TMJ pain - anyone found anything that actually works?

[sweetkitty]

I’ve had horrendous TMJ pain for 6 weeks now, been to see the dentist twice and he’s confirmed it, you can actually hear my jaw click when I try to open it. It can only open a little way (the dentist said the couldn’t even make an impression for a mouthguard). It feels sore and swollen on the outside too. I’m a teacher so can’t stop talking but am on a soft food diet which is biting me now. I’ve tried hot and cold compresses, currently taking dihydrocodeine twice a day, paracetamol and ibuprofen (usually take the dihydrocodeine for nerve pain anyway)

Dentist said he would refer me to the dental clinic but it would be months before I would get seen so I asked about private so I’ve to phone and make an appointment probably for Botox or hypnotherapy as they reckon it’s stress. I’m in so much pain it can reduce me to tears at times.

Wondered if anyone else had experience of TMJ problems?

I have exactly the same right now following dental surgery. Can’t open my mouth properly and the pain when trying to do so/yawning etc is just awful. No advice just a fellow miserable sufferer. I’ve had it now for about seven weeks.

Bumping as interested in answers too!

I've struggled for years with it. Worse in times of stress. In January my GP put me on a mild dose of Nortyptaline, it's an antidepressant but can be used for this too.

Started off on 10mg - the relief was instant. After about four months I started to have breakthrough pain - we upped to 20mg and I'm back to having no issues. Totally revolutionary for me having tried many things previously.

I did these and it did help
www.google.com/amp/s/health.clevelandclinic.org/stubborn-tmj-pain-try-trigger-point-massage-and-jaw-exercises/amp/

Clicking is totally normal. Don't worry about the click

When you say the dentist can't get an impression how wide is your mouth opening? Is it physically restricted or painful to open? If you can hear it click you must have some level of opening

Do the compresses and the antiinflammatories actually help? Have you had any improvement at all on a soft diet?

If your dentist is sure it's TMJ, and there's been no improvement you could try and get a short course of diazepam from the GP. In the long run some nortriptiline or amitriptiline can help. Both can help but ultimately you need to get the cause under control, which is usually clenching at night (hence the bite gaurd)

Once the muscles are out of spasm you will need to get a bite guard made. But if the dentist can't get an impression then that's not possible right now

@CarrotSticks23 I already take dihydrocodeine daily for other fibromyalgia related pain so they help a bit. I have both painful to open and actually won’t physically open it takes me all my time to brush my teeth with a tiny battery powered Oral B toothbrush that’s about all I can fit it, a normal toothbrush is a no go.

The pain starts on the outside by my ear on the bone and I can follow it right down to bottom jaw like I have toothache.

I’m also on citalopram 30mg daily

You need to see a maxillofacial surgeon. We always start with conservative management so heat, rest, Pain relief and bite raising appliances of varying materials and thickness. It's only in certain circumstances we move to
Botox after all other avenues have been exhausted. The clicking doesn't really matter that's not the issue it's the muscles.
No chewing gum, chewing pens etc.

I'm a max fax nurse and I also suffer with tmjd so you have my sympathies.

Im currently waiting to see maxo facial docs! Ive tried literally everything, heat, massage, pain relief, bite guard. Dentist thinks botox will help. I feel your pain op its such an awful nagging, constant pain. I hope you find something that works for you soon.

Thanks I’ve done all that no chewing. Heat and cold. My chiropractor tried some things too, it’s not surprising it’s on the right side of my body that’s where everything is, chronic migraines, trapped nerve in my neck, shoulder up at my neck (so it feels like), sciatica, pelvic pain.

My dentist said the waiting list for referral would be months so he referred me to a private clinic in Glasgow where he said Botox could help, I said I could get it for migraines too and wrinkles 3 for 1

Don’t know why I’m laughing it’s so painful only good thing is it’s stopping me eating.

@sweetkitty - I also have fibromyalgia. Please try the nortryptaline I mentioned earlier while you're waiting for anything else. It's impact on my TMJ has been nothing short of miraculous.

@WeKnowFrogsGoShaLaLaLaLa just wondering had you tried any other medication before the nortriptyline? GP had put me on amitriptyline but I didn't like the side effects. I know nortriptyline is similar but more expensive. Bit worried the nortriptyline won't work for me as the amitriptyline didn't. Although in fairness I only took it for three days but stopped due to really intrusive thoughts. @sweetkitty do you know what triggered your tmjd? I know it's common in fibro sufferers but can also be caused by clenching due to a side effect of some anti depressants. I have bilateral myofascial tmjd which is caused by clenching. I wear an nti device which is like a tiny biteguard that goes over my upper incisors. It stops me damaging my teeth (as the back teeth can't meet with it in) but it doesn't stop me from trying to clench. I've been on a soft diet for the past 18months due to it so I know how rubbish it is. Although I suspect mines is caused by a lot of stress in the home (alcoholic dp) so don't be disheartened that mine has lasted so long. Most people recover quite quickly with timely interventions. Mines started mid pregnancy so I couldn't take any pain relief/muscle relaxants.

@WeKnowFrogsGoShaLaLaLaLa

I've struggled for years with it. Worse in times of stress. In January my GP put me on a mild dose of Nortyptaline, it's an antidepressant but can be used for this too.

Started off on 10mg - the relief was instant. After about four months I started to have breakthrough pain - we upped to 20mg and I'm back to having no issues. Totally revolutionary for me having tried many things previously.

Can I ask if you had any side effects from the Nortriptyline? My gastroenterologist has recommended it for my IBS but I also have awful TMJ which aches like crazy. It would be fantastic if Nortriptyline would help that too but I’ve been put off because the side effects mention lots of weight gain and dizziness.

@TheBlueBear89 This was my first medication for it.

@Thedishwasherstacker I had a side effect of not being hungry! For the first few months I had one meal a day and I had to force myself to eat it. Unfortunately it wore off as was quite handy for weight loss. 😂

Thank you for the reply @WeKnowFrogsGoShaLaLaLaLa. I'll ask about trying nortriptyline. Do you mind me asking what your symptoms were? Abd did it affect one side or both?

Both sides. Constant locking and the jaw bones grinding. It affected my eating and my speech. I had a headache from it constantly during a flare up.

I had hypnotherapy to break the clenching at night on top of a small dose of amiltriptaline and a mouth guard. It really worked

It started about 2 weeks after I went back to work after the Summer holidays so dentist thinks it’s stress. It’s been really painful again too had to take dihydrocodeine early as they had worn off, I’m coping with 4 a day very hesitant to go up to 6. I’m going to phone and try to get. Face to face appointment with my GP (something I’ve not had in about 2 years) even before covid they were going to telephone appointments.

@Kenneldogsrock how many sessions of hypnotherapy did you have before noticing a difference? I've had one so far but no change. I wasn't expecting much of a change from one but was hoping for a slight improvement as I listened to the recording (after initial session) regularly. Yes it definitely sounds like it could be stress related @sweetkitty. Have you had any luck with GP? Can't imagine what it must be like to teach with that kind of pain.

@TheBlueBear89 - If I remember correctly then it was about 5 or 6 times in total and it was totally worth it. She also taught me some stress relieving techniques as well which still help over 10 years later.

@TheBlueBear89 to be honest I’ve wimped out and not phoned yet I’ve been very busy at work and cannot face the argument with the receptionist yet. I’m taking dihydrocodeine and paracetamol which really helps but I always know when they are wearing off. I’ve had a sore throat and cold this week too and just feel utterly miserable.

I would try a few acupuncture sessions.

Ah you poor thing @sweetkitty, you're not having an easy time of it. Might be worth looking into physio/osteopathy. I do find physio helps a bit. @Cheerfulcharlie did you try acupuncture for tmjd specifically? I've read other threads about people having success with it for other ailments. My physio actually does it but he puts the needles into the jaw, so I've been too chicken to try! I know the Chinese acupuncturist would sometimes use different pressure points though, so would maybe be more confident to try that.

I haven’t used acupuncture for tmj (I have for other things) but I have used acupressure points for tmj which helped me massively but I would say it probably wasn’t as severe as yours, although it did go on for weeks / months. Eventually I tried doing acupressure on myself several times a day for a few days and eased it massively until it went away completely. I had had a short course on acupressure a few years earlier so kind of knew the techniques of finding and pressing the points but you can probably Google it.

I've been seeing a cranial osteopath for mine after the dentist and doctor would offer nothing but a mouthguard, which actually seemed to be making things worse. I was going once a week, and having some pretty unpleasant intra-oral manipulation together with accupuncture, I'm now down to once a month. I've had to move my most recent appointment so I no haven't been for 6 weeks and I can really feel it. I wouldn't say it solved the problem completely but it has massively improved it.