Pain Management Options for TMJ Disorders

If you have pain in your jaw, head, face or neck due to a temporomandibular joint disorder (TMD), an oral and maxillofacial surgeon (OMS) who specializes in treating TMD can help ease discomfort. There are several types of TMDs that can each manifest in different ways and for various reasons. While some TMDs require surgical treatment, mild to moderate cases can be addressed with several non-surgical approaches.

Options your OMS may recommend include:

Medication for TMJ Disorders

Your OMS may prescribe medications to reduce the pain of TMD. These may include:

Pain relievers and anti-inflammatory medications: NSAIDs – such as ibuprofen and naproxen sodium – can help reduce pain and inflammation in the TMJ. Additionally, analgesics such as acetaminophen also reduce pain in individuals with TMD. Your OMS may prescribe prescription-strength doses of these drugs.
Muscle relaxants: Muscle relaxants relax the muscles around the TMJ, reducing muscle spasms and relieving pain.
Tricyclic antidepressants: While these drugs are typically used to treat depression, they are sometimes prescribed in low doses to provide pain relief and address bruxism (teeth-grinding) and sleeplessness. Examples include amitriptyline, nortriptyline and desipramine.

Occlusal Splints for TMJ Disorders

An occlusal splint (also known as a dental splint, night guard or bite guard) is a custom-made oral appliance to manage the symptoms of TMD by minimizing pressure on your TMJ and teeth. There are two main types of splints:

Soft splints: Flexible, cushion-like splints create a barrier between the upper and lower teeth, reducing the effects of clenching and bruxism and reducing stress on the TMJ.
Hard splints: A stiff splint stabilizes the TMJ and improves the bite. By redistributing the force applied to the TMJ, it can reduce the pain of TMD.

Trigger Point Injection for TMD

An OMS can give injections to individuals with specific trigger points or areas of localized pain. Not every kind of TMD will benefit from trigger point injections – your treatment will largely depend on the underlying cause of the disorder.

If your OMS decides trigger point injections are right for you, a small amount of a local anesthetic or corticosteroid – will be injected into the sensitive area to provide relief of symptoms.

Physiotherapy for TMD

Physical therapy with an OMS – or in collaboration with a physical therapist – can help manage TMJ pain. Physiotherapy may include:

Jaw exercises: These exercises strengthen the jaw muscles, increase mobility and reduce pain.
Heat or cold therapy: Applying hot or cold compresses to the TMJ can reduce inflammation and relieve pain.
Manual therapy techniques: An OMS or physical therapist can use manual techniques akin to massage or stretching to relax muscles, release tension and improve jaw function.
Improve posture: Sitting up straight can help relieve pressure on the jaw. In addition to following instructions from an OMS or physical therapist, you should use a chair with good back support if you sit at a desk for long periods of time and set your car seat as upright as possible.

Healthy Sleep Practices

Your sleeping position also can affect jaw pain. Sleeping on your back and utilizing pillows that adequately support your neck are ways to avoid putting your jaw in unnatural positions during sleep.

Review and Cease Bad Habits

Habits that may contribute to TMJ pain include nail biting, chewing lips or cheeks, resting your chin on your hand, grinding teeth and clenching your jaw. Be mindful of what habits are most common for you, and if pain is worse after doing them. Discuss these habits with your OMS

Stress Management Techniques for TMD

Stress can contribute to the symptoms and pain of TMD. Your OMS may provide guidance on stress management techniques such as relaxation exercises, deep breathing and counseling to better manage stress and reduce the impact of TMD symptoms.

Surgical Approaches for TMJ Disorders

If your pain is severe and cannot be managed with the above options, you may need to consider surgical treatment options. Several kinds of surgical treatment are available, including minimally invasive options.

Consult an OMS to determine the pain management options that are best for you. An OMS also can assess your TMD symptoms, evaluate the anatomy of your jaw and create a customized treatment plan to reduce your pain and address underlying causes.