Natural treatments for temporomandibular joint syndrome (TMJ)
Temporomandibular joint syndrome (TMJ) is a condition characterized by pain and inflammation in the joints connecting the lower jaw to the skull, leading to symptoms such as jaw pain, clicking sounds, and difficulty in jaw movement. While there are conventional treatments available, some individuals seek natural remedies to alleviate their symptoms. Proposed natural treatments include supplements like glucosamine and chondroitin, which have shown potential in alleviating TMJ pain, though more rigorous research is needed to confirm their effectiveness. Acupuncture and electromyograph biofeedback have also been explored, with some studies suggesting they may provide relief, yet they require further validation through higher-quality research. Other treatments such as massage, chiropractic care, and capsaicin cream have been discussed, although their scientific backing remains limited. Overall, while there is interest in natural treatments for TMJ, the current evidence is inconclusive, highlighting the need for additional studies to establish more definitive conclusions.
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Subject Terms
Natural treatments for temporomandibular joint syndrome (TMJ)
DEFINITION: Treatment of chronically painful and inflamed joints of the lower jaw.
PRINCIPAL PROPOSED NATURAL TREATMENTS: None
OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, capsaicin cream, chiropractic, chondroitin, electromyograph biofeedback, glucosamine, massage, prolotherapy
Introduction
Temporomandibular joint (TMJ) syndrome is a disorder involving the two joints (one on each side) that attach the lower jaw to the skull. These two joints open and close the mouth and are located directly in front of each of the ears. In TMJ syndrome, the area around the temporomandibular joints becomes chronically tender and inflamed. Symptoms include pain in the temporomandibular joint; popping, clicking, or grating in the temporomandibular joint while eating and drinking; a sensation of the jaw “catching” or “locking” briefly, while attempting to open or close the mouth or while chewing; difficulty opening the mouth completely; pain in the jaw; facial pain; muscle pain or spasm in the area of the temporomandibular joint; headache; ear pain; and neck and shoulder pain.
TMJ syndrome often occurs in people who have had accidents or injuries involving the jaw, but many others have had no such incident. It is believed that grinding the teeth or clenching the jaw in response to stress may trigger the condition in many cases. Other possible causes include arthritis of the temporomandibular joint, facial bone defects or disorders, and misalignments of the jaw or of the bite.
The underlying cause of TMJ syndrome is not known. In most cases, the joint appears to be healthy, suggesting that it is the soft tissue around the joint rather than the joint itself that has the problem. However, some cases of TMJ syndrome may be caused by TMJ arthritis, TMJ dislocation, or other forms of true joint injury.
Treatment of TMJ includes stress management, avoidance of certain foods that trigger discomfort (such as gum or beef jerky), and anti-inflammatory medications. The older antidepressant drug amitriptyline, taken in low doses, and the muscle relaxant cyclobenzaprine also may help.
According to a few controlled trials, some people with more severe forms of TMJ may benefit from the use of a dental appliance. On rare occasions, surgery may be necessary.
Proposed Natural Treatments
The supplement glucosamine, taken alone or with chondroitin, has shown considerable promise for treating osteoarthritis. Because osteoarthritis of the temporomandibular joint can play a role in some cases of TMJ syndrome, researchers have investigated the potential role of these supplements in treating the condition. Promising results were seen in a double-blind study that compared glucosamine to ibuprofen in treating forty-five people with TMJ arthritis. During the three-month study, the supplement proved equally effective as the drug Tramadol. However, because this study lacked a placebo group, it is not reliable. Another double-blind study involving glucosamine without chondroitin used a placebo group, but too many participants dropped out to allow meaningful conclusions. Further research found taking glucosamine with chondroitin for three months or more showed promise in treating TMJ pain, but more research is needed to confirm these findings.
Electromyograph (EMG) biofeedback is a form of biofeedback therapy that involves teaching a person to gain conscious control of muscle tension. A meta-analysis (formal statistical review) of published studies suggests that EMG biofeedback might be helpful for TMJ pain. However, the reviewers noted that the evidence is incomplete and that more (and better quality) research is needed.
Similarly, while preliminary controlled trials suggest that acupuncture may be helpful for TMJ syndrome, further high-quality research is needed. A preliminary study compared traditional Chinese medicine (TCM), which incorporates acupuncture among other treatments, and naturopathic medicine (NM) with care given by clinic staffed by TMJ specialists. Researchers found that both TCM and NM provided greater benefits among 128 women. Although subjects were randomized into different groups, the study was not blinded, and practitioners were permitted to treat each subject however they saw fit.
A meta-analysis of twenty-two studies involving over 450 participants found positive results when using acupuncture for TMJ pain. Some studies found results comparable to the positive impact of occlusal splints. However, the studies were described as poorly designed or very poorly designed, indicating skewed results that fail to render a reliable assessment.
Like acupuncture, transcutaneous electrical nerve stimulation (TENS), a complementary therapy often used for back pain, has shown mixed results in treating TMJ pain. In a TENS treatment, electrodes are placed on the skin, and electrical impulses contract the muscles at given strengths and intervals. Some research found pain decreased after using TENS, but longitudinal, standardized studies are needed to confirm these results.
A cream made from cayenne and other hot peppers called capsaicin cream has shown promise for many painful conditions. However, one study failed to find capsaicin cream more effective than placebo cream for TMJ syndrome. Another study using 8 percent concentrated capsicum cream found relatively positive results with no side effects. Other treatments sometimes recommended for TMJ but that lack reliable scientific support include chiropractic, massage, and prolotherapy.
Bibliography
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