CRANIO® The Journal of Craniomandibular & Sleep Practice
ISSN: 0886-9634 (Print) 2151-0903 (Online) Journal homepage: http://www.tandfonline.com/loi/ycra20
Stress: A Chain Reaction Charlotte Carey To cite this article: Charlotte Carey (1992) Stress: A Chain Reaction, CRANIO®, 10:4, 335-336, DOI: 10.1080/08869634.1992.11677933 To link to this article: http://dx.doi.org/10.1080/08869634.1992.11677933
Published online: 18 Feb 2016.
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Date: 12 August 2017, At: 16:05
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Stress: A Chain Reaction Everybody has it, everybody talks about it, yet few people have taken the trouble to find out what stress really is. The simplest definition would be a ''reaction to an action'' or ''fight or flight." To give a more thorough definition is difficult because stress means different things to different people. Is stress merely a synonym for distress? Is it effort, fatigue, pain, fear, the need for concentration, the humiliation of censure, the loss of blood, or even an unexpected great success? Every one of these conditions produces stress, but none of them can be singled out as being "it." Dr. Hans Selye, professor and director of the Institute of Experimental Medicine and Surgery at the University of Montreal, defines stress as the nonspecific response of the body to any demand made on it. Medical research has shown that in many respects, the body responds in a stereotypical manner, with identical biochemical changes, essentially meant to cope with any type of increased demand on the human machinery. The stress-producing factors, technically called the stressors, are different, yet they all elicit essentially the same biological stress response. Each demand made on our body is in a sense unique, that is, specific. Cold causes us to shiver, while heat makes us sweat. Diuretic drugs increase the production of urine; the hormone, adrenaline, augments the pulse rate and blood pressure, whereas the hormone, insulin, decreases blood sugar. Yet, no matter what kind of derangement is produced, all these agents have one thing in common; they also increase the demand for readjustment. This demand is nonspecific. It requires adaptation to a problem, irrespective of what that problem may be.
In other words, in addition to their specific actions, all agents we are exposed to also produce nonspecific increases in the need to perform adaptive functions and thereby reestablish normalcy. This is independent of the specific activity that caused the rise in requirements. The nonspecific demand for activity, as such, is the essence of stress. 1 It is immaterial whether the agent .or the situation we face is pleasant or unpleasant. The most important aspect is the intensity of the demand for readjustment or adaptation and how an individual responds to that demand. Stress as we know it is not universaU Not everyone experiences this "alerting response" to the environment. Furthermore, stress does not cause disease and illness uniformly in response to changes in the environment. The truth is that the experience and effects of stress are highly individual and variable. Moreover, some individuals exist who seemingly thrive on stress, actually becoming healthier and more effective in its presence. Other people crumble, developing stress-related illnesses and emotional disorders, and experiencing a gross disruption in functioning. 3 Temporomandibular joint dysfunction (TMD) is commonly seen in tandem with many stress-related diseases. There are three classes of causative factors in TMD. In any given patient these factors vary in their importance, but generally speaking, all interact to play a role in producing symptoms. The factors are: 1. Pathological mechanical stresses in the biting relationship (malocclusion) 2. Habit patterns. These are repetitive movements and positionings of the lower jaw outside the range of normal, functional
Charlotte Carey, P.T. Optimum Physical Therapy Center 2980 State Highway 10 Morris Plains, New Jersey 07950
''The most important aspect is the intensity of the demand for readjustment or adaptation and how an individual responds to that demand.''
335 JNL CRANlOMANDlBULAR PRAC OCTOBER 1992 VOL. 10, NO.4
Downloaded by [Australian Catholic University] at 16:05 12 August 2017
''Frequently, the patient exhibits a close relationship between periods of pain and periods of heightened stress cycles.''
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Prescriptions for Handling Stress7 1. Breathe slowly and deeply from stomach area 2. Relax muscles with tension-and-release cycles or recall relaxation 3. Imagine yourself loose, limp, and relaxed 4. Give yourself a six-second tranquilizer before answering the phone and while waiting in long lines 5. Avoid stress-inducing foods/seasonings 6. A void smoking/chewing tobacco 7. Control your weight by changing eating habits 8. Exercise regularly 9. Form a partnership with a competent, caring physician
336 JNL CRANIOMANDIBULAR PRAC OCTOBER 1992 VOL. 10, NO. 4
positions (grinding of teeth, clenching, nail biting, etc.) 3. Emotional stress. This may be associated with either longterm, deep-seated problems or problems of an everyday social, financial, interpersonal-relationship nature. 4 Pathological mechanical stresses in the biting relationship result from an alteration in the way in which teeth interdigitate in either a closing position or in a side-to-side movement of the lower jaw. The muscles responsible for the movement of the lower jaw are forced to torque the jaw into an unnatural closing or a side-to-side movement in order to achieve the desired jaw position or movement. This means a need for continued extra muscle activity just to perform usual, normal jaw movements. Continued repetitive demands on muscle activity can cause muscle spasms felt by the patient as pain and soreness distributed according to those particular muscles involved. 25 Unusual habits concerning jaw movements or positions are generally an expression of stress. The most common habits include teeth clenching and grinding, lip and cheek biting, placement of foreign objects (pipes, pens, etc.) between the teeth, chewing ice, and nail biting. The degree of their effect depends on the frequency of performance and the intensity of the forces exerted in the jaw movement or position. Hundreds of pounds per square inch can be applied during some of these habits, sending the involved muscles into spasm and creating pain. Many of the habit patterns mentioned result in heavy stresses being placed on the muscles of the jaw, as the jaw may be held in extreme positions. These forces are transmitted into the temporomandibular joint itself, and can cause pathological changes in the joint contents. This pa-
thology can then alter jaw movements to produce additional muscle spasms and further pain. Emotional stress acts to create muscle hyperactivity. Stress alone can cause all types ofTMD symptomatology without considering habit patterns or malocclusion. Stress also acts by promoting the need for habit patterns as an outlet, an escape valve. It increases the intensity of the contraction of the muscles during the habit application and does not give the patient an opportunity to allow the muscles time to rest, to reduce the strain on them. Frequently, the patient exhibits a close relationship between periods of pain and periods of heightened stress cycles. 4·6 Treating TMD involves managing all three of these causative factors. Unless all of these are addressed, hope for successful treatment is limited. Although we have little or no control over genetic predisposition and some control over environmental pathogens, improved coping strategies can be learned through a variety of relaxation and reconditioning techniques leading to a greater sense of control and well-being for the patient. There is compelling evidence that such behavioral training can bring about better health, greater job satisfaction, increased productivity, and decreased health care costs.
References I. 2. 3. 4. 5.
6. 7.
Selye H: Stress Without Distress. New York: JB Lippincott Co., 1975: 25-32 Smoller 8, Schulman 8: Pain Control: The Bethesda Program. Garden City: Doubleday and Company, Inc., 1982: 55-58 Burchfield S: The stress response: A new perspective. Psychosom Med 1979: 41 Stroebel C: QR the Quieting Reflex. New York: GP Putnam & Sons, 1982: 72-81 Kraus S: TMJ Disorders: Management of the Craniomandibular Complex. New York: Churchill Livingston, 1988: 74 Janowitz H: Your Gut Feelings. Oxford Press, 1987: 190-193 Nathan R, Staats T, Rosch P: The Doctor's Guide to Instant Stress Relief. New York: Putnam's Sons, 1987
ISSN: 0886-9634 (Print) 2151-0903 (Online) Journal homepage: http://www.tandfonline.com/loi/ycra20
Stress: A Chain Reaction Charlotte Carey To cite this article: Charlotte Carey (1992) Stress: A Chain Reaction, CRANIO®, 10:4, 335-336, DOI: 10.1080/08869634.1992.11677933 To link to this article: http://dx.doi.org/10.1080/08869634.1992.11677933
Published online: 18 Feb 2016.
Submit your article to this journal
Article views: 1
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ycra20 Download by: [Australian Catholic University]
Date: 12 August 2017, At: 16:05
Downloaded by [Australian Catholic University] at 16:05 12 August 2017
Stress: A Chain Reaction Everybody has it, everybody talks about it, yet few people have taken the trouble to find out what stress really is. The simplest definition would be a ''reaction to an action'' or ''fight or flight." To give a more thorough definition is difficult because stress means different things to different people. Is stress merely a synonym for distress? Is it effort, fatigue, pain, fear, the need for concentration, the humiliation of censure, the loss of blood, or even an unexpected great success? Every one of these conditions produces stress, but none of them can be singled out as being "it." Dr. Hans Selye, professor and director of the Institute of Experimental Medicine and Surgery at the University of Montreal, defines stress as the nonspecific response of the body to any demand made on it. Medical research has shown that in many respects, the body responds in a stereotypical manner, with identical biochemical changes, essentially meant to cope with any type of increased demand on the human machinery. The stress-producing factors, technically called the stressors, are different, yet they all elicit essentially the same biological stress response. Each demand made on our body is in a sense unique, that is, specific. Cold causes us to shiver, while heat makes us sweat. Diuretic drugs increase the production of urine; the hormone, adrenaline, augments the pulse rate and blood pressure, whereas the hormone, insulin, decreases blood sugar. Yet, no matter what kind of derangement is produced, all these agents have one thing in common; they also increase the demand for readjustment. This demand is nonspecific. It requires adaptation to a problem, irrespective of what that problem may be.
In other words, in addition to their specific actions, all agents we are exposed to also produce nonspecific increases in the need to perform adaptive functions and thereby reestablish normalcy. This is independent of the specific activity that caused the rise in requirements. The nonspecific demand for activity, as such, is the essence of stress. 1 It is immaterial whether the agent .or the situation we face is pleasant or unpleasant. The most important aspect is the intensity of the demand for readjustment or adaptation and how an individual responds to that demand. Stress as we know it is not universaU Not everyone experiences this "alerting response" to the environment. Furthermore, stress does not cause disease and illness uniformly in response to changes in the environment. The truth is that the experience and effects of stress are highly individual and variable. Moreover, some individuals exist who seemingly thrive on stress, actually becoming healthier and more effective in its presence. Other people crumble, developing stress-related illnesses and emotional disorders, and experiencing a gross disruption in functioning. 3 Temporomandibular joint dysfunction (TMD) is commonly seen in tandem with many stress-related diseases. There are three classes of causative factors in TMD. In any given patient these factors vary in their importance, but generally speaking, all interact to play a role in producing symptoms. The factors are: 1. Pathological mechanical stresses in the biting relationship (malocclusion) 2. Habit patterns. These are repetitive movements and positionings of the lower jaw outside the range of normal, functional
Charlotte Carey, P.T. Optimum Physical Therapy Center 2980 State Highway 10 Morris Plains, New Jersey 07950
''The most important aspect is the intensity of the demand for readjustment or adaptation and how an individual responds to that demand.''
335 JNL CRANlOMANDlBULAR PRAC OCTOBER 1992 VOL. 10, NO.4
Downloaded by [Australian Catholic University] at 16:05 12 August 2017
''Frequently, the patient exhibits a close relationship between periods of pain and periods of heightened stress cycles.''
'"".l
~
~
s..... ·'"".l ~
~
~ ~
~ ~
=: ~
t!)
Prescriptions for Handling Stress7 1. Breathe slowly and deeply from stomach area 2. Relax muscles with tension-and-release cycles or recall relaxation 3. Imagine yourself loose, limp, and relaxed 4. Give yourself a six-second tranquilizer before answering the phone and while waiting in long lines 5. Avoid stress-inducing foods/seasonings 6. A void smoking/chewing tobacco 7. Control your weight by changing eating habits 8. Exercise regularly 9. Form a partnership with a competent, caring physician
336 JNL CRANIOMANDIBULAR PRAC OCTOBER 1992 VOL. 10, NO. 4
positions (grinding of teeth, clenching, nail biting, etc.) 3. Emotional stress. This may be associated with either longterm, deep-seated problems or problems of an everyday social, financial, interpersonal-relationship nature. 4 Pathological mechanical stresses in the biting relationship result from an alteration in the way in which teeth interdigitate in either a closing position or in a side-to-side movement of the lower jaw. The muscles responsible for the movement of the lower jaw are forced to torque the jaw into an unnatural closing or a side-to-side movement in order to achieve the desired jaw position or movement. This means a need for continued extra muscle activity just to perform usual, normal jaw movements. Continued repetitive demands on muscle activity can cause muscle spasms felt by the patient as pain and soreness distributed according to those particular muscles involved. 25 Unusual habits concerning jaw movements or positions are generally an expression of stress. The most common habits include teeth clenching and grinding, lip and cheek biting, placement of foreign objects (pipes, pens, etc.) between the teeth, chewing ice, and nail biting. The degree of their effect depends on the frequency of performance and the intensity of the forces exerted in the jaw movement or position. Hundreds of pounds per square inch can be applied during some of these habits, sending the involved muscles into spasm and creating pain. Many of the habit patterns mentioned result in heavy stresses being placed on the muscles of the jaw, as the jaw may be held in extreme positions. These forces are transmitted into the temporomandibular joint itself, and can cause pathological changes in the joint contents. This pa-
thology can then alter jaw movements to produce additional muscle spasms and further pain. Emotional stress acts to create muscle hyperactivity. Stress alone can cause all types ofTMD symptomatology without considering habit patterns or malocclusion. Stress also acts by promoting the need for habit patterns as an outlet, an escape valve. It increases the intensity of the contraction of the muscles during the habit application and does not give the patient an opportunity to allow the muscles time to rest, to reduce the strain on them. Frequently, the patient exhibits a close relationship between periods of pain and periods of heightened stress cycles. 4·6 Treating TMD involves managing all three of these causative factors. Unless all of these are addressed, hope for successful treatment is limited. Although we have little or no control over genetic predisposition and some control over environmental pathogens, improved coping strategies can be learned through a variety of relaxation and reconditioning techniques leading to a greater sense of control and well-being for the patient. There is compelling evidence that such behavioral training can bring about better health, greater job satisfaction, increased productivity, and decreased health care costs.
References I. 2. 3. 4. 5.
6. 7.
Selye H: Stress Without Distress. New York: JB Lippincott Co., 1975: 25-32 Smoller 8, Schulman 8: Pain Control: The Bethesda Program. Garden City: Doubleday and Company, Inc., 1982: 55-58 Burchfield S: The stress response: A new perspective. Psychosom Med 1979: 41 Stroebel C: QR the Quieting Reflex. New York: GP Putnam & Sons, 1982: 72-81 Kraus S: TMJ Disorders: Management of the Craniomandibular Complex. New York: Churchill Livingston, 1988: 74 Janowitz H: Your Gut Feelings. Oxford Press, 1987: 190-193 Nathan R, Staats T, Rosch P: The Doctor's Guide to Instant Stress Relief. New York: Putnam's Sons, 1987
