Pain management for chronic and severe TMJ disorder.

[tmjpain25]

I am awaiting surgery on both sides of my TMJ. I have been on bedrest for 4 months. My surgery is scheduled for December. I have been taking hydrocdone 10mg 3-4 times per day as well as 800mg advil. I have recently been prescribed percocet 5mg every 6 hours. This is the only medicine that actually dulls my pain. My condition is chronic and can only be helped with extensive surgery. I have seen numerous specialists in town and out of town. I have tried non surgical treatments for over a year with no results. I have had a bite gaurd (made my the facial pain specialist) for over 8 years. My MRI in June showed that I only had a small sliver of tissue left in my joint space and the doctors said that once I wore through that, it would become much more painful. I now feel like a hammer is driving a nail into my jaw over and over around the clock. I want to have another MRI done asap. I think I have a hairline fracture or something. It feels like bone grinding on bone. I have dealt with this pain for a very long time, but it is so much more intense now and different. It is much sharper and severe. Anyone else had this happen? I have been to the ER several times in the past 6 months and they say that my pain levels "should be thru the roof" and so on. I have been told that my case is so severe that it could fracture at any time. I think it is finally fractured. I am dying here. The percocet dulls it slightly, but the pain gets worse each day. I am also on alprazolam to sleep at night. I can't even sleep with the meds. I am going to call my doctor first thing in the morning to get in right away and get another MRI and another prescription. I know he will not want me to take the strong pain meds for a long period of time, but they are the only thing that works for this level of pain. I do not abuse them and I take them only as instructed. The prescription should have lasted me 11 days, but I actually made it stretch out longer. I am worried that he will think badly of me if I call on Monday to request another rx. I have to have my husband get them for me because I don't drive. Any help or advise would be greatly appreciated. I cannot take the pain any longer. I just don't want my doctor to think I am a bad person for needing additional meds. I am hurting so bad and want to talk to others who are in the same boat.

[Jaybay]

Wow.  I so feel for you in this situation.  Obviously surgery is the only thing that will help you, so is there any way you can move that date up a bit from December?  

You obviously need the pain medication and are in no way abusing it, so put aside the guilt and worry and just call your doctor!  Enough is enough.  God bless you and hang in there.  :-)

[BusyGrl]

The Anxiety community on medhelp has good advice on calming down the reason you grind and clench your teeth (anxiety). I'm still struggling with it and your posts struck a nerve with me. I used narcotics the same way--very sparingly, always fearful of addiction--and my doctor seems to be very conservative about pain management with the result that I don't feel like I'm getting helped. I have been struggling the last 2 months since stopping oxycodone and clorazepate. Antidepressants, sedatives, muscle relaxers, and prescription non-narcotic pain relievers aren't quite doing it for me. It seems to take a lot of iterations and heaven forbid, going through a lot of doctors to find the sweet spot. My jaw started popping and aching a week ago, and I have trouble opening my mouth wide enough to eat normal-sized bites of food. I figure it's more of the same anxiety-related stuff rather than the deterioration you describe. I wonder if tmjpain25's pain is caused by years of bruxism to start. It sounds like a traumatic experience. I sure hope you get the help you need soon.

[SHELLBELL79]

Wow I had no idea TMJ can get that bad. I have TMJ bad, I grind my teeth 24/7 and don't have a bite guard yet and was sent to a specialist b/c haven' tdone either b/c of money. I already need almost 20 grand of work done on my teeth from all my medications drying my teeth out. My jaw constantly goes in and out of socket, cracks, severe muscle spasms, etc. I get throbbing pain on the side of my jaw and muscles spasms and knots in my jaw muscles. Sometimes when I eat my jaw will lock and hurt like hell. I know its a pain in the but. I hope everything goes good with you!
My my mother is a Dental Assistant and has worked with Regular Denists, Endodonic Specialists in Surgery, Oral Surgery and, Maxiofacial Prostdodonist for almost 40 years. She told me shes would definatly recommend you to see a Maxiofacial Prostdodonist. We only have one in our state in Louisiana. She also recommends you to definaltly see that kind of Dentist/Doctor but also get other opinions from Dentist who just specialize in TMJ, tooth grinding, pain, etc. Not just from a facial pain specailist! Good luck! I hope everything gets taken care of!!!
Shell

[Tuckamore]

Hello TMJPain,

Welcome to MedHelp. My heart goes out to you. Your pain must be excruciating. I am so sorry you are in such severe discomfort.

First let me say that you should never feel bad for taking pain medication when you need it. You have a genuine reason for pain and you should not have to apologize for needing to ease it through narcotics. In all actuality you are not taking a "real strong" medication. Yes it is supposedly stronger than Vicodin but there are many stronger opiates. And it is my suspicion that you require something more than the Oxycodone to control your pain. Your physician should understand that and prescribe you either more of the current narcotic or a more effective one. If he is educated in pain management and a compassionate physician he should not "think bad" of you. After all that is why there are opiates. If he will not prescribe you additional medication or a stronger medication than I suggest you search for another physician.

We are here any time you need to chat. We all know what pain is and can relate. Please let us know how it goes tomorrow and how you are doing. And hang in there. Take Care, Tuck