From the Guidelines
Improvement in temporomandibular joint (TMJ) disorders can be expected within 2-6 weeks with cognitive behavioural therapy (CBT) and other recommended interventions. The most recent and highest quality study, published in 2023 in the BMJ 1, provides strong recommendations for the management of chronic pain associated with temporomandibular disorders.
Key Recommendations
- Cognitive behavioural therapy (CBT) with or without biofeedback or relaxation therapy is strongly recommended for patients with chronic pain associated with TMD.
- Other strongly recommended interventions include therapist-assisted mobilisation, manual trigger point therapy, supervised postural exercise, supervised jaw exercise and stretching with or without manual trigger point therapy, and usual care.
Treatment Approach
Based on the guideline recommendations, a treatment approach that includes CBT, therapist-assisted mobilisation, and supervised exercises can be expected to show improvement within 2-6 weeks.
Important Considerations
- Conditional recommendations are made for manipulation, supervised jaw exercise with mobilisation, CBT with non-steroidal anti-inflammatory drugs (NSAIDS), manipulation with postural exercise, and acupuncture.
- Strong recommendations are made against irreversible oral splints, discectomy, and NSAIDS with opioids. It is essential to consult a healthcare provider for further evaluation if symptoms worsen or do not improve after 4-6 weeks of conservative treatment.
From the Research
Temporomandibular Joint Disorder Improvement Timeframe
The timeframe for improvement in Temporomandibular Joint (TMJ) disorder symptoms can vary depending on the treatment approach.
- Studies have shown that conservative therapies, such as nonsteroidal anti-inflammatory drugs, muscle relaxants, and physiotherapy, can lead to significant improvements in symptoms within a few weeks to a few months 2, 3.
- Minimally invasive injections, including botulinum toxin, corticosteroids, and platelet-rich plasma, have also been shown to be effective in reducing pain and improving function, with some studies reporting significant improvements within 1-6 months 4, 5.
- A comparative study found that patients treated with platelet-rich plasma injections showed the best results after 6 months, while those treated with sodium hyaluronate or betamethasone obtained the best results at the end of the first week 4.
- High-intensity laser therapy (HILT) has also been shown to be effective in reducing pain and improving function in patients with TMJ disc displacement, with significant improvements seen at 4 and 12 weeks 5.
- Physiotherapy techniques, including therapeutic exercise protocols and manual therapy, have been found to be effective in controlling primary symptoms of TMD, with the combination of different therapies achieving the best results 3.