Why am I worst after Botox for TMJ?

Question

I have had tmj that was causing tension headaches that became migraines. I had botox done 150 units in forhead, temples, jaw , neck and top of shoulders. Its been 3 months and though I didnt get a migraine my jaw is much worse. I went from a mouth opening of 37 to 28 now and now have problems chewing anything harder or chewy like bread without worse tmj pain,. Necks also worse Is this normal will it ever go away. Why would it cause my opening to get smaller? Is it not supposed to cause less pain.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about botox. Botox is used to treat TMJ pain and migraines all the time. I am not sure why you experienced a decrease in the opening angle of your jaw. I would follow up with your provider and a neurologist for a full evaluation.Botox lasts 3-4 months (some patients longer and others shorter) but within 6 months the effects of botox will have fully worn off. Most patients do experience a decrease in pain while the botox is still on board. Again I recommend following up with your provider regarding your symptoms and experience.

To be sure you receive the best treatment, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.

I hope this helps.

To be sure you receive the best treatment, see two or more experienced, licensed and board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.
 
 I hope this helps.

Sam Naficy, MD, FACS · Answer

It is very difficult to answer this question without seeing you for a full assessment. I would highly recommend following up with the provider to discuss your current situation to determine the next course of action.

Ryan M Clancy, DMD, MAGD, LVIF · Answer

While Botox can be used effectively to temporarily treat TMJ symptoms, it doesn't fix the root cause of your TMJ and doesn't always work for everyone. I would suggest visiting a dentist who specializes in TMJ to explore other treatment options and find out why your jaw and neck have gotten worse.

Promila Banerjee, MD · Answer

Not sure about the explanation for reduced angle of opening.  I suspect there are other causes for your pain (check joint alignment).  Sometimes the (mal) alignment of the joint and the joint itself causes pain.  I have seen two cases of pain locally at TMJ but both improved their headache after Botox.  By reducing the frequency and # units of Botox injected at TMJ (in subsequent session), we were able to help reduce the TMJ pain.  I suggest, take a break from TMJ Botox for 6 months.  You may benefit from a neurology consultation regarding your neck pain.
Best wishes,
Dr B

Why am I worst after Botox for TMJ?

Answers (4)