Temporomandibular disorder (TMD) is a painful problem of the joint in the jaw. These are the small joints in front of each ear. They attach the lower jaw to the skull. TMD may be in the joint in the jaw or the muscles around it.
It is treated with lifestyle changes, medicine, and physical therapy. Some people may need surgery. Others may turn to natural therapies to further ease symptoms.
These therapies are likely to help:
May Be Effective
These therapies may be effective:
- Acupuncture uses thin needles or lasers in specific body parts to ease symptoms.C1-C9
- Biofeedback is a method used to help control some body functions using electronical sensors.A1-A3
- Dry needling a needle that does not contain medication to ease pain.I1, I2
- Hypnotherapy uses hypnosis to ease pain.B1-B2
- Manipulative multi-modal therapy O1
- Manual therapy is the use of a health care worker's hands to ease soft tissue pain.L1-L3
- Physical therapy is the use of exercises and other therapies to help ease pain and restore function.J1
- Prolotherapy uses injections in the muscles to ease pain.D1-D6
- Psychosocial interventions P1
Herbs or supplements that may be effective are:
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Herbs and Supplements to Be Used With Caution
Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Be cautious when using TCHM . Herb mixtures and the amounts used vary, and can be toxic.
A1. Crider AB, Glaros AG. A meta-analysis of EMG biofeedback treatment of temporomandibular disorders. J Orofac Pain. 1999;13(1):29-37.
A2. Shedden Mora MC, Weber D, et al. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain. 2013;29(12):1057-1065.
A3. Sato M, Iizuka T, et al. Electromyogram biofeedback training for daytime clenching and its effect on sleep bruxism. J Oral Rehabil. 2015;42(2):83-89.
B1. Abrahamsen R, Baad-Hansen L, et al. Effect of hypnosis on pain and blink reflexes in patients with painful temporomandibular disorders. Clin J Pain. 2011;27(4):344-351.
B2. Zhang Y, Montoya L, et al. Hypnosis/Relaxation therapy for temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. J Oral Facial Pain Headache. 2015;29(2):115-125.
C1. Jung A, Shin BC, et al. Acupuncture for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized, sham-controlled trials. J Dent. 2011;39(5):341-350.
C2. Ferreira LA, de Oliveira RG, et al. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci. 2013;28(6):1549-1558.
C3. Huang YF, Lin JC, et al. Clinical effectiveness of laser acupuncture in the treatment of temporomandibular joint disorder. J Formos Med Assoc. 2014;113(8):535-539.
C4. Hu WL, Chang CH, et al. Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One. 2014;9(10):e110528.
C5. Fernandes AC, Duarte Moura DM, et al. Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J Oral Facial Pain Headache. 2017 Summer;31(3):225-232.
C6. Wu JY, Zhang C, et al. Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders: A PRISMA-compliant meta-analysis. Medicine (Baltimore). 2017 Mar;96(9):e6064.
C7. La Touche R, Goddard G, et al. Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2010 Jul-Aug;26(6):541-550.
C8. List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.
C9. Cho SH, Whang WW. Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain. 2010 Spring;24(2):152-162.
D1. Refai H, Altahhan O, et al. The efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: a preliminary prospective, randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2011;69(12):2962-2970.
D2. Zhou H, Hu K, et al. Modified dextrose prolotherapy for recurrent temporomandibular joint dislocation. Br J Oral Maxillofac Surg. 2014;52(1):63-66.
D3. Cömert Kiliç S, Güngörmüş M. Is dextrose prolotherapy superior to placebo for the treatment of temporomandibular joint hypermobility? A randomized clinical trial. Int J Oral Maxillofac Surg. 2016;45(7):813-819.
D4. Majumdar SK, Krishna S, et al. Single injection technique prolotherapy for hypermobility disorders of TMJ using 25%. J Maxillofac Oral Surg. 2017;16(2):226-230.
D5. Refai H. Long-term therapeutic effects of dextrose prolotherapy in patients with hypermobility of the temporomandibular joint: a single-arm study with 1-4 years' follow up. Br J Oral Maxillofac Surg. 2017;55(5):465-470.
D6. Nagori SA, Jose A, et al. The efficacy of dextrose prolotherapy over placebo for temporomandibular joint hypermobility: A systematic review and meta-analysis. J Oral Rehabil. 2018 Dec;45(12):998-1006.
E1. Cahlin BJ, Dahlström L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(6):760-766.
E2. Haghighat A, Behnia A, et al. Evaluation of glucosamine sulfate and Ibuprofen effects in patients with temporomandibular joint osteoarthritis symptom. J Res Pharm Pract. 2013;2(1):34-39.
E3. Damlar I, Esen E, et al. Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint. Med Oral Patol Oral Cir Bucal. 2015;20(3):e278-e283.
E4. Cen X, Liu Y, et al. Glucosamine oral administration as an adjunct to hyaluronic acid injection in treating temporomandibular joint osteoarthritis. Oral Dis. 2018;24(3):404-411.
E5. Melo G, Casett E, et al. Effects of glucosamine supplements on painful temporomandibular joint osteoarthritis: A systematic review. J Oral Rehabil. 2018;45(5):414-422.
Traditional Chinese Herbal Medicine
F1. Ritenbaugh C, Hammerschlag R, et al. Comparative effectiveness of traditional Chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain. J Pain. 2012;13(11):1075-1089.
G1. Winocur E, Gavish A, Halachmi M, Eli I, Gazit E. Topical application of capsaicin for the treatment of localized pain in the temporomandibular joint area. J Orofac Pain. 2000;14(1):31-36.
G2. Campbell BK, Fillingim RB, Lee S, Brao R, Price DD, Neubert JK. Effects of high-dose capsaicin on TMD subjects: a randomized clinical study. JDR Clin Trans Res. 2017;2(1):58-65.
H1. Christidis N, Lindström Ndanshau E, et al. Prevalence and treatment strategies regarding temporomandibular disorders in children and adolescents-A systematic review. J Oral Rehabil. 2019 Mar;46(3):291-301.
I1. Vier C, Almeida MB, et al. The effectiveness of dry needling for patients with orofacial pain associated with temporomandibular dysfunction: a systematic review and meta-analysis. Braz J Phys Ther. 2019 Jan - Feb;23(1):3-11.
I2. Machado E, Machado P, et al. A systematic review of different substance injection and dry needling for treatment of temporomandibular myofascial pain. Int J Oral Maxillofac Surg. 2018 Nov;47(11):1420-1432.
J1. Amorim CSM, Espirito Santo AS, et al. Effect of Physical Therapy in Bruxism Treatment: A Systematic Review. J Manipulative Physiol Ther. 2018 Jun;41(5):389-404.
K1. Armijo-Olivo S, Pitance L, et al. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016 Jan;96(1):9-25. K2. List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.
L1. Armijo-Olivo S, Pitance L, et al. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016 Jan;96(1):9-25.
L2. Martins WR, Blasczyk JC, et al. Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis. Man Ther. 2016 Feb;21:10-17.
L3. Calixtre LB, Moreira RF, et al. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil. 2015 Nov;42(11):847-861.
Cognitive Behavioral Therapy
M1. Randhawa K, Bohay R, et al. The Effectiveness of Noninvasive Interventions for Temporomandibular Disorders: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Clin J Pain. 2016 Mar;32(3):260-278.
M2. List T, Axelsson S. Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil. 2010 May;37(6):430-451.
N1. Randhawa K, Bohay R, et al. The Effectiveness of Noninvasive Interventions for Temporomandibular Disorders: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Clin J Pain. 2016 Mar;32(3):260-278.
Manipulative and Multimodal Therapy
O1. Brantingham JW, Cassa TK, et al. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review. J Manipulative Physiol Ther. 2013 Mar-Apr;36(3):143-201.
P1. Aggarwal VR, Lovell K, et al. Psychosocial interventions for the management of chronic orofacial pain. Cochrane Database Syst Rev. 2011 Nov 9;(11):CD008456.
Last reviewed December 2019 by EBSCO NAT Review Board Eric Hurwitz, DC Last Updated: 6/24/2020