Temporomandibular Joint & Muscle Community
Pain management for TMJ
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This patient support community is for discussions relating to temporomandibular joint issues including headaches and managing pain.

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Pain management for TMJ

I am a 25 y.o. with severe TMJ pain. I have seen numerous specialists including dentists, facial pain docs, tmj specialists, oral surgeons, etc. I was told by all of them that I need bilateral joint replacement using scar tissue from my c section as well as repositioning of the jaw. I have tried splint therapy, injections, physical therapy, anti inflammatories, etc. I have seen well over 10 doctors for this to get additional opinions. I have been told to take medications until surgery. Well, my surgeon (who I chose to do this because of her experience and personal recommendations) injured herself and had to reschedule my surgery. It was originally scheduled for Sept. because I had to have my other opinions, and try other methods first. She then rescheduled me for December, and now it looks like sometime early next year due to her injury. So now, she has referred me to yet another surgeon at a university out of town to do another consult. (My insurance has been an issue as well.) I see them in late Nov. My primary care doctor has been prescribing my medications which include muscle relaxers, anti inflammatories, and more recently percocet. I had been taking hydrocodone for about 4 months and then percocet for about 6 weeks. All while waiting for this surgery. Now my primary care doc has informed me that they are taking me off my meds, because they are worried I will become addicted since I have been on them for so long. They are sending me to a pain mgt. doctor. They said that they don't want to be responsible for having an addicted patient. I am so upset by this because it is not my fault that we have had to reschedule my surgery so many times. I have tried every other treatment over the past year to no avail. I just had a new MRI done that shows more damage to the joints than the one done just a couple of months ago. The ER docs who I have seen say they can't call in someone to do an emergency surgery if my jaw is not broken. I am upset and confused. I obviously have a problem, or I would not be going thru all of this. Why do they not want to treat me anymore for the pain? Why would they put me on all these meds and then say to take advil? If I could not have gotten by with just advil before, why would I be able to now when the pain is so much worse? I have been on bedrest for approx. 4 months. I have been on a non chew diet for longer than that. I do all that I can to help the pain, but still need medications to help me. I cry every night because the pain is so bad, even with the meds. I feel like no one is really doing anything to help me, and that they are just passing me on to the next doctor. I finally found a medication that works (well at least works better than the other ones) and now they are saying that they are pulling me off of the meds. I am frustrated. I am not a junkie and don't take the meds to get high. I don't take more than I am supposed to and only take them when I need them. I also don't ask for an unreasonable amount or call to get them early or anything. I just wanted to talk to others about all this. What treatments do pain mgt. docs do for tmj? Will they treat me bad because of all this? I am so nervous about them labeling me as something I know I am not. They said they want to try more injections, but I know how bad they make my pain afterwards and don't even want to try them again. I have tried all different types from all different docs and they never worked. Only temporarily. I ended up needing meds more afterwards. My surgeon does not want me to do anymore injections. What should I do? I have made copies of all my medical records to bring in. I also have my MRI hard copies and reports. I also have a list of all my medications and everything. Do you think they will help me? Any advice would be greatly appreciated. Thank you in advance.
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Avatar_m_tn
I may sound like a broken record, but surgery may not relieve your symptoms.  It sounds like they are doing a discectomy and replace the disc with scar tissue.  I hope this works.  Repositioning the condyle in the 'socket' would be a good idea. However they would need to have a repositioning splint for that before the surgery.  In my opinion one of the biggest problems is that your jaw is functioning on the tissues behind the disc and they have blood vessels, nerves and other tissues present that do not withstand the pressure and therefore cause pain.  A good repositioning splint would be helpful in determining this.  This type of splint is not always used, and I'm assuming from your description that you probably have a displaced disc, for which this type of splint is helpful. I hope the surgery helps.  Follow all the physical therapy exercises they give you so you can restore your range of motion for the TMjoint.  Good Luck, TMJDoc
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