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

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.