Self management for TMJ pain or facial pain

Four concepts to encourage healing of musculoskeletal pain include:

1. Reduce Strain
2. Relaxation
3. Posture
4. Stretching

Apply moist heat or cold, and massage tender muscle and joints

Heat or ice applications used up to four times per day while resting may relax muscles responsible for causing pain. For heat, microwave a wet towel for approximately 1 minute or until towel is warm and wrap around a hot-water bottle or heated gel pack. For cold, use ice wrapped in a thin cloth on the area until some numbness is felt. Use what feels best. Apply for 15 to 20 minutes, taking care not to burn or freeze skin.

Avoid foods that irritate your symptoms and chew on both sides

Avoid firm foods, such as French bread or bagels. Avoid chewy food such as steak or candy. Cut fruits and vegetables into small pieces. Chewing on both sides will reduce strain. Do not chew gum.

Avoid events or activities that trigger the pain

Use a pain diary to review daily activities that aggravate the pain and modify your behavior accordingly.

Avoid muscle tensing habits and activities that strain the jaw and head muscles

Notice if you do any of these oral habits. Use reminders such as stickers or timers. If noticed, replace negative habits with positive habits such as the “n” tongue position.

• Teeth clenching and grinding
• Teeth touching or resting teeth together
• Teeth tapping
• Biting cheeks, lips, and objects
• Hard and chewy foods
• Resting your jaw on your hand
• Pushing the tongue against the teeth
• Pushing the jaw forward or to the side
• Tensing the jaw
• Jaw strain from musical instruments or scuba
• Opening the mouth too wide with yawning or singing

Practice general relaxation, meditation and abdominal breathing

This helps reduce your reactions to stressful life events, decreases tension in the jaw and oral habits such as clenching. (Right now I love the Calm app, you can get it on your iphone)

Maintain good jaw posture. Keep your tongue up, teeth apart, and jaw muscles relaxed

Closely monitor your jaw position during the day (waking hours) so that you maintain your jaw in a relaxed, comfortable position. This often involves placing your tongue lightly on the palate behind your upper front teeth (find this position by saying “n”), allowing the teeth to come apart while relaxing the jaw.

Stretch the jaw and temple muscles

Place two to three fingers between your front teeth for a count to 20: Rest and repeat 6 times. Gradually increase range of motion as tolerated.

Get a good night’s sleep

Avoid caffeinated beverages (e.g) coffee, tea, and soft drinks. Improve sleep environment by reducing light and noise. Get a comfortable mattress and pillow. Reduce stimulating activities in late evening including computer work, video, and exercising. Do not sleep on your stomach.

Use anti-inflammatory and pain-reducing medications

Short-term or intermittent use of over- the-counter ibuprofen, naproxen, acetaminophen, or aspirin (without caffeine) may reduce joint and muscle pain. Prolonged use daily may contribute to rebound pain and perpetuate the pain. Consider use of combination of analgesic and muscle relaxant in evening. Consult with your primary care provider when taking medications.