I have tmj over a year. improving with acupuncture and pt - recently crawling sensation deep in ear ( tickling). is this healing or damage?

Acupuncture: I can only speek from an acupuncture perspective. I am not sure how treatments would lead to a lasting sensation of this type. I believe it warrants evaluation from your physician.

Sadly TMJ syndrome: Is a tricky one. There are many facets to its etilogy and to the symptoms it manifests. Things to also consider with TMJ are occlusion -- have you had braces? How is your present occlusion? Are your teeth worn down? How is your bite? Do you have some sort of an oral appliance to help (nti, bitesoft, ...). Also be evaluated by a TMJ specialist if no real relief. Hope this helps.