Temporomandibular joint (TMJ) disorder refers to a cluster of conditions characterized by pain in the TMJ or its surrounding tissues.1
TMJ conditions are common in the adult population and up to 75 percent of adults show at least one sign of joint dysfunction on examination and as many as one third have at least one symptom.2,3
The TMJ is a synovial joint that contains an articular disk, which allows for hinge and sliding movements. This complex combination of movements allows for painless and efficient chewing, swallowing, and speaking.
There is some evidence to suggest that anxiety, stress, and other emotional disturbances may exacerbate TMJ disorders.
Common symptoms of TMJ disorders include jaw pain, limited or painful jaw movements, headache, neck pain or stiffness, clicking or grating within the joint and occasionally, an inability to open the mouth painlessly. Some studies have shown that as many as 55 percent of patients with chronic headache who were referred to a neurologist were found to have significant signs or symptoms of a TMJ disorder. Educating patients on self-care techniques and referral for non-invasive treatment should be considered in patients with chronic undifferentiated headache or headache that is not responding to standard treatment.1
For most patients, the signs and symptoms of TMJ disorders improve over time with or without treatment. As many as 50 percent of patients improve in one year and 85 percent improve completely in three years.4 Conservative treatment should be encouraged before invasive treatment due to patients improving with or without treatment over a period of time.
A great option for non-invasive pain relief would be a topical pain cream.
A compounding pharmacy can make different combinations of compounded creams that can be applied right where it hurts. A common combination containing ketoprofen, cyclobenzaprine and baclofen is our most common combination. Contact PharmaCare with any questions in regards to treatment options for TMJ.
By: Julie Lindsay, Pharm.D. Candidate
About the Author:
Julie is a 4th year pharmacy student at Northeast Ohio Medical University (NEOMED). She is expected to graduate in May 2016 as a Doctor of Pharmacy. She will be an Integrative Pharmacologist and Compounding Pharmacist for PharmaCare Compounding Pharmacy located in Tallmadge, Ohio.
Reference:
- Buescher J MD, Temporomandibular Joint Disorders, American Family Physician 2007;76: 1477-1482. http://www.aafp.org/afp/2007/1115/p1477.pdf
- Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders. J Oral Rehabil 2004;31:287-92.
- Rutkiewicz T, Kononen M, Suominen-Taipale L, Nordblad A, Alanen P. Occurrence of clinical signs of temporomandibular disorders in adult Finns. J Orofac Pain 2006;20:208-17.
- American Society of Temporomandibular Joint Surgeons. Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio 2003;21:68-76.
As you already know, temporomandibular joint disorders (TMD) refer to a cluster of conditions that are often characterized by pain in the temporomandibular joint (TMJ) or its surrounding tissues. The surrounding tissues might include the neck, head and even shoulders. Conditions involving the TMJ are so common among the adult population that up to 75 percent show at least one sign of TMD upon examination. Let’s take a look at some of the instances in which TMD can cause further complications and how to educate your patients. It has been shown that about 55 percent of patients with chronic headaches who were referred to a neurologist actually have signs of TMD. Without the education on TMD, signs and symptoms often go overlooked and no treatment can be found.