As a TMJ specialist, there are times when medications are an important part of the treatment strategy. Though side effects must be kept in mind, there are medications that are often extremely helpful for short periods of time. So, for many TMJ sufferers, I have found that there are some medications that work rather well to address pain, muscle tension, and jaw motion restrictions.
However, it’s the way that these medications are used that differentiates their effectiveness. The following information should be very helpful to those considering (or currently) taking medications for a TMJ problem.
1. Advil (Ibuprophen) and Aleve (Naproxen): For pain, particularly when inflammation is present.
Very important! Advil and Aleve are not muscle relaxants, in spite of what many people believe. They are classified as non-steroidal anti-inflammatory drugs and designed to reduce inflammation in joints and muscles. Most important: For individuals who have had jaw problems for an extended period of time, these medications must be taken for 2-4 weeks in order to be maximally beneficial. At the same time, the factors that caused the inflammation must be addressed or the medications will have limited benefit.
For some inflammatory problems associated with the temporomandibular joints specifically, these medications may be necessary for 8-12 weeks just like they would be required for this duration for inflamed and painful knees. Because Advil and Aleve can upset the stomach and kidneys, care must be taken when extended use is prescribed. Alleve has been recently recommended to be the anti-inflammatory of choice for those at risk for a heart attack or have a history of heart problems .
2. Tylenol (Acetaminophen): For pain when inflammation is not present. Acetaminophen is a different class of drug than Advil and Aleve and is not an anti-inflammatory medication. It is an analgesic that is effective to relieve pain when inflammation is not present. Your doctor must monitor long-term use of Acetaminophen as it can induce headaches and can compromise liver function (particularly in individuals that consume alcohol daily).
3. Muscle Relaxants
Commonly known muscle relaxants are Flexeril, Soma, Skelaxin, Zanaflex and Robaxin. This class of drug can only be obtained with a prescription. Muscle relaxants can be used both during the day and at night before going to bed. Because some people experience fatigue when using them particularly during the day, we often need to try several types to get the right one.
Muscle relaxants can also be used while taking other products such as Aleve, Advil and other prescription anti-inflammatory options. The time frame over which these medications are taken is variable but can be used for many months (particularly when taken only at bedtime).
An added bonus for patients taking muscle relaxants is that they promote restful sleep and can often reduce the intensity of nighttime grinding and clenching of the teeth.
4. Anti-Anxiety Medication
When anxiety and worry are driving muscle tension and pain in the face and jaw it is not uncommon to prescribe small doses of anti-anxiety medications for a short period of time to be taken during the day, at bedtime, or both. These medications work in the brain and help reduce the ability of muscles to “brace” as a consequence of life events, thoughts, and or emotions.
The commonly known medications in this category are Valium, Xanax, Klonopin, and Ativan. These are controlled substances, available by prescription only, and registered in a national data bank to help prevent overuse and abuse.
When taken at bedtime they are very effective (in short term periods) in reducing tooth grinding and clenching and the consequent symptoms of pain and muscle tension in the morning. My patients often report that anti-anxiety medication “takes the edge of my pain and muscle tension.”
So, for TMJ sufferers, medications have proven to be very helpful in breaking the “pain cycle” and allowing other therapies to begin to work for long-term relief. The key is using the right one, careful monitoring, and short-term use.
I am a resident of Georgia, and I have seen three different Neuromusclar – dentists. I have my fourth set of splints, and I still have no success with managing my clenching behaviors at night. Do you have an suggestions for dentist in Georgia? I use neruomusclar massage therapy and chiropractors weekly.
Hi Selena,
I’m sorry to hear of your troubles. Here’s what I suggest: go to the website of the American Academy of Orofacial Pain and search the directory for a DIPLOMATE in your state. Hope you get some relief soon.
Dr. Tanenbaum
I have been experiencing TMJ and severe right ear pain for 2 months with severe ear ringing. I have been to my M.D. to two oral surgeons, and an ENT. I had a severe head trauma 14yrs ago but have never really experienced these painful symptoms. The oral surgeon diagnosed mis-aligned jaw and DMD, and wants to charge a fortune for orthotics. My M.D. says I should wait and take meds to try to resolve issue, she wanted to order MRI and I cannot have that because I have an pain stimulator in my body. She is ordering an Brain scan because I have so much pain in my right ear. I fear a tumor or another underlying issues. She believes since it started 2 month ago there was a trigger and believes bruxism the issue and stress related. I have read online about TMD, as well as tinnitus. I feel so confused and dis-oriented. Can you provide recommendations or advice. I reside in Florida and do not feel I am getting best possible medical advice.
Hi Mariza, Tinnitus may be related to your jaw and neck muscles if they are hyperactive.If tinnitus changes with jaw function and/or head positional changes, then there may be a relationship. Otherwise it will be unclear. Before you make any decision, go to the AAOP.org website and look for diplomate who practices near you. Make sure it’s a doctor designated as a diplomate.
I wish you luck and hope you start feeling better soon.
Dr. T.
Hi, I have been suffering with tmd since high school off and on. I’m now hitting 40. I have broken several teeth from grinding, not to the point others can tell but I can definitely cut my tounge on my teeth and spit out pieces of tooth. I have many in extremely bad shape, the denten is exposed on most. I brux day and night. Jaw hurts all the time. Teeth and gums too, I’m miserable and it’s affecting my daily life which is also affecting my kids. I reside in NC and tried a dentist locally that went really bad. Started with a cleaning and c/u. Jaw locked the next day. Got a night guard and it helped at first but now doesn’t feel right and hurts (this was 6 months ago). Now I’m searching for help and don’t know who I should make an appointment with, as in what field. Btw I have tried prescription strength magnesium these 6 months and it hasn’t helped. Please, who should I see that can fix the damaged teeth and treat the tmd/bruxism? Any advice is sooo welcomed. I’m to the point that I’m willing to travel out of town for someone who can help me.
Hi There,
Sorry to hear of your troubles. Here’s what you should do…go to this website: http://www.aaop.org. That’s the American Academy of Orofacial Pain. Find a doctor in your area who is listed as DIPLOMATE.
I hope you feel better!
Dr. T.
I have suffered long term from tmj, chiropractor and acupuncture most effective. Also take 5mg baclofen at night or if really painful, take ibuprofen or naproxen. Conciously relaxing jaw, ice, massaging facial muscles a must. Hope this helps someone.
Hello,
i have a TMJ jaw locking issue. It started sometime back. I am using night guard however often one side of my jaw gets very tight and i am not able to fully open my mouth for food etc. I do not have any pain.
I do hot compress, wear night guard and also working on my habit consciously like biting my gums of cheeks.
How to open my jaw fully ?
Thanks