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Medical care is a partnership between you and your medical professional, and you must be very vocal. Pain management is no different. Treatment with no options is simply not acceptable anymore!
Getting the standard of care that you deserve does not necessarily mean that you must accept the care that someone else has been deemed appropriate for you.
As the patient you have a responsibility to be as informed as possible before having procedures done or agreeing to any type of treatment. It is essential that you take advantage of the vast resources that are available at your fingertips (like this website!).
If you are more vocal, create a partnership with your health care provider, become informed about your condition, and research any new information or procedures, you will automatically have better pain management (and possibly, better treatment in other areas of your life and health, too!).
Who Can Treat Pain?
Your primary care doctor may decide to assume the responsibility for your pain management, or you may be referred to a pain management specialist or pain management center. A pain management specialist is a physician who is board certified in pain management or related fields.
Your specific needs will dictate what type of doctor you choose, and it is expected that you only see that person for your pain medication needs. In some cases, the doctor will have you sign a contract, which states that you will only receive pain medication from him/her, and will consent to random urine testing, pill counts, or other measures that protect both you and the doctor against misuse or diversion of your pain medication. You can also ask your physician to write a prescription for emergency room visits that indicates what medications you are on, which ER you should go to, and what you should be given in the event of an accident or other type of emergency.
How is Pain Treated?
Pain management can be trial and error. Pain can occur from various sources so a combination of medications may be needed. Some examples of the different types of medications used for pain management are:
- Anti-inflammatories – help reduce swelling and pain. Examples are Relafen, Mobic
Celebrex, Ibuprofen, and Naproxen.
- Analgesics – the most common pain relieving medications. Examples range from mild
pain relieving agents such as Aspirin or Tylenol, to those used for moderate or
severe pain such as Lortab, Percocet, and other opiates. (see below for more on opiates).
- Muscle Relaxants – Help to reduce muscle spasms and tightness. Examples
include Soma, Zanaflex, Flexeril, Baclofen, and Skelaxin.
- Nerve Pain Medications – These help to reduce pain due to nerve damage and
can be used to lower pain in general. Examples include Neurontin, Topamax, Keppra,
- Anti-Anxiety Medications – Help to reduce anxiety. Examples include Valium,
Klonipin, Ativan, and Xanax.
- Anti-Depressants – Help with depression as well as reduce pain in general.
Examples include Lexapro, Wellbutrin, Paxil, Nortriptalyine, Elavil, and Prozac.
Opiates are used to reduce moderate to severe pain. Medications such as Vicodin, Lortab, and Percocet are often used for acute or breakthrough pain and are generally
prescribed for short periods of time. However, if a patient is taking an appropriate amount, the doctor may prescribe for longer periods.
If short acting medication is not adequate enough to decrease the pain, long-acting opiates may be prescribed. These opiates are slowly released into the system over
a period of hours or days depending on the medication. Examples are Oxycontin, Duragesic (Fentanyl) patches, MS Contin, and Methadone. It is important to note that these medications can not be stopped abruptly. They need to be slowly tapered off to avoid side effects and withdrawal symptoms. It is essential that dosing instructions are followed carefully to avoid potential problems.
Other Types of Treatment and Pain Management
Many TMJ disorder patients find that a variety of different treatments are necessary to manage chronic jaw pain. This often involves a multi-disciplinary team approach.
Treatment modalities may include:
- Physical Therapy – The use of physical agents and methods such as massage, therapeutic exercises, cold, heat, hydrotherapy, & electrical stimulation can help patients in restoring function and providing pain relief during TMJ disorder or after TMJ surgery. Also called physiotherapy.
- Massage Therapy – While we have not heard of any completed or active clinical trials on TMJ disorder and massage therapy, we have heard that it is helpful for some patients. We have also heard from patients that describe it as “very painful.”
- Acupuncture – There is no specific evidence that points to the effectiveness of acupuncture for temporomandibular joint disorder. However, recently there was a study that came out explaining that acupuncture was indeed helpful for young patients with chronic illness (Science Daily). It helped ease nausea, fatigue and other effects of living with a chronic illness. Some TMJ patients have said that acupuncture offers them pain relief. Also, for the most part, it is usually extremely safe.
- Lifestyle Changes - Just like our self-care article states, exercise, a healthy diet, and reduced stress can help many TMJD patients to reduce their pain.
If you have any further questions about your medications, their side effects, dosing instructions, etc, please direct them to your pharmacist or doctor.
Managing your TMJ pain is extremely important! Having a lower pain level allows you make more rational decisions since you are not desperate with pain. In general, patients who have good pain management tend to have less invasive treatments and surgeries because they are not trying to find an elusive “fix” or “cure” for their problems.
Pain management gives us the gift of patience, and allows patients to look into the future with optimism instead of dread.
Overall, pain management helps by allowing TMJ disorder patients to THRIVE, instead of just existing with excruciating pain.