Do Pain Management Doctors Treat TMJ?

Yes, pain management doctors treat disorders of the temporomandibular joint (TMJ), as the primary symptom is pain. There are numerous treatments that a pain specialist may suggest or conduct. One of the most effective treatments for TMJ disorder is TENS therapy. TENS stands for transcutaneous electrical nerve stimulation and works by delivering electrical currents at a low voltage through adhesive electrodes placed over the area of pain.

These electrical currents help block pain signals sent from the nerves to the brain. TENS may also help in TMJ cases, particularly as the electrical impulses can help relax unnecessarily tight muscles that could contribute to your symptoms. Another treatment that a pain specialist may use for TMD (temporomandibular joint disorder) is neuromuscular orthotics. These appliances are similar to mouth guards in that they are placed over the teeth, usually the lower arch. However, neuromuscular orthotics also have enlarged areas that keep the jaw in a particular position when relaxed.

Orthotic applications can be custom-made to fit a patient’s mouth and support their jaw in the way they need. Further, they can be used long-term for pain prevention in TMJ patients. Similarly, neuromuscular dentures may be made for TMJ patients as well. Suppose your TMJ is more influenced by the position and misalignment of the mandible (jaw bone) or malocclusion, the misalignment of the upper and lower arches resulting in an over or underbite. In this case, orthodontic treatment might be best for you. Braces may be applied to correct the jaw and teeth positioning to relieve TMJ pain.

Crowns and veneers may also be a treatment option if biting or decaying teeth are the root cause. Overall, pain management doctors can help you relieve your TMJ symptoms through various techniques, ranging in severity. They can also communicate closely with other healthcare providers and specialists apart from your care team to establish an individualized treatment plan that targets the source of the problem.

Any health professional with the ability to diagnose conditions can diagnose TMJ. This may include your primary care physician, a dentist, or a specialized doctor. These health care professionals may use various techniques to diagnose you with TMD, ranging from a patient exam and interview to medical imaging and monitoring.

Usually, TMJ pain can be diagnosed with a patient consultation and physical exam. In this case, your doctor will ask you various questions to decipher your symptomatic experience. The medical field is generally assessed using the acronym PQRST: P – provoking and palliative, Q – quality, R – region and radiation, S – severity, and T – time. You will be asked what your pain feels like (quality); in TMD, patients typically describe TMJ pain as an aching sensation. You will be asked what region the pain is and if the pain radiates anywhere else.

TMJ patients experience pain mainly in the temporomandibular joint area in front of the ear, though it can radiate further into the jaw, teeth, ear, head, and neck. Your doctor will further question your experience, what makes it better (palliative), and what makes it worse (provoking). TMJ pain is typically alleviated using over-the-counter anti-inflammatory, pain-relieving medications, such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) and alternating hot and cold compresses. TMJ pain is often made worse with chewing, teeth grinding, clenching, and sometimes talking.

For a time, your doctor will want to know when the pain began and if it is constant or comes and goes in waves. Finally, you will be asked to rate your pain on a scale of 1 to 10 (severity). A brief physical exam will follow patient interviews. The doctor may ask you to move your joint in various ways with and without applying pressure to gauge your range of motion and strength of mastication (chewing) muscles. The doctor will likely palpate the joint with his fingers which you perform these movements and are stationary, to determine if there is any clicking, popping, or crepitus (grinding).

Magnetic resonance imaging (MRI) is the most effective medical imagery to diagnose TMD. The articular disc found in the joint between the mandible (jawbone) and the temporal skull bone can be evaluated, as can the joint’s soft tissues, like the synovial membrane and ligaments.

If the cause of your TMJ is osseous (pertaining to the bones), a CT scan, specifically a cone-beam CT, may be used to identify tumors, abnormal growths, bone deformities, and degenerative changes of the bone causing your pain. Panoramic radiography, a type of dental x-ray, could also be used to diagnose TMD if the cause is odontogenic (pertaining to the teeth).

Any doctor with the privilege to prescribe medication can do so for TMJ patients. In minor cases, these medications likely include NSAIDs (non-steroidal anti-inflammatory drugs) such as meloxicam (Mobic) or piroxicam (Feldene). Tricyclic antidepressants, such as amitriptyline (Elavil), may be used for muscle relaxant qualities. Skeletal muscle relaxants, such as metaxalone (Skelaxin), may also be used, effectively reducing the pain signals sent to the brain.

At Koala® Center For Sleep & TMJ Disorders, we are offering a free TMJ screening over the phone. Alternatively, you may book an appointment by phone or online to meet with one of our exceptional doctors face to face to discuss your concerns with TMJ. We look forward to meeting you and helping you get back to a pain-free life.