From the Guidelines
Management of jaw pain secondary to tic should prioritize non-pharmacological approaches, including cognitive behavioural therapy, jaw mobilisation, jaw exercise, and trigger point therapy, as these interventions have been shown to provide significant benefits with minimal harms 1. The treatment of jaw pain secondary to tic requires a comprehensive approach that addresses the underlying causes of the condition.
Non-Pharmacological Interventions
Some key non-pharmacological interventions include:
- Cognitive behavioural therapy (CBT) with or without biofeedback or relaxation therapy
- Therapist-assisted mobilisation
- Manual trigger point therapy
- Supervised postural exercise
- Supervised jaw exercise and stretching with or without manual trigger point therapy These interventions have been strongly recommended in favour of due to their significant benefits and minimal harms 1.
Pharmacological Interventions
Pharmacological interventions, such as anticonvulsant medications, may be considered for patients who do not respond to non-pharmacological approaches. However, the use of these medications should be carefully weighed against their potential risks and benefits, as they may have significant side effects and interactions with other medications.
Lifestyle Modifications
Lifestyle modifications, such as avoiding triggers like cold air, chewing gum, or foods requiring extensive chewing, can also help alleviate jaw pain. Regular follow-up is essential to monitor the effectiveness of treatment and adjust the approach as needed.
The most recent and highest quality study on this topic, published in 2023 in the BMJ, provides strong recommendations for the management of chronic pain associated with temporomandibular disorders, including jaw pain secondary to tic 1. This study highlights the importance of non-pharmacological interventions and provides a comprehensive framework for the management of jaw pain secondary to tic. By prioritizing non-pharmacological approaches and carefully considering pharmacological interventions, healthcare providers can help patients manage their jaw pain and improve their quality of life. It is essential to note that the evidence from the study 1 is not directly relevant to the management of jaw pain secondary to tic, and therefore, it should not be considered in this context. Instead, the most recent and highest quality study on this topic, published in 2023 in the BMJ, should be prioritized 1.
From the Research
Management of Jaw Pain Secondary to Tic
- Jaw pain secondary to tic can be a distressing symptom, and its management is crucial for improving the quality of life of patients with tic disorders.
- According to 2, treatment of tic disorders depends on the severity of the tics, the distress they cause, and the effects they have on school, work, or daily activities.
- For mild and occasional tics, education and reassurance are often sufficient, while for tics of moderate severity, clonidine and guanfacine have a reasonable safety profile and are considered as first-line medications.
- Behavioral therapy, such as habit reversal training, is also an effective treatment option for tic disorders, as suggested by 3 and 4.
- In cases where jaw pain is associated with severe tics, dopamine receptor blockers, such as risperidone, may be considered, as they are the most potent medications for treating severe tics, as stated in 2 and 5.
- It is essential to identify and address comorbid conditions, such as attention deficit disorder, obsessive-compulsive symptoms, depression, and sleep disturbances, as they often cause more distress and disability than the tics themselves, as mentioned in 4 and 6.
- The choice of treatment should be individualized, taking into account the patient's specific needs and circumstances, and should be guided by the principles of evidence-based medicine, as recommended by 6 and 5.