Corticosteroid injections have been used to reduce pain and improve function of arthritic joints in various parts of the body. What about the temporomandibular joint?
Not so fast, say the editors of a review article examining the evidence on steroid use to treat temporomandibular disorders (TMD). There been no well-controlled randomized clinical trials with long-term follow-up, but only small studies with no controls and “information presented … based on perception and opinion.”
This does not mean that steroids should never be used. But specific guidelines are simply not available. There has been no assessment of the various formulations of steroid available, the dosages, and variations in injection techniques. Further complicating steroid treatment in the jaw is the fact that there is no one cause of jaw pain and dysfunction; and certainly not every TMD patient has degenerative joint disease. Moreover, there are risks with steroid injections, with the potential for damage to cartilage and fibrous tissue. All told, The TMJ Association agrees with the conclusion of the article: “There is just too little science evaluating short and long term efficacy.”
In a few selected instances, some conditions (such as juvenile rheumatoid arthritis of the jaw and TM joint arthralgia) associated with acute inflammation and osteoarthritis, may find relief via steroid injections, but even here repeated injections are not recommended.