TMJ alternative treatment and practitioner recommendations for New York City

October 7, 2009 6:38 AM

Please share advice for non-dental treatments for TMJ. I've been dealing with this for about a decade, and had a custom made night guard, that I wore religiously, for all this time. Maybe it's slowing down the rate at at which the TMJ is getting worse, but it's still getting worse and I hate it.

Osteopathy? Acupuncture? I've heard of both as possible alternative treatments - and my insurance would help pay for them. Has anyone had positive experiences with them? Or can recommend a practitioner (who takes health insurance) in Manhattan or Brooklyn? Or has other suggestions for treatment to explore?

Thank you!

posted by Salamandrous to health & fitness (14 comments total)

Last time I went in to get my nightguard adjusted, my specialist told me about the NTI appliance, which sounds like a neat idea and seems to be slowly replacing nightguard-type splint devices. I haven't tried it yet, but you might consider looking into it if you're having problems with your current situation.

More info is here.
posted by you're a kitty! at 6:43 AM on October 7

I found that magnesium supplements helped mine quite a lot.
posted by bac at 6:45 AM on October 7

There are doctors who specialize in this kind of thing. I went to one, and he did an MRI of my jaw and concluded there was nothing surgical to be done. So he prescribed massage and physiotherapy, which combined ultrasound treatments, strengthening, stretching and relaxing techniques. It was working very well, unfortunately I had to leave the country in the middle of the treatment, so it hasn't stuck all that well.

Being in the states, a specialist and an MRI might be a bit out of reach. But, I really recommend physio though. They'll take you're whole body into account, as a single system. They realized that the problems in my jaw were exacerbated by weakness in my core, so they had me working on my lower abs to fix my jaw. Sounds crazy, but its helped both the TMJ and a bunch of other minor pain.

Oh, and long ago, I had a consultation with a surgeon who recommended against surgery and instead froze my jaw and cranked it open with a little tiny jack and left it for a while. It worked fairly well, and the physios said I have one of the better cases of long term TMJ that they've seen. So, if you have someone who is recommending surgery, ask about your other options first and get a second opinion.
posted by carmen at 6:47 AM on October 7

Mine is manageable when the stress level is low. If I go to sleep worried about something, it's a morning of hell after a night of (I assume) jaw-clenching. If I go to sleep in a low-stress relaxed state, I wake up with a pain-free jaw.

I suspect the oft-reported benefits of acupuncture are similarly really about reduced stress levels. On that bandwidth, I imagine yoga or TM might help, too.

It's been only an occasional annoyance my whole life. I can make lovely popcorn sounds in my ears. I've never worn anything or tried any serious treatment because it's been more hassle than serious problem.
posted by rokusan at 6:47 AM on October 7

I know some chiropractors specialize in TMJ treatment, but I don't have any experience in what it entails or how successful it is. Just another avenue to explore.
posted by inturnaround at 6:51 AM on October 7

I recommend massage. My massage therapy instructor specialized in TMJ treatment. It's a bit strange having someone's gloved hand in your mouth massaging your jaw but it works very well. I am very far from New York so I can't recommend anyone specifically but google TMJ massage with your location and you'll find quite a few therapists.

Something you can try for yourself: Self Massage. Scroll down to Minute Massage for jaw tension and TMJ pain.


I'm not sure about the validity of the studies on this website but: Relieve TMJ Pain with Massage
posted by shmurley at 7:35 AM on October 7 [1 favorite has favorites]

My jaw pain is correlated perfectly with my stress level. The way I see it, the stress has to go somewhere, and it shows up in a tense jaw. A few things have helped: Meditation, first. This is more of a long-term cure.

Second - Finding a different way to express my tension. Playing Left 4 Dead helps. Exercising is a great way to relieve tension. Doing pushups until I can do no more, etc.

Third - Being honest with the people in my life helps (not trying to "be" anything specific, just relaxing into my imperfect self). Most of my jaw tension is a sort of physical manifestation of "keeping my mouth shut".
posted by amanzi at 7:39 AM on October 7

I went to a TMJ specialist. After the x-rays, he said he'd not seen an area in that bad shape short of a car accident. Kinda a mess, as the muscles had actually pulled vertebrae out of line and were pulling on my collar bone. A night guard did nothing except protect my teeth. He referred me to a physical therapist. She gave me specific exercises to do, and did the ultrasound on that area. The ultrasound provided immediate relief for me, to the point of tears because it felt so good to be released from the pain. It was temporary, though.

The doctor also prescribed ibuprofen, but allowed that I could take an equivalent in over-the-counter pills. It was 8 Advil, 3 times per day (24 over-the-counter Advils per day). I don't think that would be recommended anymore, as this is terrible for your liver. Don't do it unless a doctor says to, and is watching over your care.

My TMJ disappeared almost overnight, not because of the physical therapy or the medicine. It happened when I got a divorce. To me, this implies that my stress level was causing my problem; please consider if that may be the case for you, too.
posted by Houstonian at 8:23 AM on October 7

(By "TMJ Specialist" I mean a medical doctor.)
posted by Houstonian at 8:24 AM on October 7

'TMJ' is a catch-all that is commonly ascribed to any number of conditions that involve a very complex system in and around your temporo-mandibular joint (tmj).
Do you have a degenerative condition in the joint itself? Myofacial pain? Capsulitis? A Malocclusion? these and others will guide the appropriate diagnosis and subsequent therapy for your condition.
Bottom line: start with a proper diagnosis of your condition; take the time to try to understand this; go in amenable to a multi-disciplinary approach to treatment, which may, if appropriate, include physical therapy, dental appliances, accupuncture, etc.
This is your jaw, which you use to chew, swallow, and speak...treat it as seriously as a knee or shoulder.
Of course IANYD.
posted by OHenryPacey at 9:10 AM on October 7

I had TMJ - really bad for years. Couldn't open my mouth without the clicking. Got the guard and like you wore it religiously - but it didn't do the trick. One day I bit down on some really hard Yemenite yeast bread and in a flash the jaw moved back onto its axis and never had TMJ again. It's something like Homer Simpson's garbage pail cure for a back ache and I wouldn't go around telling people to bite into a hunk of hard bread - but it did the trick for me.
posted by watercarrier at 9:49 AM on October 7 [1 favorite has favorites]

The Egoscue Method is a gentle exercise-based, non-medical pain therapy centered on the premise that most chronic pain is sourced in poor muscloskeletal alignment and posture. When we're out of proper alignment, we move in violation of our biomechanical design, which leads to pain.

And the root cause for much of this misalignment is movement starvation. We're desk bound, ferried around in cars, and don't give our bodies the daily movement, in both intensity and range of motion, that is required to keep us healthy. And this causes misalignment and dysfunction, movement to be painful, which causes us to limit our movement, which causes more misalignment and dysfunction, and on down the spiral.

But the reverse is true; if we get ourselves into proper alignment and give our bodies the daily movement they require, the body heals itself.

Pete Egoscue was shot in Vietnam, and refused to accept the diagnosis of permanent pain, restriction, and dysfunction that his physical therapist gave him. And so he developed his method. Here's an interview with Pete where he lays out the basics of his method, his experience, and how/why the human body works the way it does.

Pete has authored several books on ending chronic pain. I'd recommend you go right out and get a copy of Pain Free.

Lexica (my wife) got herself off industrial grade pain meds post severe foot accident after four days of doing the exercises Pete listed in his book. Got herself off as in "I forgot to take my opiates because I wasn't in pain". And she got Pete's books out of the Library.

Lexi & I eventually both signed up for customized personal therapy at the Egoscue clinic in 'Frisco. Best choice we ever made. It is because of our Egoscue work that this formerly overweight, joint-pain sufferer and his formerly weak, frail wife have commenced training for the 2010 Oaktown Marathon.

You don't have to live in pain.

BTW, there's an Egoscue clinic in Westchester county.

Best wishes.
posted by Pirate-Bartender-Zombie-Monkey at 11:08 AM on October 7 [1 favorite has favorites]

Houstonian: My TMJ disappeared almost overnight, not because of the physical therapy or the medicine. It happened when I got a divorce. To me, this implies that my stress level was causing my problem; please consider if that may be the case for you, too.

Hey, me too. I had a pretty bad case as well; to the point where the disc in my jaw "popped" out of place and I couldn't open my mouth more than a fraction of an inch (I know, paging Dr. Freud).

It took months of wearing the mouthguard 24/7 and frequent neck massage to lower the chronic pain. It was constant agony and a liquid diet.

But truly, once I told the husband-at-the-time to get out, I was all better. So in my case, the stress settled in the jaw.
posted by dzaz at 2:09 PM on October 7

I have seen a chiropractor for it - he attached electrodes to my face and it was the worst feeling ever, because my eyes were vibrating and, just, ick. The best result was when I saw a maxillofacial surgeon who flushed out the joint with a steroid solution. I forget the name of this procedure. I get it done every five years or so.
posted by Ruki at 4:31 PM on October 7