From the Guidelines
Treatment for temporomandibular joint disorder (TMD or TMJ) should begin with conservative approaches, prioritizing reassurance, education, and avoidance of aggravating activities, as recommended by the most recent guidelines 1. The primary goal is to reduce pain and inflammation while improving jaw mobility and function.
- Start with over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-500mg twice daily) to reduce inflammation and pain, as suggested by various guidelines 1.
- Apply moist heat or ice packs to the affected area for 10-15 minutes several times daily to help relax the jaw muscles and increase blood flow.
- Practice soft diet modifications by avoiding hard, chewy foods and cutting food into smaller pieces to reduce strain on the jaw.
- Gentle jaw exercises, including controlled opening and closing movements and side-to-side movements (3 sets of 10 repetitions, twice daily), can help improve mobility and reduce stiffness.
- For nighttime teeth grinding, consider using a custom-fitted night guard from your dentist or an over-the-counter version to prevent further jaw strain and damage.
- Stress management techniques like deep breathing, meditation, or yoga may help reduce jaw tension and promote overall well-being. If these measures don't provide relief within 2-3 weeks, consult a healthcare provider who might recommend physical therapy, prescription muscle relaxants like cyclobenzaprine (5-10mg at bedtime), or in severe cases, corticosteroid injections 1. These treatments work by reducing inflammation, relaxing tense muscles, and correcting jaw alignment issues that contribute to TMJ pain and dysfunction, ultimately improving morbidity, mortality, and quality of life outcomes.
From the Research
Treatment Options for Gastroesophageal Reflux Disease (GERD)
- The treatment of GERD typically involves a combination of lifestyle modifications, diagnostic testing, pharmaceuticals, and surgery 2, 3.
- Lifestyle changes are crucial in the treatment of GERD, and individual variances can be seen in how GERD symptoms change in response to different diets 3.
- Factors involved in lifestyle modifications include the head of the bed, patients' lying down position, smoking, fat or obesity, and physical exercise 3.
Pharmaceutical Treatment
- Proton pump inhibitors (PPIs) have been the cornerstone of medical treatment for GERD for the past thirty years 3.
- PPIs provide a sustained inhibition of gastric acid production, and are superior to antacids and histamine-2 receptor antagonists (H2 RAs) for control of gastric acid and treatment of frequent heartburn 4.
- A PPI dose of 20 mg is optimal for empiric treatment of frequent heartburn, and consistent with the 2013 treatment guidelines established by the American College of Gastroenterology (ACG) for treatment with a minimum effective dose 4.