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Have had TMJ Jaw for about 15 years. Recently (past 2

Have had TMJ Jaw...

Have had TMJ Jaw for about 15 years. Recently (past 2 months) it has become increasingly painful to the point of eating has become uncomfortable. Can feel jaw cracking when trying to open my mouth. About 10 yrs ago doctor began giving me cortizone shots about once a month in my jaw that seemed to help. I stopped the injections after 2 yrs. My current dr. has put me on Baclofen 10 mg 1 tablet 3 times a day. Still have extreme pain. What other treatment is there?

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

Xanex 5 mg 1-2 daily as needed, Paxil 20 mg 1 daily, Tenormin 50 mg 1 daily, Lisinopril 10 mg 1 daily.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

High Blood Pressure. Had both right & left Corodid (sp?) artery blockage surgery in 2016.

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Answered in 45 minutes by:
3/27/2018
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 6,338
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about your health in the form of severe and refractory TMJ as you have described above. As a Neurologist I frequently diagnose & treat this type of health situation, and I can certainly help you in this regard.

I see you have been suffering from chronic TMJ and recently for the past 2 months it has become increasingly more severe and also affecting your ability to eat too.

I see steroid cortisone shot had helped you in the past, and recently your dr has put you on baclofen but you are still having extreme pain.

Now coming to the various treatment options that are available for the management of TMJ;

First of all please see the baclofen dose can be optimized further. I see you are currently on total 30 mg per day, the dose can be increased up to 20 mg three times per day = 60 mg per day.

This is one option to consider; I am giving this suggestion because since you are already having this med with you so it will be easy to adjust the dose

However if increasing the dose of baclofen does not help, or for some reasons you do not want to increase the dose further then please consider the following various treatment options to help with this extremely severe TMJ.

The following are the various treatment options for TMJ dysfunction (if you see any treatment you have already tried please disregard it);

A) Home remedies, General measures or Over the counter treatments such as the following;

Avoiding any triggers that may be causing or worsening the tmj

Practicing relaxation and light stretching techniques to decrease tension in the jaw

Modifying diet to include softer foods that require less chewing power

Ice pack or compress can help in reducing inflammation & pain

Some patients may benefit from hot packs or compress too

Epsom salt compress

Home physical therapy or exercise program to the jaw joint

https://healdove.com/disease-illness/Exercises-to-Help-Alleviate-TMJJaw-Pain

http://www.healthline.com/health/tmj-exercises#exercise2

https://www.sovanightguard.com/blog/8-jaw-exercises-to-relieve-tmj-pain/

Over the counter pain & inflammation relieving meds such as Naproxen, or Ibuprofen

Over the counter pain & inflammation relieving creams or sprays such as Biofreeze or Myoflex

Over the counter essential oil rubs such as Peppermint oil, or Lavender oil, or Eucalyptus oil, or Wintergreen oil

Magnesium supplements

Night guards (also called by various other names such as Mouth guards, or Stabilization Splints, or Bite guard) etc

B) Prescription meds or treatments such as the following;

A course of oral steroids or steroid shots (I see you were on steroid cortisone shot but this time your dr did not start it, I am not sure whether it is due to high blood pressure issue or other reasons, if the blood pressure is under control then this is one treatment option to consider especially considering steroid did help you in the past)

Muscle relaxants such as Baclofen or Tizanidine – you are already on Baclofen and dose increase is one option to consider as discussed earlier above

Botox injections etc

C) Complementary & Alternative medicine treatments such as the following;

Biofeedback

Hypnotherapy

Acupuncture

Relaxation techniques etc

D) A course of physical therapy through TMJ experienced physical therapist;

Earlier I had mentioned about some home based physical therapy, if that is not helpful then seeing a TMJ experienced physical therapist can help

E) Medical devices or special procedures such as the following;

Laser therapy (Cold laser therapy) etc

F) Surgical treatments (if nothing else helps);

Arthrocentesis and washing with saline

Arthrocentesis followed by steroid or local anesthetic injection into the joint space

Arthroscopic surgery

Open surgery for hemi or total joint replacement etc

Most of the patients do not require surgeries to control TMJ, rather one or more of the above mentioned non-surgical therapeutic interventions are sufficient to control this condition.

The above are the various treatment options to consider, but please see not all these above mentioned treatments may be required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with several treatments that are available for helping with your health condition and you may try to use them as necessary. If you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried. I am very sure you must have already tried many of the above mentioned treatments considering you are having TMJ for the past about 15 years, but I earnestly hope you see some treatment, or treatment approach in the above list that is still new to you.

In addition to the above, you may also consider trying certain over the counter/non-prescription nutritional supplements such as Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2), L Acetyl Carnitine etc and these can also boost the effect of other treatments mentioned above.

To summarize once again;

1) Optimizing the dose of baclofen is one option to consider as discussed earlier above

2) If optimizing the baclofen dose does not help, or for some reason you are not considering optimizing baclofen dose any further then to consider exploring the other treatment options mentioned earlier

3) Since steroid cortisone shot had helped you before so this is another treatment option to consider, unless there is a concern about the blood pressure, or there are other reasons not to try it this time

4) You may also consider a course of above mentioned nutritional supplement to boost the effect of other treatments used for TMJ

5) And also very importantly, please see TMJ can be successfully treated, so please not to lose hopes, please consider the above discussed various treatment options and I earnestly hope the above information & the list of treatments will substantially help you with this unfortunate & extremely severe TMJ recurrence.

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & professional effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now will not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

For future questions you can follow up either here, or you can reach me directly with "a question for Dr Subbanna MD" through my Just Answer direct link mentioned below here;

http://www.justanswer.com/medical/expert-drsubbannamd

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Customer reply replied 3 months ago
Thank you very much for your concern and suggestions. I prefer not to increase the mg. of Baclofen. I may try the Acupuncture. Have tried it for a back injury and had positive results. Again, thank you.

You are very welcome! My pleasure! I am very glad you found the above information helpful!

Acupuncture is an excellent treatment too, so it is really worth trying it to help you. And also it had helped you for back condition, so there is a very high possibility it will help you with TMJ too!

Please do not forget to take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & professional effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now will not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Wishing you all the very best!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 6,338
Experience: American Board Certified Neurologist, Internal Medicine
Verified
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