I wonder if any one knows of a good NSAID alternative for TMJ. Tylenol doesn’t do squat. The doctor gave me tramadol, but that doesn’t help either. I’m not bothered by it all the time, but when it happens it reoccurs several days in a row. Ibuprofen knocks it out, but gives me bleeding issues. Anyone have experience with this? What do you do?
Oops - meant to include TMJ in the title. Sometimes I’m an idiot.
Aleve, but it might also give you bleeding issues. It’s common among NSAIDS.
Hot compresses help with mobility; cold packs will help reduce with inflammation.
Thanks GrumpyBunny. I don’t have issues with mobility. It’s the pain I don’t like. 
I’ll try the cold packs since reducing the inflammation with Ibuprofen almost always seems to work.
Dentist here. NSAIDs work because they are anti-inflammatory, Tylenol is not. As GrumpyBunny said heat often helps. In some cases it isn’t the joint but the muscles. In these cases muscle relaxants usually help.
Ice and relaxation and Aleve is the key for me. But if no Aleve, ice and relaxation.
Put a pencil between your front teeth and focus on letting it sit there without chomping on it. And/or massage your scalp.
Thanks. I was wondering about muscle relaxants. It hurts right in front of my ear and hurts to press on the tendons or muscles or whatever is there. When it gets bad it feels like the whole area in front of my ear. I’ll ask the doc about that medication when I go back.
Naproxen … ah reading the wikipedia they say this works better for joint pain as it is a COX 1 and 2 inhibitor ; (Tylenol not being a COX1/2 inhibitor, it works for headache, fever and skin injury but not real well for joint and tendon pains.)
Warning: Naproxen has a risk of stomach ulcers and heart attacks and various contra-indications besides (kidney failure and so on) .
Tylenol with Codeine ( aka co-cadomol , panadeine , among others…) is the next step up from pure substances… eg codeine may help you sleep. You can take naproxen and codeine at the same time, so as to avoid side effects of higher doses of either Naproxen or Codeine.
See Codeine/paracetamol - Wikipedia
Treat a co-codamol tablet as one acetaminophen tablet… so as to avoid overdosing on acetaminophen.
Maybe ask your doctor about taking Naproxen with a GI protectant like famotidine or even omeprazole? An NSAID combined with a mild muscle relaxant like Flexeril should give you relief, but yeah, if all NSAIDs are an issue for you, try the Flexeril or whatever muscle relaxer your doc recommends alone and see if that does the trick.
My doctor prescribed me Etodolac for TMJ. It is an NSAID that is made to be easier on your stomach. I’ve taken it for a few years now with no problems.
NSAIDs wreck my stomach too. My doc has me on Voltaren, a topical version for my plantar fasciitis. Maybe it work for TMJ?
Dentists are among my heroes. Your dental health is seriously important!
In addition to the NSAID (I’m fond of naproxen) topical Salonpas applied to the tender bits is surprisingly effective. Neck massage. Ice. Yoga- the kind that relaxes neck and upper back, often called “heart opening” asanas, because they relax attached muscles. Acupuncture.
Tramadol is an opioid. It’s not anti inflammatory at all, and has very recently been elevated to controlled drug status needing hard copy. It has its place, but treating chronic musculoskeletal pain is probably not one of them (arms raised protecting head).
Have you tried a mouth guard or having been given a retainer? The other recommendations are great, but prevention is even better.
I came in here looking for an alternative to NSAIDs. Until very recently I was taking 1600 mg per day of ibuprofen for osteoarthritis but my blood pressure had been getting high, in the 150 over 85 neighborhood. I dropped the ibuprofen for acetaminophen which dropped my BP down to 120 over 72, but as far as joint pain went was only slightly more effective than Tic-Tacs.
Now I’m using 150 mg a day of Tramadol, half the prescribed dosage of 2X50 mg tablets 3 times per day. Some drug panic just raised it to a Schedule IV narcotic so paper prescriptions are required. Tramadol works well on pain but as has already been stated, is not an anti-inflammatory. Don’t get old kids, it’s not for sissies.
I just realized this may seem flippant. I mention it because that’s what I got back when I had frequent TMJ, and it seems to have gone away now, flaring up only for a few hours if I eat something really, really chewy.
This is a great idea! I’ll ask about it. I would think that if it isn’t even getting into your GI system, it shouldn’t have those bad side effects. I had a few episodes of crapping blood after taking Ibuprofen. (I did have a colonoscopy months after I gave up Ibuprofen and they didn’t find anything.) But damn, that stuff works. Could the topical gel get to my colon somehow? (ha) I’ll ask the doc.
I laughed about the Tylenol working as well as tic tacs. But it’s true. I’ve only ever found it to be good for fever when I had the flu. Tramadol doesn’t do crap for jaw pain. I wonder if the topical Voltaren NSAID affects blood pressure? Interesting question.
No one has ever told me I’m a night time tooth grinder, so I don’t see the point.
I thought only Schedule II drugs required a paper script. Did that change?
I haven’t studied the issue, but my primary care physician said so and I took his word for it.
Federally, you are correct, though the company I work for is about to launch electronic prescribing of controlled substances in our pharmacy system, so we’ll soon be able to receive e-rx’s for controlled substances if the physician’s office is also certified to send them. Where it gets tricky is on the state level. In my state, Ohio, we can currently receive faxed or phoned in Schedule III-V drugs. Check with your pharmacist to see what’s allowed in your state (they should know since every state requires new pharmacist graduates to pass a separate law exam (MPJE) in addition to the pharmacy competency exam (NAPLEX) in order to practice).