TMJ pain is a condition for which a lack of familiarity among many in the medical community may prevent some patients from seeking treatment at all. TMJ pain can be debilitating and create a downward spiral of events that make everything worse.
Mouth and jaw pain from TMJ can make it difficult to sleep without medication, make it difficult to eat, make it difficult to drink, and make it difficult to exercise, and even talk normally, which can cause social stigma or fear of social interaction.
Imagine if you talk to your doctor and they don’t actually have a good treatment option for you; they will probably give you advice on temporary relief like over-the-counter medications and icing and other things that can bring a little relief for a short time.
The prevailing preference of all patients is that they can find a treatment that does not produce unfavorable side effects and has lasting results.
Fortunately, nonsurgical treatments exist for the condition. However, the most important thing that patients seeking treatment for any painful condition must consider is that they consider the ramifications associated with each treatment option, both positive and negative.
What Do We Know About TMJ Pain?
Temporomandibular joint (TMJ) pain falls into the category of a Temporomandibular Disorder (or TMD). The two temporomandibular joints – one on each side of the face – connect your jaw to the base of your skull and are the hinges that allow you to open your mouth when speaking or eating.
TMJ pain and discomfort can occur due to several factors, including arthritis, jaw injury, genetics, and abnormal joint mechanics. Additionally, there may be pain in the jaw area if the ligaments and tendons surrounding the temporomandibular joint become inflamed or damaged.
Today, over 10 million Americans suffer from TMJ disorders. Nonetheless, due to the many risk factors that contribute to it and the different symptoms it causes, this condition remains clinically challenging to diagnose and treat.
For example, clenching and grinding the teeth could be a risk factor for TMJ pain, but not all people with bruxism develop temporomandibular disorders. What’s more, the symptoms and discomfort deriving from TMJ can vary in nature and intensity from one person to another.
In any case, understanding the condition and obtaining an accurate diagnosis are the first steps to finding adequate treatment. So, let’s start by looking into the key facts you should know about TMJ.
Patients, when asked to explain their experiences with TMJ pain, will often cite their experience with one or both joints increasing in pain. Over time and without treatment, patients also explain how the pain increases to where they will not or cannot open their mouths because of the swelling and locking of these joints.
Beyond the pain in one or both of the temporomandibular joints, TMJ disorders can manifest themselves as a range of signs and symptoms, including the following:
- Tenderness and aching in the jaw area
- Facial pain and discomfort that radiates to the ears
- Aching sensations in the shoulders and neck area
- Difficulty opening mouth and chewing
- Earaches and ear problems such as tinnitus (ringing in ears)
- Tooth pain (especially if TMJ disorders are caused by teeth grinding and clenching)
- Swelling around the jaw area, often associated with inflammation
TMJ disorders can also cause clicking, grinding, and popping noises when opening and closing the mouth.
One unfamiliar with the condition of TMJ pain can only imagine the issues this would cause for patients who wish to eat, drink, and clearly communicate.
In some cases, TMJ might be temporary. This can happen if the condition is caused by high levels of stress or inflammation of the tissue around the joint. However, in most cases, TMJ disorders cause long-lasting pain that worsen over time. This is especially true if this condition is caused by the degeneration of the joint’s components.
This degeneration may involve:
- The joint’s cartilage (a cushioning disk between the joint’s bones) erodes or is damaged by arthritis
- The joint’s components move out of alignment and cause mechanical issues
- Jaw deformities, such as malformations at birth
- Direct trauma to the joint
In these cases, TMJ pain can cause chronic and acute pain that lasts for months or years. The discomfort can start as a mild soreness in the jaw area, but it can progress into a reduced range of motion for the mouth, difficulty eating, and daily migraines. Over time, TMJ dysfunctions can also cause changes in the way the teeth fit together and cause permanent damage to the teeth.
TMJ disorders are diagnosed by a dentist or other specialized healthcare professional.
During a dental check-up, a dentist will assess the jaw’s range of motion and determine what areas cause discomfort. The doctor might also conduct a series of tests to determine what’s causing the TMJ pain. These examinations include imaging tests such as panoramic X-rays, cone beam computed tomography (CBCT) tests, and MRI scans.
These tests aim to determine what parts of the joints have been damaged, whether there are mechanical issues, or if the tissues around the TMJ are affected by inflammation.
What The Research Says About TMJ Pain
While our knowledge of TMJ pain may be limited, such is the case for many pain conditions. Luckily, as our search for a treatment for this pain condition continues, many continue to research and put in the work to make these solutions manifest.
The existing body of research focuses on determining the causes and symptoms of TMJ pain, as well as assessing what demographic groups are more affected by this condition. 2021 studies also aimed to resolve controversies in the diagnosis and management of this condition.
Although a lot is yet to be understood, recent research is providing today’s patients with invaluable insights that can be used to prevent and manage TMJ dysfunction. Let’s look at what the research says about TMJ below.
The Complex Origins Of TMJ Pain
One of the most important aspects of TMJ pain is that it regularly points to a complex origin.
Doctor Miho Ibi of Iwate Medical University breaks down TMJ’s origin by explaining that, “Temporomandibular disorders (TMD) are a common stomatognathic disease affecting all age groups. Patients with internal derangement (ID) or osteoarthritis (OA) of temporomandibular joint (TMJ) often have TMJ synovitis [swelling]” (2019).
In other words, TMJ pain is a TMD that can affect everyone, and it is often a form of osteoarthritis in the TMJ itself. Dr. Ibi continues to elaborate on the condition’s causes by stating that, “[w]hen TMJ synovial membrane is damaged, many inflammatory cytokines [crucial proteins that work for the immune system] are produced and secreted from TMJ synoviocytes to the synovial fluid of TMJ.”
What Dr. Ibi describes is an inflammation that is triggered by TMJ pain and further exacerbated by the reaction from inflammatory cytokines, the proteins that drive the immune system’s cells, and the inflammation response mechanism.
As we have discussed many times before, the pain and inflammation cycle are often a downward spiral effect of chronic pain.
This is clearly an issue, as many patients who experience swelling in the TMJ will have difficulty speaking and/or eating when the TMJ increases in swelling with each movement, as well as experiencing malnutrition, due to pain from chewing essential foods.
While Dr. Ibi points to osteoarthritis as the cause of TMJ pain, the direct cause is not easily determined, and it’s due to multiple factors, including injury or even the habitual grinding of teeth.
However, Dr. Ibi is correct to diagnose that the most common cause for TMJ pain is osteoarthritis which wears down the disk that lies between the TMJ and the base of the skull.
Normally, this disk would absorb the impact or shock from the chewing and sliding of the jaw. Much like the disks that lie between the vertebrae in our spines, the disks in our TMJ will wear out over time due to the risk factors discussed. Regardless of the cause of TMJ pain, the hassle of living with this condition cannot be understated.
The High Probability Of TMD and TMJ Pain In Women
Dr. Sebastien Sannajust and his associates determined that while TMD and TMJ pain can manifest in everyone, “(w)omen are more commonly diagnosed with TMD and are more likely to seek care at tertiary orofacial pain clinics.
Limited knowledge regarding mechanisms underlying TMJ pain impairs the development of improved pain management strategies” (2019).
In simpler terms, TMJ is 1.5-2 times more prevalent in women than in men, and 80% of the patients treated with TMJ are women. Nonetheless, little is understood about why women are more likely to suffer from TMJ.
A few factors that may come into play and increase the prevalence of TMJ among the female population include:
- Drops in estrogen levels: Estrogen is a powerful anti-inflammatory hormone. During life events such as menopause, the levels of estrogen in a woman’s body drop, thus leaving females more exposed to inflammatory conditions such as arthritis and inflammatory TMJ pain.
- Progesterone fluctuations: Changes in the levels of progesterone may affect the body’s ability to form bones and maintain the health of the joints.
- Anatomical factors: Women’s joints are more lax and more unstable than men’s. This can make mechanical issues more likely and increase the risk of a joint’s components sliding out of alignment.
- Stress management: Women show a different psychological and physiological response to stress than men, which makes them more likely to develop problems such as bruxism and teeth grinding.
The Side Effects Of TMJ Pain On Daily Life
Although at first, TMJ pain might seem nothing more than a minor issue, the pain and discomfort can progress over time and begin to affect all aspects of life.
Firstly, pain that radiates to the ears and neck can cause recurring migraines or severe headaches, which is one of the most common conditions associated with TMJ dysfunction. Headaches can cause fatigue, inability to focus at work, and reduced productivity.
Physically, TMJ pain can prevent a person from opening and closing their mouth properly, or lead to a jaw that “locks up” during movement. These consequences aren’t just painful; they can also cause severe health complications. It might lead to a person struggling to eat and drink normally.
Not being able to eat or drink well is obviously going to cause nutritional deficiencies and dehydration over time. People already don’t drink enough water, so any aspect of life that further reduces hydration is a detriment to health.
Additionally, TMJ pain is known to be worse at night time. While sleeping, a person is more prone to teeth clenching and grinding as their body tries to keep the airways open and they don’t have control over voluntary movements of the jaw.
The pain and discomfort that radiates from the jaw to the neck, shoulder, ears, and head can keep a person with TMJ awake at night and prevent them from getting enough rest. Currently, it is estimated that more than 50% of TMD patients suffer from sleep disturbances.
Reduced sleep is one of the most widely known causes of continued downward health spirals. If you can’t sleep well, you can’t ensure your health and your body can’t overcome systemic inflammation if the tissues are constantly under stress and pain from not being able to sleep.
These elements alone are enough for most patients to realize that they need an option that can relieve the pain and restore health in order to regain their quality of life.
Fortunately, there is more than one valid treatment option that allows for easing pain deriving from a temporomandibular joint disorder without surgery or medications. Let’s look at the different therapies available and which one might be the best choice.
How To Relieve TMJ Pain At Home
Because the pain deriving from temporomandibular joint disorders is often not properly understood or diagnosed, many patients are encouraged to manage their discomfort with at-home methods.
These strategies include:
- Soft-Food Diets: Avoiding hard and crunchy foods can reduce the stress on the joint’s components while eating, thus preventing the pain that usually accompanies chewing.
- Compresses: Compresses and ice packs can reduce the swelling and sensations of warmth that are commonly associated with the high levels of inflammation in TMJ pain.
- Avoiding Excessive Motion And Pressure In The Jaw: If one or more of the components of the temporomandibular joint has been injured, it may be a good idea to avoid movement of or pressure on the jaw.
- Massages: Massages can ease the tension in the muscles around the jaw area, which can reduce stress-related grinding and clenching of the teeth.
While these solutions might provide short-term relief, they are impractical at best, and inefficient at worst. Indeed, relying on compresses or only eating soft foods can cause severe limitations to a social or personal life. Plus, these solutions are ineffective in addressing the underlying cause of TMJ dysfunction in the long-term.
Why Medications Don’t Always Work For TMJ Pain
In recent years, so much effort in the pharmaceutical production field is directed toward anti-inflammatory medications. This is also the reason for the wide-scale use of steroids to reduce inflammation, which reduces pain.
However, pain-relievers, non-steroidal anti-inflammatory drugs should not be considered a long-term solution for TMJ pain.
While these therapies are easily available and affordable for most patients, they may come with severe side effects. Let’s look at the reasons why it’s important to look beyond pharmaceutical remedies for TMJ pain.
Over-The-Counter Pain Medications
Pain-relievers and non-steroidal anti-inflammatory drugs (NSAIDs) are easily accessible as over-the-counter therapies. These medications can reduce pain in the short-term and provide relief from the discomfort caused by TMJ disorders.
However, depending on the underlying cause of TMJ pain, this condition can last weeks, months, or even years. Taking NSAIDs and pain relievers for such long periods of time can expose a person to a cascade of side effects, including:
- Sweating and hot flashes
- Digestive issues such as nausea and vomiting
- Dizziness and vertigos
- Fatigues and lethargy
- Loss of coordination
- Increased risk of heart attacks and strokes
- Increased risk of gastrointestinal problems such as ulcers and bleeding
When taken over long periods, these medications can also lead to increased tolerance and dependency.
Several medications can be prescribed to ease the pain of TMJ. These include muscle relaxants such as Zanaflex and sedative-like drugs such as Valium. In some cases, your doctor might prescribe medications such as Cyclobenzaprine, which have been seen to prevent pain sensations from reaching the brain.
Although these medications might provide relief from TMJ pain in the short term and help to restore sleep, it is essential to be aware of the side effects they might cause.
Steroids are the artificial version of chemicals that are naturally present in the human body. These compounds are responsible for managing the inflammatory response and can help ease the pain and discomfort of an inflamed temporomandibular joint for weeks at a time.
However, resorting to steroid injections can lead to hormonal problems such as acne and cause severe mood swings. In extreme cases, one might even experience muscle weakness (especially around the injection area) and slower wound healing.
Non-Surgical Alternatives In Conservative Treatment
As the symptoms of a TMJ dysfunction begin to appear, it is important to consider trying non-surgical, conservative treatments. Often, these therapies offer relief but are not disease-modifying nor curative, meaning that they won’t address the underlying cause of TMJ pain.
Generally, conservative treatments strive to reduce pain and prevent further damage to the joint. These therapies include:
- Wearing a mouth guard: Night guards and splints are removable devices that are worn over the upper or lower teeth. They absorb the shock during mouth closure and prevent the teeth from being damaged by grinding and clenching motions. At nighttime, they can ease the tension in the muscles around the jaw joint, reducing pain.
- Exercises: Some jaw exercises such as gentle stretching can relieve muscle tension and improve jaw function. They are more efficient when coupled with icing and moist heat compresses.
- Physical therapy: Physical therapy for the jaw includes stretching and strengthening exercises that aim to improve the conditioning of the muscles, tendons, and ligaments around the jaw joint, thus providing support to damaged components.
Surgery: The Last Resort
If the TMJ pain is getting worse and not responding well to treatments, surgery might start to seem like the last viable treatment route. In some cases, (such as if the TMJ disorder is caused by missing or crooked teeth) oral surgery and other corrective dental treatments might be required to restore your oral and bite health.
If the temporomandibular joint disorder is caused by stress, inflammation, or arthritis, surgery might not be the best option to consider. Some of the most common surgical procedures for TMJ include:
- Botox injections: Botulinum toxin injections are used to reduce inflammation in painful trigger points and reduce muscle mass.
- Arthrocentesis: This procedure aims to remove inflammatory fluid and debris from the joint, thus relieving the pressure caused by swelling and easing inflammation.
- Arthroscopy: This type of surgery involves inserting an arthroscope (a diagnostic instrument) into the joint to diagnose any problem. The surgeon will use the visual guidance provided by the arthroscope to operate the joint.
- Joint replacement surgery: Open-joint surgery is performed in severe cases, where one or more parts of the temporomandibular joint have been irreversibly damaged and require replacement.
Surgical and invasive procedures for TMJ pain come with long rehabilitation periods and they might not be effective in the long term. In a study conducted in 2013, nearly 40% of the patients who underwent arthroscopy for TMJ pain eventually required further surgical interventions.
Our Neurofunctional Pain Management May Be Your Best Option
Neuragenex is pioneering the field of Neurofunctional Pain Management and stands at the forefront of innovative next-generation pain management. Neurofunctional Pain Management is the concept of using non-invasive, non-surgical, non-pharmaceutical, and non-chiropractic techniques to relieve pain and restore health.
Some of the therapies and techniques we use as part of our individualized Neurofunctional Pain Management program include:
- Viscosupplementation: These procedures use hyaluronic acid to replenish the levels of lubricating fluids in the damaged temporomandibular joint disorder. Even after a single injection, hyaluronic acid can restore the jaw movement’s fluidity, reduce friction, ease inflammation, and broaden the jaw’s range of movement.
- Natural therapies – Therapies that leverage a patient’s own growth factors can support the body’s ability to heal itself and regenerate tissue damaged by inflammation and friction.
- Lifestyle counseling – Beyond simply providing patients with TMJ pain treatments, we look at how to address the lifestyle factors that might be worsening this condition. Through our lifestyle counseling programs, we are able to modify risk factors for TMJ such as posture, eating habits, sleep quality, and stress levels.
This approach to chronic pain management means that Neuragenex aims to relieve pain so that health can be restored, and quality of life can be improved in an upward spiral event. With a large variety of treated pain conditions, from temporomandibular joint pain to endometriosis, to peripheral neuropathy pain, patients know that Neuragenex will have a safe and effective treatment option for them.
As the pioneer of Neurofunctional Pain Management, Neuragenex is creating the next generation of pain management practices across the nation that will be the first step in the journey of chronic pain relief.
Why We Use The Neurofunctional Approach
Neurofunctional Pain Management addresses not only the pain and physical health of a patient in chronic pain but also the mental health of a patient going through life in chronic pain.
There is a well-known correlation between chronic pain and deterioration in behavioral health. Being able to at least address this correlation is important to the overall outcome of chronic pain relief.
Unlike most in-and-out medical solutions, Neuragenex spends quality time with patients to learn about their condition and their overall situation. This is what Neurofunctional Pain Management is all about.
The Phases Of The Neurofunctional Pain Management Protocol For TMJ Pain Relief
With Neuragenex and the next generation of pain management treatments using Neurofunctional Pain Management, there are few downsides to the treatment protocols we offer.
The combination of high pulse electrical stimulation and specialized hydration therapy creates an enduring pain relief effect that Neuragenex calls its Neurofunctional Pain Management treatment protocol.
Neurofunctional Pain Management is a proprietary treatment protocol using the elements listed above. Neuragenex is a non-pharmaceutical, non-surgical, non-invasive, and non-chiropractic pain treatment program. Patients are offered safe and effective treatment options they really want and options that relieve pain, restore health and magnify the quality of life.
Pain signals have the purpose of driving us to seek treatment or to stop using the affected area altogether. With Neurofunctional Pain Management we can manage the pain signals that trigger the pain while treating the chronic inflammation condition with hydration therapy, so we lessen pain over time.
While TMJ pain is largely treatable through Neurofunctional Pain Management, some causes of TMJ are mechanical issues that will likely require an orthopedic mechanical treatment to actually correct. When there is no safe orthopedic option available, it simply becomes a process of mitigating the pain and living with chronic pain.
Phase 1: Pain Management Through Electrical Stimulation
TMJ pain as a chronic pain condition falls into the same category of other pain conditions that are chronically inflamed because of the pain and inflammation cycle, and is effectively treated with Neurofunctional Pain Management techniques found at Neuragenex.
Neurofunctional Pain Management, or NFPM, is a combination of high-pulse electrical stimulation that relieves pain through a process called sustained depolarization. High-pulse electrical stimulation is the first aspect of NFPM because patients need to experience pain relief before they are willing to engage in additional life-improving activities.
This effect is only created with high-pulse electrical fields that are unavailable to non-physicians and non-medical offices. The devices you may see from chiropractors or physical therapists are likely not true high pulse electroanalgesia devices because they would require a medical provider on site to use and receive reimbursement for those devices.
Phase 2: Hydration Therapy
Restoring health is the second phase of Neurofunctional Pain Management by using a specialized hydration therapy that balances nutritional deficiencies and reduces chronic systemic inflammation.
Systemic inflammation is becoming one of the known and accepted causes of chronic pain. Pain and inflammation are symbiotic cycles, where one causes the other which causes the other, and so on.
Phase 3: Nutritional Counseling
For patients to continue healing and living without pain, it is essential that they not only find a way to treat the pain, but that they also restore health and regain their quality of life.
As patients experience treatment, they will also be given extensive education opportunities through lifestyle counseling and coaching. This enables patients to educate themselves on their condition, which will assist them in furthering their pain treatment effectiveness and relief.
Effective Pain Relief For TMJ Is Within Your Reach
Temporomandibular joint disorders can have a profound impact on a person’s life, from preventing them from enjoying a meal with friends to causing severe sleep disturbances. However, a diagnosis of TMJ dysfunction does not necessarily mean they have to live in fear of relying on medications or having to undergo surgery.
Neuragenex offers next-generation pain management solutions to help in overcoming TMJ pain, restoring overall health, and improving quality of life.