Temporo-mandibular joint (TMJ) chronic pain

Management of chronic jaw pain

Clinical practice recommendations for chronic TMJ pain

Chronic temporomandibular joint (TMJ) pain is the second most common cause of chronic musculoskeletal pain after low-back pain, affecting 6-9% of adults worldwide. It manifest as pain in the jaw and associated structures, as well as symptoms such as headaches, ear pain, noises or crackles in the temporomandibular joint, and impaired mandibular function. Chronic pain is defined as pain that has been present for more than 3 months.

Current clinical recommendations for the management of chronic jaw pain are mainly based on expert consensus.

symptomes des dysfonctions de la machoire

Recommendations for the management of chronic jaw pain

The latest treatment recommendations published in the British medical journal (BMJ) in December 2023.

Chronic TMJ pain:
- Moderate TMJ joint pain: VAS 4-6/10 for at least 3 months.
- Pain associated with TMJ joint dysfunction.

Strong recommendations in favor:
- Cognitive behavioral therapy (CBT)
  - Passive joint mobilization.
  - Posture exercises.
  - Exercises and stretching of TMJ muscles.
  - Trigger point therapy.
  - Routine care.
Recommendations under certain conditions:
- Manipulation
- Non-steroidal anti-inflammatory drugs + CBT
- Acupuncture.
- Exercises + joint mobilization.

Recommendation de traitement de douleur chronique de la mâchoire

Osteopathy and manual therapy for chronic jaw pain

Osteopathy and manual therapy are approaches that have been scientifically proven to be effective in the management of chronic jaw pain, and have been shown to significantly reduce pain and improve patients' quality of life. Osteopathic techniques include specific, safe manual techniques to relax the muscles of the temporomandibular joint and the neck.

Mr Charbel Kortbawi DO, MSc, an osteopath specialized in pain management, treats acute and chronic TMJ pain in his practice in Paris 16.