of these painful structures lies below multiple layers of muscle and fascia, Tucker uses a therapeutic laser device that has the ability to penetrate multiple layers of tissue.
Treatment plans include:
• Sports Medicine Laser Therapy.
• Painless laser therapy sessions (You must feel it to see why).
• Specialized plans for chronic pain relief.
• Deep Muscle Stimulator (DMS) massage.
• Exclusive 30-minutes sessions directly with Dr. Tucker.
• No long term commitment treatment plans. You can be done with care.
• Specialized Corrective Exercise Training.
• Myofascial Trigger Point Therapy for misdiagnosed pain.
• Nutritional & weight loss advice.
• Performance Enhancement.
What is High Power Deep Tissue Laser Therapy?
Laser Therapy is a non-invasive, safe, and effective treatment modality where light is used to relieve pain, reduce inflammation, and promote wound healing and soft tissue repair. Most therapy lasers on the market today have a power range from 5mw to 500mw, making them a cold laser. Our laser will emit a power range from 1000mw to 10,000mw, making this a high-power heat deep tissue laser that can put an end to your pain fast!

You get better FAST!

How is the treatment done?
The laser is placed in contact with the skin allowing the healing energy to penetrate tissue, where it interacts with various intracellular bio-molecules resulting in the restoration of normal cell function. This also enhances the body’s natural healing processes. In essence, light energy is converted into biochemical energy.

The result; normal cell functions are restored. The process results in a disappearance of symptoms and increases the speed at which your body heals.

Other Effects; the immune system response is stimulated, lymphatic drainage is improved, production of growth hormone is increased, & the body’s natural healing process are enhanced.

FAQ’s

What does laser therapy have over other forms of therapy?
It does not require the use of drugs or surgery, there are less side effects or risks, and it is quick and convenient. Studies have shown that it is equal to or more effective than other forms of physical therapy. Pain relief is often immediate.

Does it hurt? What does the treatment feel like?
There is a warm heat sensation during treatment. Clients work with me to make sure the temperature is not too hot. There is no pain associated with the treatment. Laser treatment is relaxing and you welcome to ‘dose off’ during the session or we can talk during the session. Occasionally it occurs that pain can increase or begin 6-24 hours after a treatment session. This is because the laser light starts the healing process. This type of pain is particularly likely to arise when the health problems are chronic in their nature. It usually subsides after a few days but can, in rare cases, last longer.

How long does the treatment take?
The typical course of treatment is 10-20 minutes, depending on the size of the area being treated. Acute conditions may be treated daily, particularly if they are accompanied by significant pain. More chronic problems respond better when treatments are received 2 to 3 times a week. Treatment plans are determined on an individual basis.

How many treatments does it take?
This depends on the nature of the condition being treated. For some acute conditions, 3 to 6 treatments may be sufficient. More chronic conditions may require 6-12 sessions. Conditions such as severe arthritis may require ongoing periodic care to control pain.

How long before results are felt?
You may feel improvement in your condition (usually pain reduction) after the very first treatment. Each treatment is cumulative and results are often felt after 2 to 4 sessions. If you don’t notice relief with the laser, I will add the Deep Muscle Stimulator (DMS) to your therapy. Depending on your condition I may start with the DMS first.

Are the results long lasting?
Therapeutic Laser Therapy is about healing. It’s not about masking or covering up a condition. When you feel better from this therapy… it’s because you are better. Therefore results have been found to be quite long lasting.

Can it be used in conjunction with other forms of treatment?
Yes, laser therapy is even more effective when combined with other forms of therapy, including physical therapy, chiropractic, massage, soft tissue mobilization, electrotherapy, and following surgery. I combine our warm laser therapy with specialized corrective exercise techniques to relieve your pain fast!

Is it a cold laser treatment?
NO! Our laser is a Class-4 Deep Tissue Laser with much deeper penetrating power. No cold laser on the market today can come close to the fast-acting therapeutic effects of our Class-4 device. Chronic pain relief and hard-to-fix cases are my specialty. I have many patient’s who have tried cold laser therapy with no success and with just ONE Class IV heat laser treatment they start feeling better. All lasers are not the same.

How do I know if laser therapy is right for me?
I will evaluate your condition and perform a complete functional examination to determine if you are a candidate for this procedure. Call us to schedule your evaluation and Q&A session. The only way to know is to try a course of therapy.

Can laser therapy be used over medical implants or over metal?
Yes, laser therapy is a light treatment. No heating is involved with the surgical or metal implants. It can be used safely with no side effects. It is extremely effective for post-operative wound healing. Many hip and knee replacement patients see us for care.

Is it covered by medical insurance?
Some insurance covers the procedure, but not many. Most patients who decide to receive the benefits of laser therapy are sick and tired of being sick and tired, so they choose to seek this effective method of treatment on their own. Price is usually not a consideration when you have been suffering for so long.

The average course of therapy in our facility is just 10 visits. Other facilities with cold lasers can reach 20 or more visits. So you get better faster, which saves you money on additional insurance co-pays and deductibles.

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TMJ Exercises

Joint/Muscle Relaxation

Place tongue on roof of mouth as far back as possible. Slowly open mouth as far as possible, tongue on the roof.

Repeat 20 times per set.
One set per session.
Complete as needed daily.

Lateral Glide (Isometric)

Place two fingers on right side of jaw. Resist movement of jaw to same side. Relax. Repeat on opposite side.

Hold for 10 seconds.
Repeat 10 times per side, per set.
One set per session.
Complete as needed daily.

Protrusion (Isometric)

Place two fingers on chin. Resist forward movement of chin. Relax. Repeat.

Hold for 10 seconds.
Repeat 10 times per set.
One set per session.
Complete as needed daily.

Opening (Isometric)

Place fist below jaw. Resist downward movement of chin. Hold. Relax.

Hold for 10 seconds.
Repeat 10 times per set.
One set per session.
Complete as needed daily.

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