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Acupuncture Case: Kill Two Birds with One Needle: TMJ + IBS

Woman clutching her stomach

Temporomandibular Joint disorder (TMJ) and Irritable Bowel Syndrome (IBS) are common chronic conditions that affect many people and both correlate with high stress levels. I have treated both conditions in my practice with Chinese herbal medicine and acupuncture. In this case, I only used acupuncture and the outcome was a little surprising for both my patient and I. Before I dive into the details, let’s briefly review the nature of these two conditions (you can skip directly to the case description).

What is Temporomandibular Joint disorder (TMJ) and its symptoms?

Temporomandibular Joint (TMJ) disorder is a common condition, especially among those who suffer from generally high levels of stress.
Common TMJ Symptoms include:

  • Headaches
  • Difficulty with opening the mouth
  • Pain while chewing
  • Jaw pain
  • Inflamed temporomandibular joints
  • Grinding of the teeth
  • Shoulder and neck tension

What is Irritable Bowel Syndrome and its symptoms?

Irritable Bowel Syndrome (IBS) is a common digestive disorder(link to digestive health page). Some experts believe it is related to a condition in which the body overproduces histamine, an abundant chemical in our body, as part of the inflammatory response. There is not much that Western medicine can do about histamine intolerance, other than alter the diet and manage the stress. Many digestive issues are sharing common underlying factors such as inflammation. One study shows that forty to eighty percent of diagnosed IBS cases are actually Small Intestinal Bacterial Overgrowth(SIBO), another stubborn digestive condition that has many symptoms that overlap with IBS, such as diarrhea, bloating and constipation. You can read the post I wrote to discuss How Chinese Medicine Treats SIBO and Prevents it From Reoccurring (link to SIBO).
Common symptoms related to IBS and histamine intolerance include:

  • Bloating or gas
  • Diarrhea or constipation
  • Stomach cramps
  • Headache or migraine
  • Skin rash
  • Fatigue
  • Irregular menstruation
  • Nausea or vomiting

Case: TCM Acupuncture Treatment for TMJ and IBS at Kampo Health

Chinese medicine is a holistic medicine that focuses on addressing the underlying causes in order to cure or alleviate diseases. This approach applies when it comes to treating TMJ, given that it is believed to be a typical musculoskeletal(MSK) condition by most healthcare professionals. I’ve just had an interesting case recently and would like to share my experience and demonstrate how applying a holistic approach is necessary to address a MSK condition.

A few months ago, MH walked into my clinic, seeking treatment for her chronic Temporomandibular Joint (TMJ) pain. MH is a female professional in her late 20s who had been suffering from TMJ for decades. Her jaw pain and headache were constantly bothering her. In fact, she had to take pain medication every day to help her perform her daily tasks. In the last couple of years, she has undergone dozens of botox injections to numb her nerves and control the pain. However, the botox treatment provided little relief from the debilitating pain.

MH had been regularly seeing a variety of manual therapy practitioners for general relaxation and her TMJ. The treatments included massage therapy, chiropractic and physiotherapy. However, they could only provide her with very short-lived relief from the pain.

After I thoroughly assessed her condition, I concluded that there was tensional imbalance around her neck, upper back and shoulder areas. There were also signs of systemic inflammation in her body. In Chinese medicine, this pattern is called Liver and Stomach Fire. Internally, Liver Fire is related to chronic stress. Physically, most of the symptoms presented in the jaw and temple areas, which are related to the Gallbladder (the Liver’s “sister organ”) and Stomach meridians.
We set up a weekly acupuncture treatment plan with some specific manual therapy that targeted the imbalance in the upper body area. The acupuncture treatment was focused on the pattern that I just mentioned above. I also gave her a couple of simple exercises that were designed to keep the tension around the jaw at bay and maintain the overall tension balance. Specifically for TMJ disorder, I have developed a set of empirical acupuncture points to release the tension in the jaw and temple area. I discussed the details of my TMJ approach in the post “Temporomandibular joint (TMJ) disorder with acupuncture”.
During her next follow-up session, MH said she had already experienced a significant improvement. After a few sessions, her visits were reduced to once every two weeks. This was due to the fact that the pain had decreased to a mild level that was manageable without the need for any pain medication.

A pleasant surprise

In her last session, MH mentioned something she noticed after starting the TMJ acupuncture treatment. She explained that she had had Irritable Bowel Syndrome (IBS) for years. And due to IBS, she would usually have bad stomach cramps and diarrhea whenever she ate “junk food”, such as pizza. Yet, she noticed that her digestive function had gotten better since she began coming to my clinic. A perfect example was last weekend, she explained. MH had gone to the CNE (the Canadian National Exhibition, an annual fair in Toronto) with her friends and of course, enjoyed “a bunch of junk food” there. To her surprise, she felt absolutely fine after the outing. There were no cramps, no diarrhea and no unpleasant experience. This had not happened to her for many years!

I wasn’t aware that she had IBS . She hadn’t mentioned it to me earlier. Even though we didn’t know exactly what had happened to her stomach, she was very pleased with the fact that her digestive system was better and not as sensitive as before.

Discussion

From my years of experience practising Chinese medicine, a situation like this happens very often. This “off-label” use of acupuncture (or other Chinese medicine therapies) shows its holistic nature. From a broader perspective, when the underlying factors are changed, either by medical intervention or natural events, everything downstream will change as a result. This can happen both ways, either positively or negatively. It can be a pleasant surprise like what MH experienced, or it can have some unintended consequences under the name of side effects.

Chronic Stress and Liver Qi Stagnation in TCM

From Chinese medicine’s point of view, Liver patterns, such as Liver Qi Stagnation and Liver Fire, are the main patterns that underlie Irritable Bowel Syndrome. Keep in mind that the “Liver” in Chinese medicine refers not only to the organ, but also relates to the Limbic System (link to definition from other website) that regulates our response to stress functions and emotions. This is the reason chronic stress is often manifested in Liver pathology in Chinese medicine’s assessment. Thus addressing the Liver Qi Stagnation is an essential part of TCM protocol in treating diseases that are related to chronic stress.

Conclusion

This case demonstrates the importance of applying a holistic approach to address underlying factors in chronic conditions. And Chinese medicine can be used as a safe and effective alternative solution for many chronic diseases in conjunction with other forms of medicine or as a stand alone treatment.

If you are suffering from chronic diseases and looking for an alternative solution. feel free to contact me or leave a comment.

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