Injections

You may need injections if more conservative treatments do not relieve your pain.

Myofascial trigger point injections – A myofascial trigger point is a tender, painful knot of muscle. It forms when tiny fibers, or bands, within the muscle become abnormally tight and will not relax. People with TMD may have one or more trigger points in the head, neck and shoulder muscles. A myofascial trigger point injection (shot) is given directly into a trigger point. The injection may contain a local anesthetic, sterile saline, steroids, Botox or no medication (“dry needle” injection). It may help relax the muscle and relieve pain.
Nerve blocks – Your health care provider may give you a nerve block as a test to see if your pain is being caused by an irritated nerve. If it helps relieve your pain, more nerve blocks may be given as part of your treatment plan. Nerve blocks are given as an injection (a shot), usually with a local anesthetic. They may cause numbness similar to the shots you get before you have a tooth filled. In addition to pain relief, a nerve block may give you an increased ability to move and use your jaw normally.
Prolotherapy – This is also called “proliferation therapy” or “regenerative injection therapy.” During prolotherapy, a sugar solution (dextrose) is injected into the tissues surrounding the joint. This causes inflammation, increased blood supply to the area and growth of new tissue. New tissue growth can help provide better stability and support for the TMJ when you do things like open and close your mouth. It may also help relieve pain and decrease joint noise. Prolotherapy is usually given in a series of four or more treatments. Prolotherapy is not well supported by research and is not proven to be more effective than sterile saline injected into the joint.
Arthrocentesis – This non-surgical injection is done to lubricate the joint surfaces and decrease inflammation. It is also called “joint aspiration.” During an arthocentesis, a specially-trained dentist removes the fluid that is normally found in the TMJ. He or she injects a local anesthetic to numb the affected TMJ, and then flushes it with a sterile solution. Next, the dentist may inject steroids or other medicines to help decrease inflammation in the joint. He or she may also use jaw manipulation to move a displaced disc back into the right place and/or to remove adhesions.