Dr. Sanjay Arora

BDS, MDS( Endodontist),
Special interest: TMJ ( Neuro Muscular Dentistry/ Cranio-Sacral Dentistry, Occlusion,
Special interests in Cranio facial Epigenetics, Master Ceramist,
BSc (Physics)
Location: New Delhi, India

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What Do You Understand By Fibromyalgia?

Fibromyalgia is considered as a chronic pain illnessmainly affecting the muscles and soft tissues.

It is characterized by chronic musculoskeletalpain and stiffness, tenderness in soft tissues, fatigue, sleep disturbances and TMJD (TEMPORO MANDIBULAR DISORDER).

Most common sites involved include the neck, back, shoulders, pelvic girdle and hands, though any body part can be involved.

Fibromyalgia affects about 7-8 percent of the general population.

It can affect people of all ages. Even children may get affected by fibromyalgia.

It is more common in women.

Many people who suffer from fibromyalgia also suffer from TMJD.

Causes Of Fibromyalgia

The exact etiology of fibromyalgia is unknown.

Though many factors may be found associated with this condition like-

  • Genetics- Fibromyalgia tends to run in families. Thus genetic mutations may make you more susceptible to developing this disorder.
  • Physical or emotional trauma. Post-traumatic stress disorder has also been linked to fibromyalgia.
  • The pain pathways

Damage to the TMJ (Temporomandibular joint)) can produce a REGIONAL FIBROMYALGIA of the head, neck and face.

Most of the time, the person suffering from TMJD is usually under tremendous stress and thus they tend to either clench or grind their teeth. As a result of the clenching or grinding, the jaw joint become damaged or dislocated thereby resulting in clicking, ringing, and popping noises which are heard in the ears.Individuals suffering with TMJD also show symptoms of fibromyalgia like dizziness, neck, shoulder, back pain, headaches, pain and pressure behind the eyes, sinus problems, and headaches due to musculoskeletal over-activity and imbalance.

TMJD may arise as a result of-

  • Mal-alignment of teeth or jaw causing the TMJ joint disc to move out from its normal position.
  • Trauma to the jaw causing damage or dislocation of the jaw joint.
  • Inflammatory involvement of jaw joint bone causing damage to jaw joint cartilage.
  • Missing teeth or ill-fitting dentures

TMJD is an Infratemporal fossa catastrophe, occurring due to inward disc (medial) displacement of the Jaw Joint or TMJ.

This happens due to abnormal teeth grinding, which causes a tilt in the jaw joint leading to abnormal residual forces in the jaw joint.

Inside or on the inside of joint exists major structures travelling from and to the brain like nerves and blood vessels. This leads to compression of these structures. A cascade of events is now triggered.

The first nerve to be encountered, at a distance of just 0.5 cm or an ants length is the accessory nerve or the number 11 cranial nerve. The job of this nerve is to maintain the head on shoulders at the “COG” or the center of gravity.

Irritation of this nerve alters the muscle function and hence the head position, thereby ultimately resulting in fibromyalgia.

  • Hormonal changes
  • Immune system disturbances

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Diagnosis Of Fibromyalgia

Fibromyalgia can sometimes be difficult to diagnose because there are no definite sensitive tests to diagnose this condition.

Fibromyalgia is mostly diagnosed based on detailed patient physical examination and presence of symptoms.

Symptoms Of Fibromyalgia:

Symptoms of fibromyalgia are usually chronic but may fluctuate throughout the day.

  • Widespread long term pain all over the body of duration more than 3 months.
  • Moderate or severe fatigue and decreased energy
  • Sleep difficulties(insomnia) and lack of freshness after waking up in the morning
  • Feeling anxious or depressed
  • Brain fog or difficulty in remembering,concentrating and performing simple mental task
  • Stiffness upon waking or after staying in one position for too long
  • Muscle spasms or tightness
  • Numbness or tingling sensation felt in the face, arms, hands, legs, or feet.
  • Irritability/anger
  • Tension or migraine headaches
  • Short term memory loss
  • Jaw and facial tenderness
  • Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome)
  • Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold
  • Increase in urinary urgency or frequency (irritable bladder)
  • A feeling of swelling (without actual swelling) in the hands and feet

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Fibromyalgia Treatment


Pain Relief: Medication to relief from deep muscle and soft tissue pain can be achieved by a combination of nerve medicines to relieve the nerves and safe pain killers, which needs to be continued for longer periods of time.

Medications treat symptoms, such as the deep muscle pain, sleep problems, anxiety, and depression.

Physical Therapy

Once adequate relief from the muscle and soft tissue pain has been achieved through medication, often physical therapy is recommended to help further ease the fibromyalgia pain.


If the culprit behind fibromyalgia is suspected to be due to TMJD (Temporomandibular joint disorder), then it becomes utmost important to confirm it with the aid of various sophisticated and most advanced diagnostic technology (AVAILABLE ONLY AT Zental Tmj & Body Pain Division BODY PAIN TREATMENTCENTRE, only SUPERSPECIALIZED DENTAL clinic in INDIA and PERHAPS IN ASIA TOO), like-

Once the diagnosis is confirmed and connection between TMJD and fibromyalgia has been established, various treatment procedures can be done to eliminate back aches from the roots. It includes-

  • Home care remedies
  • Medicines-pain relievers, muscle relaxants, anti-depressants.
  • Orthotic/splint
  • Orthodontic treatment
  • Veneers, Crown and bridges
  • Botox

Various other approaches to improve the quality of life include:

  • Modifications In Daily Lifestyle Activities Maintaining a proper posture during sitting, standing, work and sleep tominimize muscle stiffness. Managing stress and pacing your daily activities.
  • Exercises: Exercises that includes stretching of muscles and mobility of all joints of the body can help relieving muscle stiffness and pain. You can start initially with just 5 minutes in a day in the form of gentle walks or stretching muscle exercises. This can gradually be increased up to 15-20 minutes every day. It is equally important to provide proper rest to the muscles and joints of the body and not overexerting the body muscles and joints by exercises.
  • Swimming/Aquatic Therapy: Regular swimming or hydrotherapy may also aid in improving the quality of life by helping in relieving the muscle stiffness and improvingmuscle flexibility.
  • Yoga: Regular yoga exercises helps in relaxing muscle stiffnessand improving body flexibility. Yoga also aids in pain relief and mind relaxation.
  • Maintaining A Regular Sleep/Wake Cycle: A 6-8 hours of regular sleep is needed to minimize the fatigue and muscle stiffness.
  • Therapy: Muscle strengthening exercises, massage, ultrasound, TENS (Transcutaneous electrical nerve stimulation) can help you in relaxing muscles and relief the pain.
Consult Best Body Pain Treatment Centre In Delhi, India.