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Ice or Heat For TMJ Pain?

  • Ice or Heat For TMJ Pain
    Ice or Heat For TMJ Pain?
    • Ann C McCulloch
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    If you have a jaw injury, you might be wondering, “Do I use ice or heat for TMJ pain?”. While much depends on the type of injury or temporomandibular joint (TMJ) condition you have, using both is often optimal. Here we break down the rationale for using ice, heat, or both for TMJ pain.

    Ice for Jaw Pain

    Ice therapy (cryotherapy) is generally used in the context of an acute injury, such as jaw sprain or strain. When an injury occurs, the healing response comes in the form of inflammation. Healing is a good thing, but sometimes the inflammatory response sets you up for more pain in the long run. Here’s what ice can do for a jaw injury.

    • Decrease Inflammation: Ice causes blood vessels to constrict. Decreased circulation to the injured region will slow swelling and any underlying inflammatory reaction.
    • Decrease Joint Fluid Production: In cases of arthritic joints, the amount of joint fluid (called synovial fluid) can contribute to the joint pain. Icing can decrease the joint fluid production and provide relief.
    • Pain Relief: The anti-inflammatory effect of ice can reduce the burden of pain. Ice will also cause local nerves to be distracted from the injury. This decreases neuronal excitability and interrupts pain signals to the brain.

    Heat for Jaw Pain

    Heat therapy (thermotherapy) is generally used for chronic pain conditions, but it can be used in acute settings too. Here are some things that heat can do for your jaw pain:

    • Increased Circulation: Blood vessel dilation brings more oxygen, nutrients, and immune cells to the jaw injury. These are key factors in the healing process.
    • Elimination of Waste Products: Metabolic residues build up after an injury and cause increased pain and spasm in the muscle. The increased circulation promotes the elimination of metabolic waste.
    • Increased Lymphatic Flow: The immune cells that enter the injured area absorb waste products leave the area through the lymphatic system. Heat accelerates this process.
    • Increased Tissue Extensibility: Heat will cause the underlying tissue to be more flexible. This will relax the jaw and facilitate movement.
    • Pain Relief: Just like with ice, heat will distract the local nerve response to injury. This interruption of neuron excitability is what makes heat feel comforting to an injury.

    Heat has also been shown to be effective for chronic temporomandibular disorders (TMD). A review of the literature on using heat for temporomandibular disorders found that heat treatment resulted in significant pain reduction, relief of muscle tension, and improved mobility of the TMJ.

    Should You Use Ice or Heat for TMJ Pain? (Or Both?)

    The current thinking in the heat vs ice debate for joint injury is in transition. The traditional approach is to ice an acute injury and to use heat for comfort and flexibility. However, several practitioners are now advocating the exclusive use of heat for joint injuries.

    The treatment of TMJ pain is unique in that there is a priority on pain relief after injury. Interrupting the neural pathways from jaw pain after an injury may prevent a prolonged TMD from developing. This is important because people with acute trauma to the jaw have a fourfold increase in the risk of developing a chronic TMD, according to a 2019 study in the journal Pain.

    Because both ice and heat are useful in their own ways for relieving pain, the use of alternating ice and heat is a sensible approach in the case of TMJ pain. “The key is to treat jaw pain aggressively up front so that we prevent the development of a chronic pain disorder.  We use every tool we can in the early stages of injury to get pain under control”, explains Bradley Eli, DMD, MS, a specialist in orofacial pain disorders.

    How to Use Heat Or Ice For TMJ Pain

    Here are some general recommendations for the use of ice or heat for TMJ pain:

    • Ice: If there is an acute injury, use ice alone for the first 24-48 hours. Apply the ice for no more than 15-20 mins.  Try to do this up to 6 times a day for the first 48 hours.
    • Heat: If there is minimal swelling, you can start the use of heat for comfort and relaxation.  Use heat for no more than 15-20 minutes. Again, shoot for 1-3 times a day.

    Most cases of acute jaw injury (such as whiplash injuries or jaw sprain/strain) have a normal recovery period of two to four weeks.  The calming and pain relieving use of ice and heat is beneficial for a return to normal jaw function.  Use this time to focus on stress relief and taking positive steps to promote healing.

    Jaw Pain Relief

    We have outlined the use of ice and heat for TMJ pain, especially jaw and muscle sprain/strain. Now consider these additional important steps as part of a comprehensive approach to jaw pain relief:

    • Jaw Rest: Adopt a soft diet and avoid eating hard foods or chewing gum.
    • Gentle Exercise: Early mobility of an injured joint is important for the healing process. Make use of physical therapy exercises designed for the jaw.
    • Oral Splint Therapy: The use of an anterior bite guard like the Quicksplint protects against muscle hyperactivity and protective guarding in the context of jaw injury and pain.
    • Medication: Anti-inflammatory medications are generally helpful for acute injuries to reduce pain as quickly as possible.

    The Speed2Treat Home Healing Kit contains convenient hot/cold packs that are inserted in an adjustable neoprene wrap that fit the head, neck, or jaws. The kit also includes an anterior bite guard (an oral appliance worn at night, short-term use only), and a comprehensive 4-Week care plan designed to prevent the development of chronic TMDs. Start your journey towards TMJ pain relief with the Home Healing Kit today!

     

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    Founder and CEO of Orofacial Therapeutics

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