TMJ Forum - I'm About to Scream..

Hi Mari Kay,
There are a host of medications that can be taken to help relieve TMJ symptoms (and yes, all your symptoms you mention here are quite normal for TMJ). Usually to take most possible medications, it is necessary to see a pain management doctor of some sort.

Ibuprofen is probably the best painkiller to take but you do have to be careful about your stomach. 600 to 800 mg can be taken at a time but with food or milk. I personally have discovered over the years that no strong prescription pain med (including narcotics) helped anymore than Ibuprofen, unbelievably. Not until Vicoprofen. It's Hydrocodone with Ibuprofen (Vicodin is Hydrocodone with Tylenol). Even tho this narcotic helps me, not always (maybe 60/40).

Narcotics are tricky to take and there are so many different attitudes about them. Too many people take them for recreational purposes or abuse them. This has caused the government to strictly regulate them making many doctors uncomfortable and unwilling to prescribe narcotics, thus, hurting the pain patient even more than they already are. Pain management is so messed up in this country.

Well, off my grand stand now - of course, we all react differently to every drug there is out there on the market; that's where a pain manager is helpful. You may have to try several different kinds of meds separately and together before finding the best combination. It can be very frustrating to find a good, caring doctor, and then to find that perfect treatment plan (combination of meds, PT, bite splints, etc., etc.) And people wonder why chronic pain patients get stressed out sometimes. Sheesh!

To continue - frequently, Oral Surgeons (and others) prescribe Valium or Xanax for new TMJ patients to see if a few weeks taking them at night will help break up night-time clenching, grinding and spasms. Sadly, even if they help, they should not be taken for any length of time due to addiction issues and because they lose their effectiveness after a bit. There are some long-acting anti-anxiety drugs, which can be taken for a longer time, but I am unfamiliar with any (except Prozac and Buspar).

Anti-depressants are often used for people with chronic pain. Again, there are many different kinds. It is wise to do your homework before trying any really. I personally take Prozac and do believe it makes a huge difference. It seems to bring an inner peace to my body. BUT, Prozac is also an SSRI anti-d, which has been shown to cause some people to clench/grind. When I initially went on Prozac, it was great! But a few years later, stress hit me hard, and the spasms and pain all came back. I researched and found out that if a very small dose of Buspar is added to the SSRI (Prozac, Zoloft, etc.), the clenching will stop. Well, I tried it and it does work (for me anyway). Buspar is not normally taken with Prozac tho. That's where you have to take your "homework" from the Internet (from reputable sites) to your doctor so he/she can see the research.

Another classification of drugs that are used frequently are muscle relaxants. And again, there are many different kinds so if one doesn't work, try another. It took me 3 tries before I found Zanaflex, but it also has its down sides. It helps get rid of the spasms but also relaxes my eyes so much, I can't keep them open. The very lowest dose cut into quarters can be slightly helpful sometimes tho.

Doctors are also prescribing anti-convulsant drugs for people with TMJ, Fibromyalgia, etc., and finding them helpful. I can't think of the name of the drug I was going to mention but do your homework. None of them helped me, but I do know some TMJers who are helped.

Another type of drugs to possibly try with a pain doctor is nerve pain killers. Sorry, I don't know the classification name but Lyrica and Neurontin are two kinds. Since I used to have such severe facial burning pain, a neurologist had me slowly try Lyrica and I was surprised a few weeks later when I realized the burning was gone. I find them to be a challenge to take because of how often they must be taken to be truly effective. I take one 75 mg pill every 8 hours (that's 3 times a day). It took me a while to remember to take the middle-of-the-day pill, but I finally got there (most of the time). But I don't like how I get the side effects if I miss doses. I suppose that's just a part of managing chronic pain.

There always seems to be downsides of taking any type of pain (or other) medication. I know I must sound like a broken record, but it is so very important to do all the research you can about medications, and TMJ itself. Be careful, though, because not every source is reliable. Also, our bodies act so differently to everything. I could tell you what helps me and you might not even be able to take the meds I do. We almost feel like guinea pigs sometimes, sorry to say.

MOST IMPORTANT - medications on their own will not help TMJ patients, in my opinion. Physical therapy or regular massage therapy, reducing stress, watching posture, being careful about what we eat, and so much more, are equally, if not more important than medications. Pills are only a band-aid, but sometimes we need a band-aid if we are to even function.

Sorry about the length of this posting. I hope something here will help you or someone else.

God bless…
Carol