What are the recommended first-line treatments for managing TMJ pain in adults?

Recommended first-line treatments for managing temporomandibular joint (TMJ) pain in adults include:

• Taking a biopsychosocial approach that includes reassurance that the condition is usually non-progressive and symptoms may fluctuate but should improve.
• Educating the patient about the disorder, its causes, anatomy, management options, and therapy goals.
• Encouraging self-management strategies such as eating a soft diet and resting the jaw during acute pain episodes, avoiding parafunctional activities (e.g., wide yawning, teeth grinding, jaw clenching, chewing gum, nail biting), and using local measures like applying covered ice, warm flannels, heat pads, or muscle massage.
• Reinforcing positive lifestyle strategies including gentle regular exercise, maintaining social interactions, relaxation, stress management, and good sleep hygiene.
• Considering short-term use of simple analgesics such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
• For acute and severe myogenous pain, a short course (maximum 5 days) of low-dose benzodiazepines (e.g., diazepam 2 mg up to three times daily) may be considered.

These first-line treatments focus on conservative management in primary care before considering referral for specialist investigations or additional therapies.

References: NICE CKS