Botox vs. Trigger Point Injections: Which Is Best for My TMJ Pain?

Musculoskeletal pain patients often have MPS. MPS causes muscle and fascia pain. Patients usually have localized or referred pain with various patterns. Dry needling, trigger point injections, and Botox are all different types of therapy because they are used for TMJ pain and work in different ways.

Use Local Anesthetic Trigger Point Injections

Dr. Janet Travell was the first person to characterize myofascial trigger points as focal "knots" in tightly contracted skeletal muscle in 1942. Trigger point injections (TPI) are used by orofacial pain experts to treat jaw or neck muscle discomfort. Long-lasting anesthetics are injected; one such is 0.5% bupivacaine. A trigger point in a muscle is injected with medicine by TPI to stop the pain and get control of it. While numbing and reducing inflammation, the anesthetic eases muscle tension and pain, breaking the cycle of pain.

Musculoskeletal pain can be eased with primary or adjunctive trigger point injections. These injections can also increase range of motion. People with myofascial pain and tension headaches often feel better right away, but only for a short time. To keep the benefits going, you may need to keep getting treatments. In very few cases, trigger point injections from the pain clinic in Dallas can help people with oromandibular dystonia who are in pain from muscle spasms. They don't work as well for this purpose as Botox.  Trigger point diagnosis is still subjective. Trigger point injection's effects and efficacy are unclear.

If your TMJ hurts, you may want to try everything. This hinge connects your upper and lower jaw, making it necessary for eating and talking. Luckily, your dentist or pain physicians in plano can recommend jaw-healthy treatments and exercises. 

Lidocaine Trigger Point Injections

Trigger point injections help treat myofascial pain after the patient follows the home stretching protocol. These injections treat extremely painful muscle areas that won't stretch. A trigger point, also called a knot or ropy muscle band, happens when muscles don't relax enough. It's common to feel the knot under the skin.

How Injection Works? 

A small needle is used to prick the trigger point, and 0.5 cc of 1% or 0.5% lidocaine is injected. Trigger points are turned off with this injection, which helps to lower pain. It is rare to feel numb for an hour and get a bruise at the injection site. It will feel better after a day or two of wet heat and ice. After every TP injection, you stretch. If redness or swelling occurs, call the pain doctor in plano. A trigger point injection in a muscle near the ribcage could puncture the lung or pleura.

TMJ Steroids Injections

For joint pain and swelling, NSAIDs should be tried for two weeks before a TMJ joint injection. If medication or self-treatment fails in two weeks, local anesthetic/corticosteroid-assisted TM joint mobilization should be considered by pain management in plano. The patient is either given home stretching exercises or an injection of anesthetic and steroids into the joint during an outpatient office visit. The jaw is then gently mobilized or stretched open.

Intra-articular injections are sometimes used to diagnose and treat joint pain. Joint capsule pain is the main sign that this surgery is needed. You should numb the joint with 2% lidocaine (no epinephrine) and then do joint lavage and an intracapsular steroid injection with Kenalog-40. At most, ten times, and no more than once every three months, for a total of four years. A TMJ corticosteroid injection is given.

Hyaluronate TM Joint Injections

Injecting artificial joint fluid can treat severe friction-related joint dysfunction (e.g., frequent painful clicking, episodic closed or open locking, or recent painful crepitation). All synovial joints contain essential hyaluronic acid, a natural lubricant. The first treatments are NSAIDs and two weeks of not being able to move around. If two weeks don't help, you might want to add 1 ml (1 cc) of hyaluronic acid to the space above your TMJ.

Synvisc or Hyalgan are the products that are sold in stores. Both can help, and most people need two injections, three to four weeks apart. This operation can be done without waiting.

BotNa Injections

Botulinum toxin blocks neurotransmitter exocytosis by preventing nerve cell wall membrane-bound vesicles from releasing their contents into the synaptic cleft. This toxin blocks acetylcholine release from motor nerves, causing muscle contraction. By locating motor neurons, a toxin injected into a muscle blocks exocytosis and lessens muscular contraction.

Motor nerves cannot drive a continuous taut band in the muscle when botulinum toxin is injected close to a motor end plate where a trigger point would develop. Reduced taut bands mean less metabolic waste accumulates and sensitive c-fiber nerves "desensitize" over time. Botulinum toxin is used to treat persistently taut band myofascial changed muscles.

Does Botox Therapy Help With TMJ Pain?

The main reason why Botox is used is to treat orofacial dystonia. The lower facial muscles, jaw muscles, and tongue muscles all contract involuntarily as a result of this induction. Botox is given to people with TMD and myofascial pain who don't get better with standard treatments. It works to ease the pain that comes from clenching your teeth because your muscles are too active. By blocking acetylcholine at the neuromuscular junction, Botox temporarily stops muscles from moving. Less active muscles may help with pain and hyperactivity in people with oromandibular dystonia and bruxism.

According to NIH research, the results on myofascial pain are not clear-cut. Some patients feel a lot less pain, while others do not. The different responses may be because myofascial pain is complicated and each patient is different. Botox helps people with refractory TMD feel less pain and do more. BTX makes the pain from TTH less severe and intense. There is evidence from a systematic review that Botox injections may help people who haven't responded to other treatments.

 Botox is the best way to treat oromandibular dystonia because it stops muscles from contracting without the person's permission and makes life better overall. There isn't a lot of scientific evidence to support BTX injections for TMJ articular disorders, but there is evidence for masseter hypertrophy and myogenous TMDs. More research is needed to find out how well BTX injections work for treating myogenous and articular TMJ pain and to come up with good treatment plans for different TMDs.

What  Should I Get Trigger Point Injections or Botox Dry Needling?

Think about the patient's condition, past treatments, and how they responded to those treatments when choosing between trigger point injections, dry needling, and Botox. These methods can sometimes treat all four conditions at the same time: myofascial pain, TMD, TTH, and oromandibular dystonia. You should talk to your pain management doctors in plano about this before you decide.

Some people who are in a lot of pain use trigger point injections because they work quickly. Case studies that show years of clinical use can help people who are in pain. Randomized controlled trials show that it is faster and more useful to inject a trigger point. It hurts less than a BTX-A injection and not as much as dry needling.