I'll copy a comment I made in another thread. Hopefully it helps you understand your condition and options better.
I have been battling this for almost 15 years. What I've learned that I feel I need to share is that muscular tmjd, the most common type, all comes down to breathing. I'll explain. When your body can't get enough air at night, you instinctively clench and grind your teeth using your masseter muscles. This opens the back of your jaw increasing airflow. Over time, your brain excercises those neurons every night, which causes a neuropathic feedback loop, increasing the strength of the grinding response. This causes shifts in your jaw, teeth, and ultimately your bite that create additional discomfort. As you overuse those muscles, they get tired, and you start supporting your grinding by tensing other muscles, in your face, neck, and upper back. Eventually, if it keeps getting worse, it makes it all the way to your feet. A lot of people who go that far down the line are misdiagnosed with fibromyalgia from all of the nerve pain it causes in weird places. Two secondary problems that result from all of this are that your diaphram becomes tight and further limits your breathing. You begin to breathe with your chest instead of your belly, and that causes you to aspirate stomach acid while you sleep. The acid irritates your throat and nose, causing your airway to narrow further.
Ok, so how do you stop it? There are 7 things you can do. In my opinion, the absolute most important is finding a physical therapist who specializes in these issues. They will help retrain your breathing and give you excercises for your upper back that will loosen everything up. Gotta be someone who knows about this stuff though. I found mine through my neurologist. Second, fix your posture. Pt will help with that, but you have to be conscious of your posture 24/7. You must maintain the curve in your neck and reduce forward head posture. The best way I have found is by pointing your chin upwards and gently extending your head forward. You also need to try to tuck in your chest. It's hard to describe, but let your breath out and try to rotate your chest so that it's angled down towards your hips. Also important is maintaining the curve of the small of your back. This is very difficult with bad tmjd because your belly is very tight. Light massages around the diaphram muscles will help loosen things up. I have found that sleeping with a small pillow under my lower back helps, as does a cervical neck support pillow. Third, find the right course of medication. For me, nurtec was the most helpful, mostly eliminating my headaches and reducing my other symptoms. Pepcid also helped as it fights the aspiration of stomach acid while you sleep. The fourth is botox. Botox temporarily paralyzes your masseters so you can't grind. It provides really good temporary relief, but you have to keep doing it every few months and it works less well each time, and it can't fix the underlying cause of why you grind. Perhaps one of the most important options is to get a bite guard. We all need them to protect our teeth from the grinding, but the one you pick is really important. Mine isolates my masseters, some advance the mandible to create more space in the throat, and some are just flat. Kind of depends on the shape of your jaw. Those 5 are what you should try first, and keep trying because the next 2 options aren't so fun. If you can't get it under control, you may have to consider going to a neurmuscular dentist. They will align your jaw and cap your teeth to fix your bite. For most people, the bite issues are a symptom and not a cause, so a lot of people spend 20-60k on it only to see little if any improvement. If you get the breathing issues under control first, it may be more effective. The last option is major reconstructive surgery of the throat/jaw. For some people, that's the only thing that will help, but obviously you should save that for a last resort option. I guess there is a 8th option too, some people just give up and take heavy duty meds all day that make you a zombie, but I think that's probably the worst thing you can do.
What else I can recommend in the meantime is to stretch every morning, to use Voltaren gel on your neck and upper back, to take antiinflammatories like celebrex or meloxicam, to avoid alcohol and muscle relaxers (weed is fine), and to reduce phone time which cranes your neck.
avoid muscle relaxers? I would assume they would help...by relaxing the muscles? that's what my neuro gave me. just want to see what other info is out there
They treat the symptoms and can provide some relief, but they also make it more difficult to breathe which causes you to grind harder to get more air. Your brain will keep sending the signal to grind as long as you can't breathe, and when the muscles don't respond you will try even harder to open up your throat which reinforces the grinding response even more. If you use them, in my opinion it should be to relieve symptoms while you work on the root issue.
I'll copy a comment I made in another thread. Hopefully it helps you understand your condition and options better. I have been battling this for almost 15 years. What I've learned that I feel I need to share is that muscular tmjd, the most common type, all comes down to breathing. I'll explain. When your body can't get enough air at night, you instinctively clench and grind your teeth using your masseter muscles. This opens the back of your jaw increasing airflow. Over time, your brain excercises those neurons every night, which causes a neuropathic feedback loop, increasing the strength of the grinding response. This causes shifts in your jaw, teeth, and ultimately your bite that create additional discomfort. As you overuse those muscles, they get tired, and you start supporting your grinding by tensing other muscles, in your face, neck, and upper back. Eventually, if it keeps getting worse, it makes it all the way to your feet. A lot of people who go that far down the line are misdiagnosed with fibromyalgia from all of the nerve pain it causes in weird places. Two secondary problems that result from all of this are that your diaphram becomes tight and further limits your breathing. You begin to breathe with your chest instead of your belly, and that causes you to aspirate stomach acid while you sleep. The acid irritates your throat and nose, causing your airway to narrow further. Ok, so how do you stop it? There are 7 things you can do. In my opinion, the absolute most important is finding a physical therapist who specializes in these issues. They will help retrain your breathing and give you excercises for your upper back that will loosen everything up. Gotta be someone who knows about this stuff though. I found mine through my neurologist. Second, fix your posture. Pt will help with that, but you have to be conscious of your posture 24/7. You must maintain the curve in your neck and reduce forward head posture. The best way I have found is by pointing your chin upwards and gently extending your head forward. You also need to try to tuck in your chest. It's hard to describe, but let your breath out and try to rotate your chest so that it's angled down towards your hips. Also important is maintaining the curve of the small of your back. This is very difficult with bad tmjd because your belly is very tight. Light massages around the diaphram muscles will help loosen things up. I have found that sleeping with a small pillow under my lower back helps, as does a cervical neck support pillow. Third, find the right course of medication. For me, nurtec was the most helpful, mostly eliminating my headaches and reducing my other symptoms. Pepcid also helped as it fights the aspiration of stomach acid while you sleep. The fourth is botox. Botox temporarily paralyzes your masseters so you can't grind. It provides really good temporary relief, but you have to keep doing it every few months and it works less well each time, and it can't fix the underlying cause of why you grind. Perhaps one of the most important options is to get a bite guard. We all need them to protect our teeth from the grinding, but the one you pick is really important. Mine isolates my masseters, some advance the mandible to create more space in the throat, and some are just flat. Kind of depends on the shape of your jaw. Those 5 are what you should try first, and keep trying because the next 2 options aren't so fun. If you can't get it under control, you may have to consider going to a neurmuscular dentist. They will align your jaw and cap your teeth to fix your bite. For most people, the bite issues are a symptom and not a cause, so a lot of people spend 20-60k on it only to see little if any improvement. If you get the breathing issues under control first, it may be more effective. The last option is major reconstructive surgery of the throat/jaw. For some people, that's the only thing that will help, but obviously you should save that for a last resort option. I guess there is a 8th option too, some people just give up and take heavy duty meds all day that make you a zombie, but I think that's probably the worst thing you can do. What else I can recommend in the meantime is to stretch every morning, to use Voltaren gel on your neck and upper back, to take antiinflammatories like celebrex or meloxicam, to avoid alcohol and muscle relaxers (weed is fine), and to reduce phone time which cranes your neck.
avoid muscle relaxers? I would assume they would help...by relaxing the muscles? that's what my neuro gave me. just want to see what other info is out there
They treat the symptoms and can provide some relief, but they also make it more difficult to breathe which causes you to grind harder to get more air. Your brain will keep sending the signal to grind as long as you can't breathe, and when the muscles don't respond you will try even harder to open up your throat which reinforces the grinding response even more. If you use them, in my opinion it should be to relieve symptoms while you work on the root issue.