The temporomandibular (tem-puh-roe-mun-DIB-u-lur) joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull. You have one joint on each side of your jaw. TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement.
The exact cause of a person’s TMJ disorder is often difficult to determine. Your pain may be due to a combination of factors, such as genetics, arthritis or jaw injury. Some people who have jaw pain also tend to clench or grind their teeth, although many people habitually clench or grind their teeth and never develop TMJ disorders.
Treatment. In some cases, the symptoms of TMJ disorders may go away without treatment. If your symptoms persist, your doctor may recommend a variety of treatment options, often more than one to be done at the same time.
Medications. Along with other nonsurgical treatments, these medication options may help relieve the pain associated with TMJ disorders:
Pain relievers and anti-inflammatories. If over-the-counter pain medications aren’t enough to relieve TMJ pain, your doctor or dentist may prescribe stronger pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others), are a mainstay of treatment.
Tricyclic antidepressants. These medications, such as amitriptyline, used to be used mostly for depression, but now are sometimes used for pain relief.
Muscle relaxants. These types of drugs are sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders.
Therapies. Nondrug therapies for TMJ disorder include:
Oral splints or mouth guards (occlusal appliances). Often, people with jaw pain will benefit from wearing a soft or firm device inserted over their teeth, but the reasons why these devices are beneficial are not well-understood.
Physical therapy. Treatments might include ultrasound, moist heat and ice — along with exercises to stretch and strengthen jaw muscles.
Counseling. Education and counseling can help you understand the factors and behaviors that may aggravate your pain, so you can avoid them. Examples include teeth clenching or grinding, leaning on your chin, or biting fingernails.
Surgical or other procedures. When other methods don’t help, your doctor might suggest procedures such as:
Arthrocentesis. Arthrocentesis (ahr-throe-sen-TEE-sis) is a minimally invasive procedure that involves the insertion of small needles into the joint so that fluid can be irrigated through the joint to remove debris and inflammatory byproducts.
Injections. In some people, corticosteroid injections into the joint may be helpful. Infrequently, injecting botulinum toxin type A (Botox, others) into the jaw muscles used for chewing may relieve pain associated with TMJ disorders.
TMJ arthroscopy. In some cases, arthroscopic surgery can be as effective for treating various types of TMJ disorders as open-joint surgery. A small thin tube (cannula) is placed into the joint space, an arthroscope is then inserted, and small surgical instruments are used for surgery.