A temporomandibular joint (TMJ) injection with steroids is used to treat acute or chronic capsulitis of the jaw joint. This condition involves inflammation of the joint capsule and can cause significant discomfort and functional limitation.
Capsulitis of the temporomandibular joint may result from several factors:
The symptoms of TMJ capsulitis typically include:
The temporomandibular joint space can be palpated just in front of the ear as the patient opens and closes the mouth. Inside the joint lies a meniscus (articular disc). The needle must be placed beneath this meniscus to enter the joint space properly. The joint is easiest to infiltrate when the jaw is opened wide. Occasionally, trauma may cause a tear of the meniscus.
After the injection, patients should avoid excessive jaw movements such as biting into a large apple or eating hard foods. Gentle active movements and isometric exercises may be performed. A mouthguard for nighttime teeth grinding and/or consultation with an orthodontist may be necessary.
The needle may need to be repositioned to bypass the meniscus. In cases of meniscus displacement, an attempt should be made to reduce it through manipulation approximately one week after the injection, once the inflammation has subsided.
In resistant cases, surgery may be required. Occasionally, this condition occurs in patients suffering from significant tension; in such instances, it is worthwhile to explore an appropriate stress reduction approach.
One study found that the TMJ steroid injection technique can be safely performed by experienced oral and maxillofacial surgeons without the need for computed tomography guidance. Furthermore, these results suggest that TMJ steroid injections may be effective in treating TMJ arthritis, although further research is needed.
Another study concluded that intra-articular injection of corticosteroids and sodium hyaluronate appears to be an effective method for treating internal TMJ disorders.
