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Compounded Topical Pain Medications for TMJ Pain

Creams, Arnica Gel, Compounded Topical Pain Medications for TMJ, Muscle and Nerve Pain

What are topical compounded medications? 

Topical compounded medications are uniquely formulated ointments, mouth rinses and medical creams for the treatment of various pain conditions. These medications are applied directly to the painful area for direct delivery to the pain source. These creams, rinses and ointments are special formulations of medication prepared by a pharmacist based on your exact needs. Conditions treated with topical medications can vary, and may range anywhere from arthritis to nerve or muscle pain. Dr. Bakhtiari will prescribe a topical treatment best suited to your unique condition, and send the script to a pharmacy that will mix together the desired medication.

What conditions can be treated or managed with topical medications? 

Conditions that can be treated or managed with topical medications include trigeminal neuralgia, neuropathic pain, TMJ, facial pain, arthritis and muscle spasms.

Topical medications have also been found to work particularly well in managing or treating continuous neuropathic pain conditions such as phantom tooth pain (atypical odontalgia), burning mouth syndrome, and traumatic trigeminal neuropathy.

What are the common ingredients in topical medications?

One commonly applied topical medication ingredient is lidocaine in the form of lidocaine patches (Lidoderm®), which are used in the treatment of peripheral neuropathic pain. Another commonly used topical ingredient is capsaicin, which can be very helpful in the treatment of burning mouth syndrome. Overall, many medications may be added to a topical compound, and they range from anti-inflammatory medications (ketoprofen, etc.), anti-histamines, membrane stabilizers (gabapentin / Neurontin®, pregabalin / Lyrica®, carbamazepine / Tegretol®, oxcarbazepine / Trileptal®) to tricyclic antidepressants (amitriptyline / Elavil®, nortriptyline / Pamelor®, etc.). Additionally, there are naturally-derived creams such as CBD, arnica, and magnesium which appear promising.

When do you use topical medications (in the form of ointments or creams) instead of pills?

In some instances, the pills that may be used for the treatment of trigeminal neuralgia, TMJ, facial pain, arthritis or muscle spasms cannot be tolerated by the patient due to adverse side effects. One way to minimize or circumvent these negative side effects is to apply the medication directly to the painful area instead of taking the medication in pill form. One method to potentially achieve optimal pain relief would be to use both a topical medication and an oral pill at the same time.

How expensive are topical compounds?

Some are readily available in health food stores, while others need to be prescribed. Some insurance companies will cover a significant portion of the cost of a topical medication, while other insurance carriers will not. Whether or not your insurance covers the price of the compounded medication depends on your exact insurance plan and coverage. One benefit of topical medications is that the pharmacist is able to minimize its cost by fabricating a medication that is limited to the ingredients that you absolutely need, as determined by the pharmacist and Dr. Nojan. This can be done to ensure that the cost of the medication does not prevent you from managing or treating your pain.


TMJ Treatment options vary depending on the individual suffering from TMJ and the specifics of their condition. Since TMJ/TMD can affect the musculature, tendons, bones and joint of the jaw, a thorough examination and diagnosis is paramount prior to initiating any treatment. Treatments include therapeutic injections of muscles and the joints, custom fabricated orthotics (also called splints, mouth guards, nightguards or occlusal guards), medications, creams, botox©, jaw stretching exercises, and physical therapy.

TMJ therapies should never include grinding down of otherwise healthy teeth. It is ill-advised to suggest to a patient that grinding of their otherwise healthy natural teeth is related to the TMJ pain they are perceiving. This treatment philosophy of “correcting the bite”, by either grinding down teeth (occlusal adjustments), restoring teeth with crowns, or moving teeth with braces or invisalign©, has been debunked in the dental and scientific literature.

Get started on your path to alleviating TMJ Pain Today!