The Ultimate Guide To Treating TMJ/Jaw Pain

Overwhelming; that is the best word to describe the world of TMJ and jaw pain treatments. It’s a treacherous minefield of unproven and unregulated treatments, snake oil salesmen masquerading as “specialists” and unending traps that drain you of money and put you at risk of permanent impairment. But as many horror stories as there are, almost every treatment will have their activists as well. So in this article, we want to help you navigate this minefield in a way that minimizes risk and maximizes success, by going over (nearly) every treatment method you’ve ever heard of.

So what is TMJ Disorder, and what’s it got to do with jaw pain?

Well the TMJ (Temporomandibular Joint) is actually your jaw joint. And TMJ Disorder is when there’s any jaw pain, jaw tension, clicking/popping, lockups, earaches, headaches, etc. If you’d like to learn more about it generally, read this article and come back to discover everything about its treatments: https://mytmjrelief.com/blogs/mytmj-blog/okay-so-whats-tmj 

The treatments below are listed from least to most risky (both financially and medically). But many are not likely to be effective, so read the details to truly see if the treatment is worth it for you.

Heat & Massage

Maybe you're just dealing with muscle spasms/pressure points. For example if you have headaches in your temple, this is likely the cause. Heat and massage do a great job relaxing muscles and promoting blood flow to reduce these muscle knots. There’s also a chance that this works to prevent further deterioration of the condition as often times over-tensioned muscles can pull the disc your jaw is supposed to slide on out of place, casing pain, clicking, and lockups as described in this article: https://mytmjrelief.com/blogs/mytmj-blog/why-is-my-jaw-popping-cracking-clicking-and-locking 

Cold Pack

Only use when you’re confident issues are coming from inflammation. So for example if you have arthritis or joint deterioration that’s causing inflammation and pain, use ice. In most cases though, TMJ flare-ups are muscle related and will be made WORSE with cold.

Anti-Inflammatories

This includes NSAIDs (Non Steroidal Anti-Inflammatories) like ibuprofen or prescribed steroidal anti-inflammatories like Methylprednisolone dose packs

Postural Changes

This actually has some of the highest chances of curing your TMJ Disorders on this list. The problem is that figuring out what exactly needs to change is hard because researching is a rabbit hole and results may take some time. However, you should spend a large part of your research efforts here. Things like neck posture are a huge root cause. Even tongue posture, or an incorrect resting bite have direct links to TMJ and Jaw pain. Check this article for more details: https://mytmjrelief.com/blogs/mytmj-blog/the-viral-cause-and-cure-for-tmj 

Prescribed Muscle Relaxants

It’s widely known that overused muscles (for example if you clench) can become over-tensed and over-strengthened over time. This can cause pain through not only muscle knots/spasms but also through pulling your jaw and the disc it slides on out of place. Muscle relaxants can help relieve this pain, and even prevent clenching/grinding at night. Muscle relaxants are however not widely recommended to be used all the time, since they can be habit forming, and often only address the symptoms without addressing the root cause for TMJ Disorder. However, if they help, it can be a very good hint as to what is causing your jaw pain, and can help you pinpoint a more permanent solution.

Physical Therapy/Chiropractors

The reason this is higher “risk” is because a lot of cases of TMD get better with prior steps, and PT can cost you a decent amount of money, especially if it's uninsured. But remember, there are also a lot of exercises you can find online if cost is prohibitive. But you MUST do research first. Because the last thing you want is to do strengthening exercises on the wrong muscles that may make the condition worse. Here are some examples: https://mytmjrelief.com/blogs/mytmj-exercises 

Important note: Most chiropractors take similar approaches to TMD treatment as PTs. But it's CRITICAL that they don't do those fast powerful adjustments that you see in back cracking videos. The TMJ is a very sensitive area and can be damaged very easily by these kinds of adjustments.

Transcutaneous electrical nerve stimulation (TENS)

What they say is that TENS uses small electrical stimulation to relax jaw muscles, but this is probably not the case. In reality, the electrical nerve stimulation simply “tricks” the TMJ nerves into sending fewer pain signals back to the brain because of this new external stimulation. This is why over time this treatment becomes less and less effective. There is very little clinical evidence that this really works to “treat” anything, but it is a very low risk pain relief option that doesn’t hurt to try as long as you don’t pay too much for it.

Ultrasound Therapy

The idea here is that ultrasound heats up deep muscle tissue near the TMJ, which can relax muscles and promote blood flow. There is some evidence that it does do this, but research is very limited. More importantly, some people say it helps them, and there isn’t too much risk if your PT office has an ultrasound at their disposal. It’s worth being careful using ultrasound too close to the ear though, since this may exacerbate tinnitus or ear pain in some cases. 

Botox

This is a controversial one. Basically Botox is an injection of neurotoxin into your jaw muscles that force them to relax. You’ll probably have heard by now stories of people that live by this stuff. This makes sense for the same reasons described above for muscle relaxants, except more potent and localized. And it is true that the long term medical risk is quite low, since Botox wears off after a couple months. But this is a double edged sword, because you’re going to be spending a lot of money getting these injections (more than $500), and if you experience relief, it won’t last forever. It has the same problem that if your TMJ Disorder comes from postural problems, the root cause won’t be dealt with. However if your TMJ Disorder comes from something like clenching or jaw muscle overuse, it may be of more use pinpointing and treating the real issue. For example, a long enough time on botox may help with disc displacement if it has been shifted due to muscle tightness. It’s vital to state the risks though as well. First of all, Botox isn’t FDA approved, which means no insurance and little research. Second of all, many Botox injections are performed incorrectly - either improper dosing or incorrect injection spots. This may just end up being a waste of money or make you unable to smile for the next few months. More information can be found here: https://mytmjrelief.com/blogs/mytmj-blog/botox-for-tmj-what-does-it-do 

Temporary Splints (As opposed to the more risky permanent repositioning splints)

There’s a lot to dive into with splints, and if you want some more information, read this article: https://mytmjrelief.com/blogs/mytmj-blog/splint-therapy-for-tmj-jaw-pain-and-why-you-need-to-be-extra-careful 

But most basically, they are removable appliances that are custom fitted by your dentist or orthodontist with the aim of repositioning your bite and jaw joint to a more favorable position. The key word here is TEMPORARY. What we mean is that they are worn for a couple weeks and not during the entire day (nighttime is common). This is because the goal of these is not to completely reshape your mouth and permanently reposition your bite. 

Occlusal splints are one of the most common treatments for TMJ Disorders you will face, especially from dentists, which is why it’s important to understand the risks. First of all it’s vital that you make sure your dentist doesn’t have the goal of permanently reforming your bite here. Second, it is more than common for people to feel greater pain when using a splint. If this persists, do NOT continue using the splint, as it probably needs re-adjustment. In fact, you should be coming in for readjustment regardless after the first couple weeks to make sure the jaw joint is being set in a favorable position and not one that makes things worse. If your dentist isn’t doing a proper job of communicating these risks, it may be time to find someone else. 

Arthroscopy/Arthrocentesis:

This is a minimally invasive surgery with only a couple days of recovery in which the surgeon inserts a microscopic camera and syringe into the TMJ. This not only lets the doctor physically see what’s going on (inflammation, scarring, disc-displacement, folding, etc) which is a powerful diagnostic tool, but also flush out any inflammation and damaged tissue, break any adhesions, and inject steroids. Around 80% of patients feel improved range of motion and pain relief after this surgery. 

Permanent Repositioning Splints

Before getting too far into it, this is where the vast majority of scams lie. The most common thing people face are the 2 phase TMJ “specialists” or “Neuromuscular Dentists” that charge you several tens of thousands of dollars to put you in a splint that permanently changes your jaw position and then requires orthodontics to permanently change your tooth position. Now, in theory, this may work. However, there is no clinical evidence that points to this being a proper treatment for TMJ. And the level of thoroughness required to not make things worse (reposition the jaw joint into a worse place or ruin your bite or a million other issues) is way too high to be expected from any of these “specialists”. They also often ask for money up front - before any results, even if you come out worse than you came in. Basically unless you have complete trust in your dentist, it’s best to stay away from these permanent repositioning splints both for financial and medical reasons.

Other TMJ Surgeries

TMJ surgery is out of our scope, but the gist is that surgery should be a last resort after trying all less risky and viable treatment options. But by that point, you will hopefully have already been referred to a maxillofacial/orofacial surgeon that can discuss next steps. 

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