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Review
. 2025 May;15(5):285-296.
doi: 10.1080/17581869.2025.2502311. Epub 2025 May 8.

Pharmacological and non-pharmacological approaches to temporomandibular disorder chronic pain: a narrative review

Fanny Jogna  1 , Adriana Graenicher A  1 , Quentin Rey-Millet  2 , Alexandra Groz  3   4 , Jehanne De Grasset  4 , Fabiola Stollar  4   5   6 , Matteo Coen  1   4   7 , Anna Faivre  1
Affiliations
Review

Pharmacological and non-pharmacological approaches to temporomandibular disorder chronic pain: a narrative review

Fanny Jogna et al. Pain Manag. 2025 May.

Abstract

Temporomandibular disorders (TMD) involve the temporomandibular joint and related structures, causing chronic pain, impaired jaw function, and reduced quality of life. TMD has multifactorial origins, including mechanical, neuromuscular, and inflammatory factors. Chronic TMD pain is difficult to manage due to its complex pathophysiology and the limited long-term effectiveness of existing treatments. A combination of pharmacological and non-pharmacological strategies is essential for optimal pain management. This narrative review provides an integrative overview of current treatments for TMD-associated chronic pain. Pharmacological options discussed include analgesics, muscle relaxants, antidepressants, anticonvulsants, and botulinum toxin injections. Non-pharmacological strategies include physical therapy, cognitive-behavioral therapy, acupuncture, and lifestyle modifications. A comprehensive literature search was conducted using PubMed, Embase.com, Cochrane, and Evidence Alerts databases through October 2024. We focused on original research articles, randomized controlled trials, narrative and systematic reviews, and meta-analyses. Effective management of chronic TMD pain requires a multidisciplinary approach tailored to individual needs. Evidence supports the integration of physical and psychological therapies into treatment plans. Future research should aim to develop targeted interventions that address underlying mechanisms of TMD pain and evaluate the long-term outcomes of noninvasive therapies.

Keywords: Temporomandibular disorders; chronic pain; complementary therapy; integrative medicine; nociceptive pain; pain management; pharmacology.

Plain language summary

TMD is a condition that causes pain and problems in the jaw joint and the muscles that control jaw movement. This can lead to long-term pain, trouble moving the jaw, and a lower quality of life. TMD has many causes, like stress on the joint, muscle problems, and swelling, which makes it hard to treat. Current treatments don’t always work well over time, so using a mix of different treatments is important for better pain relief. This review looked at both medicine-based and non-medicine treatments for TMD pain. Medicine treatments include painkillers, muscle relaxers, antidepressants, seizure medications, and Botox injections. Non-medicine treatments include physical therapy, therapy for mental health, acupuncture, and lifestyle changes. The authors searched medical research studies without date limits, focusing on high-quality studies. They found that the best way to treat chronic TMD pain is to combine medicine and non-medicine treatments, designed to meet each person’s physical and emotional needs.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.
Number of PubMed occurrences per year and per treatment for the last 10 years, focusing on non-pharmacological and non-surgical approaches.
See this image and copyright information in PMC

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