Temporomandibular Joint Syndrome (TMJ)

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is the treatment for TMJ syndrome? Are there any home remedies that provide TMJ pain relief?

Many symptoms of TMJ syndrome can respond well to home remedies or stress reduction and relaxation techniques. The following home remedies may provide some relief:

  • Ice or cold packs to the area of the joint
  • Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), and other pain relievers, including aspirin (Ecotrin) and acetaminophen (Tylenol)
  • Eating soft foods and avoiding chewing gum
  • Massage or gentle self-stretching of the jaw and neck muscles (A doctor or physical therapist can recommend appropriate stretches.)
  • Relaxation techniques and stress management and reduction

When home remedies are not effective, medical treatment options may be necessary. Most of these types of treatments and remedies will not cure TMJ, but they can provide temporary and even long-term relief from the pain symptoms. These include the following:

  • Dental splint (occlusal splint or stabilization splint or bite guard), which is a dental appliance placed in the mouth that keeps the teeth in alignment and prevents tooth grinding. This resembles a mouth guard and is usually prescribed and fitted by a jaw specialist.
  • Botox may be used to relax the muscles of the jaw. However, this is not currently an FDA-approved treatment for TMJ syndrome.
  • Physical therapy with jaw exercises can strengthen muscles, improve flexibility, and range of motion.
  • In states where medical marijuana is legal, it may be prescribed to help with severe TMJ pain.
  • Biobehavioral management (biofeedback, cognitive behavioral therapy [CBT]) may help diminish pain intensity.
  • Trigger point acupuncture can sometimes be helpful.
  • In severe cases, surgery on the jaw or dental surgery may be necessary.
    • TMJ arthroscopy or arthrocentesis is a minimally invasive procedure usually done in an outpatient setting. Recovery time for this procedure is about a week.
    • Sometimes a total joint replacement is needed. This generally requires a stay in the hospital for several days, and recovery time is four to six weeks.
  • The following prescription-strength medicines may be used to treat TMJ:
    • Muscle relaxers: metaxalone (Skelaxin), cyclobenzaprine (Flexeril)
    • Anti-inflammatory medications: nabumetone (Relafen), meloxicam (Mobic), celecoxib (Celebrex)
    • Steroid injections: beclomethasone (Qvar)
    • Tricyclic antidepressants: nortriptyline (Pamelor), amitriptyline (Elavil, Endep), and desipramine (Norpramin), imipramine (Norfranil, Tipramine, Tofranil)
    • Benzodiazapines: diazepam (Valium), clonazepam (Klonopin), alprazolam (Xanax)
    • Sleep medications: doxepin (Silenor)
    • Nerve pain medications: gabapentin (Neurontin), topiramate (Topamax), levetiracetam (Keppra), pregabalin (Lyrica)
    • Opiate pain medications hydrocodone and acetaminophen (Vicodin, Lortab), oxycodone and acetaminophen (Percocet) Continue Reading
Reviewed on 3/29/2016
References
REFERENCES:

American College of Prosthodontists. "Temporomandibular Joint Disorder & Facial/Jaw Pain." <http://www.gotoapro.org/temporomandibular-joint/>.

Scrivani, J., and Noshir R. Mehta. "Temporomandibular Disorders in Adults." UpToDate.com. Aug. 2015. <http://www.uptodate.com/contents/temporomandibular-disorders-in-adults?source=search_result&search=tmj&selectedTitle=1~77>.

"Study Evaluates Risk Factors for Chronic Temporomandibular Joint and Muscle Disoders." National Institute of Dental and Craniofacial Research. 10 Nov. 2011.

"TMJ." Amerian Academy of Otolaryngology - Head and Neck Surgery. Dec. 2010.

The TMJ Association. "Arthroscopy." June 18, 2014. <http://tmj.org/site/page?pageId=263>.

"TMJ Disorders." National Institute of Dental and Craniofacial Research. Aug. 2013.

TMJ Hope. "TMJD Pain Management." <http://www.tmjhope.org/tmj-treatment/pain-management/>.

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