Pain Management Procedures
Temporomandibular Joint Injection
Temporomandibular Joint (TMJ) Injection
What is a TMJ injection?
The temporomandibular joints, or TMJs, connect the lower jaw to the skull just in front of each ear. Arthritis, inflammation, injury, or internal joint problems can cause jaw pain, stiffness, clicking, and difficulty opening the mouth. A TMJ injection places medication into the joint to reduce inflammation or help confirm that the joint is the pain source.
When may it be recommended?
Injection is generally considered after evaluation of dental causes, jaw mechanics, muscle-related pain, and other facial-pain conditions. It may be appropriate when conservative treatment - such as activity changes, a soft diet, oral medication, a dental appliance, or therapy - has not provided enough relief. Not every clicking joint needs an injection.
What happens?
The skin in front of the ear is cleaned and numbed. Ultrasound or another imaging method may guide a small needle into the joint. The clinician may first remove excess joint fluid, then inject local anesthetic, corticosteroid, or another selected treatment. The exact technique and medication depend on the diagnosis.
What should I expect afterward?
The jaw may feel temporarily numb or full, and mild soreness can occur. You may be asked to use a soft diet briefly and avoid excessive chewing. Any steroid benefit may take several days. Relief varies because TMJ symptoms can arise from the joint, surrounding muscles, teeth, or several sources at once.
Important risks
Risks include bleeding, infection, medication reaction, temporary facial numbness or weakness, increased pain, and injury to nearby structures. Repeated steroid exposure can affect cartilage and other tissue, so injections should be used selectively. Fever, increasing swelling, drainage, or new facial weakness should be reported promptly.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.