I’m sorry to hear about the challenges you’ve been facing. Chronic pain can be incredibly frustrating, especially when diagnostic tests don’t provide clear answers. Let’s carefully assess your situation. Could Invisalign or teeth shifting cause these issues?Yes, it is possible. While Invisalign is generally considered safe, the alignment of teeth can influence the jaw (temporomandibular joint or TMJ) and surrounding structures, including the neck and shoulders. Misalignment or changes in bite during or after orthodontic treatment can lead to TMJ dysfunction, which might cause: -Headaches-Dizziness (sometimes related to TMJ or cervical spine tension)-Neck and shoulder pain-Numbness or tingling (potentially from muscle tension irritating nearby nerves) The jaw and cervical spine are biomechanically connected, meaning shifts in one can influence the other. Invisalign moves teeth gradually, and some individuals may experience unintended strain or tension in the TMJ or surrounding muscles, which can radiate to the neck and shoulders. What should you do now?Here’s a structured approach to addressing your pain: -Consult a TMJ Specialist:A dentist or oral maxillofacial specialist with expertise in TMJ disorders can evaluate your jaw alignment and determine if your symptoms are related to bite changes. They may recommend a bite adjustment, splint therapy, or other interventions. -Physical Therapy:Seek out a physical therapist experienced in treating TMJ disorders and cervical spine issues. They can assess whether muscle tension or postural changes contribute to your symptoms and design a tailored program to relieve pain. -Postural Assessment:Orthodontic changes can sometimes alter posture. Poor posture (especially forward head posture) can exacerbate neck and shoulder pain. A physical therapist or chiropractor can help identify and correct any postural imbalances. -Neurological Assessment:Although your nerve testing has been clear, consider a second opinion if symptoms persist. Rarely, nerve compression or irritation from cervical spine issues (like herniated discs) can cause referred pain and numbness. -Stress Management:Chronic pain can lead to tension and exacerbate symptoms. Consider relaxation techniques, such as mindfulness, yoga, or biofeedback, to reduce stress on the muscles of your neck and jaw. -Orthodontic Review:Discuss your symptoms with the orthodontist who oversaw your Invisalign treatment. They may identify if bite alignment issues remain or if further adjustments are necessary. Dr. Miller Vieira Paula