Use of Ge Gen for TMJ

This is a guest post, written by Kathryn Sanders, who practices acupuncture and Chinese herbal medicine in New York City. Kathryn is a recent graduate of SIOM where she acquired the ability to read medical Chinese. This case study is a good example of using Puerariae Radix (gé gën) to treat head and neck symptoms that include TMJ. Read on!

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Ge Gen Is Good at Treating Temporomandibular Joint Disorder Syndrome
Shandong province Liao city nursing school (Shangdong 252060) By Zhū Shù Kuān

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For nearly 10 years I have used Puerariae Radix (gé gën) as the primary herb in pattern differentiation and treatment of 30 cases of temporomandibular joint [TMJ] disorder, with rather good results. Case presentations are as follows.
These 30 cases, all of which are outpatient cases, conform to the diagnostic criteria for TMJ disorder. Among these cases are 19 males and 11 females, with the youngest patient being 23 years old and the oldest being 40 years old; the longest term of the disorder was 11 years, and the shortest three months. Treatment results: Among these 30 cases, the treatment was curative for 26 cases and there was improvement in the other four cases. Treatment in all cases was considered to be efficacious. The greatest amount of herbs used in treatment was 26 packs, and the least amount was six packs; the average being 16 packs of herbs.

One example is the treatment of Ms. Li, a 23 year-old female teacher. Her first visit was on February 3, 1994. Three months earlier the patient had contracted a wind-cold. Afterwards, she had a nasal congestion with clear runny mucus. Overall her body and joints were inflexible, tense, and painful. After taking aspirin the wind-cold resolved, and all the symptoms diminished. However, three days later she had pain and a loud clicking sound that came from the temporomandibular joint with mastication, and at the same time she had difficulty opening her mouth. She went immediately to the local hospital for treatment, where she was diagnosed with TMJ syndrome. She was treated for half a month with Oryzanol, vitamin B1, and oxytetracycline; results were less than effective.

I saw that the patient still had generalized body tightness and discomfort, as well as thirst and vexation. The tongue body was red with a thin coat, the pulse sunken and wiry, the diagnosis is wind-cold binding the exterior, with suppression of the defensive qi, leading to heat being generated constraint. She was given a modification of Cinnamon Twig, Peony, and Anemarrhena Decoction (guì zhï sháo yào zhï mû täng): Cinnamomi Ramulus (guì zhï) 10g, Paeoniae Radix (sháo yào) 15g, Anemarrhenae Rhizoma (zhï mû) 15g, Ephedrae Herba (má huáng) 6g, Aconiti Radix lateralis preparata (zhì fù zî) 6g, Saposhnikoviae Radix (fáng fëng) 6g, Angelicae dahuricae Radix (bái zhî) 15g, Gentianae Macrophyllae Radix (qín jiäo) 15g, Puerariae Radix (gé gën) 30g, Glycyrrhizae Radix (gän câo) 3g. Formula was decocted in water and taken warm, 1 packet a day. After taking five packs she was able to open her mouth. The remaining symptom was that she lacked strength when she chewing. She continued with five more packs of the same formula to strengthen and consolidate the treatment. No recurrences of the problem were noted at a one-year checkup.

Note: TMJ disorder is chiefly due to invading wind, cold, and damp pathogens. This results in stasis and obstruction of the channels and collaterals. The defensive and constructive qi become disharmonized, leading to the tendon-channels losing moistening nourishment. Consider that Puerariae Radix (gé gën) is good at releasing spasms and helps to moisten the sinews. In the clinic it is frequently used to treat cervical spine symptoms like those, which lead to extreme stiffness in the nape and neck, Puerariae Radix (gé gën) is used to treat TMJ disorder and spasms of the masseter muscles while chewing by helping to guide [the effects of the formula] to this area. As mentioned above it requires 30 or more grams of Puerariae Radix (gé gën) to be used; only then is the treatment remarkable.

Bibliography: Zhongyi Zazhi, June 1999, Vol. 40, No.6, p.327