Botox injections for TMJ pain (pain in the jaw or jaw joint)
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People want relief if they are living with jaw pain, TMJD (temporomandibular joint dysfunction), or craniofacial pain - call it what you want. Many have heard about Botox and are curious about what it is, how it works and if I recommend it.
Since Botox is drug, and I’m a licensed massage therapist, I can not and will not tell my clients to try or not to try Botox. That is outside of my scope of practice. However, I can inform my clients on the research I’ve gathered and offer options that they never thought of. That is what I’ll share with you here and two client stories you might learn from.
What is Botox and how does it work?
Botox is an injectable neurotoxin protein. It temporarily prevents nerve cell signals from reaching your muscles and reduces abnormal muscle contractions. It is FDA approved for small dose use for some medical and cosmetic procedures, like wrinkle augmentation. FDA has NOT approved it for treatment of temporomandibular joint disorder. The idea behind its use for TMJD is to relax the muscles crossing the TM joint by paralyzing them and thus relieve pain.
From asking a lot of professionals that do Botox injections I understand that they use a significantly higher amount for TMD injections compared to cosmetic injections.
Will insurance pay for Botox for TMJD?
Since Botox is NOT a FDA-approved treatment for TMJ disorders and jaw problems, insurance will likely NOT pay for this expensive treatment. One of my clients reported paying $1,000 to an oral surgeon for one round of Botox injections to only the masseter muscles. Multiple injection sessions might be needed over the span of several months since the results do wear off.
Treating the symptoms, not the cause
Botox injections are just treating one of the symptoms of TMJD, not actually fixing the entire TMJD issue. Since TMJD can be complicated, some dentists argue that Botox can interfere with a proper diagnosis of the cause of your pain and note that Botox is not a long term solution.
Complementary treatment
I do understand fully that sometimes you just want to find that magical bandaid for the pain while you are getting the treatment you need from a massage therapist, physical therapist, dentist, orthodontist or oral surgeon. If you are going to choose Botox injections this does not mean you have to exclude working with those professionals. Botox should be in conjunction with investigation of your issues and seeking long term support.
Know that most dentists and oral surgeons only do Botox injections to the masseter muscle. The masseter is your big cheek muscle. It closes and clenches the jaw. But that is not the ONLY jaw muscle and place that you can have a muscle dysfunction. Muscles of the jaw, neck and tongue need to be addressed. There are also more ways than Botox to treat a muscle dysfunction. Manual therapy by a massage therapist or physical therapist are the most common. You can also be taught self-massage to maintain relief.
If you are even considering Botox, take it as a signal to double down on your self-care and self-treatment. Habits and postures need to be addressed and cleaned up. This includes in your daily functions, eating posture and sleeping posture.
Client story 1
The first client I’ll tell you about had classic jaw pain through her lower face and a grinding sound in her TM joints when she opened her jaw. Her dentist did Botox injections to just the masseter muscle. Her pain reduced only a smidge. A few days later she saw me for her first TMJ massage. I massaged all of her jaw muscles to relax the over engaged muscles, and did some training to engage the lazy muscles. My intention was to reduce active trigger points giving her pain, decompress the TMJ, and ask the muscles and nerves of the left and right joint to work as a team to get a smooth opening motion.
The results, her grinding sound went away, she reported an ease in opening her jaw, and a dramatic reduction in pain for the next two weeks.
Client story 2
My second client went first to her oral surgeon looking for relief. She had pain in the face and jaw, and her occlusion or bite strike was mainly hitting on the left. After evaluation, the surgeon said he didn’t need to do surgery, it was just tight muscles creating the pain and uneven occlusion. The only tool this surgeon had in his tool belt for tight muscles was Botox to the masseter. So she agreed. She got zero relief from that $1000 Botox injection. Masseter alone is rarely the problem! When she and I worked together later that month to address ALL the tight jaw muscles, she got relief. Her pain went down, her opening was smoother and wider and her occlusion now felt equal to her. The dramatic improvement for her was treating the muscles medial and lateral pterygoid. Botox wasn’t administered to these muscles.
At home care
I taught both of these clients how to do self-massage for their own jaw muscles at home to maintain the relief. And I was able to identify a lot of irritating habits and postures that they could improve. If you are saying, “I want some of this non-drug relief” know that you can do a lot of this yourself! You just need a teacher.
I want you to sign up for a free training video using the form on this page. You’ll get a video sent to your inbox to train you on self-massage and stretching for the masseter muscle as well as one habit to change now.
Then consider my full online, learn at your own pace video course called Self Help to Relieve Head, Neck and Jaw Pain. I’ll teach you self-massage, stretching, stabilization, basic airway involvement, tongue position, and habits to address.
If you do this self-care your body just might be more receptive to Botox, if you still need it, and dental interventions for sure.
