Cortisone Shot for TMJ
Edited by Merve Aydin, Health Content Editor · About 8 min read · General information, not medical advice
| Corticosteroid (cortisone) | Inside the TMJ | Mayo Clinic says it may help; AAFP: no better than saline flushing, not recommended due to potential cartilage damage |
|---|---|---|
| Arthrocentesis (saline flush) | Inside the TMJ | NIDCR: can relieve pain and improve mouth opening when the disc is displaced, with inconsistent results |
| Botulinum toxin (Botox) | Rarely, the chewing muscles | NIDCR: not FDA-approved for TMDs, mixed results; Cleveland Clinic: lasts about three to four months |
| Sodium hyaluronate | Inside the TMJ | AAFP: no consistent benefit over arthrocentesis alone |
| Trigger point injections | Tight jaw or neck muscles | Cleveland Clinic: dry needling or steroid shots listed among nonsurgical options |
If you want detail on the flush procedure, see our page on the tmj arthrocentesis procedure, and for the muscle-relaxing alternative see tmj botox injection sites.
What to expect at the appointment
- Exam first. A clinician listens to and feels your jaw as it opens and closes, checks your range of motion, and presses around the joint and chewing muscles; the AAFP notes an opening of less than 30 to 35 mm is considered abnormal.
- Possible imaging. X-rays, CT, or MRI may be ordered if the diagnosis is in doubt or conservative treatment is not working.
- A conservative-care conversation. Expect discussion of soft foods, heat or cold, exercises, and medicines before any needle comes up.
- A detailed risk discussion. Before agreeing to an injection or other procedure, NIDCR advises asking how it may help your specific TMD, what the risks are, and considering a second opinion from a qualified specialist.
- The procedure. Numbing medicine is typically used and a needle is placed into or beside the joint; arthrocentesis, for example, uses small needles so fluid can flow through the joint.
- Follow-up. Pain and jaw function are usually rechecked over the following weeks to months, since the trial evidence tracks outcomes at 1, 3, 6, and 12 months.
What to try before considering an injection
Because many TMDs settle on their own, simple measures come first. NIDCR recommends soft foods, applying heat or cold, gentle jaw exercises, over-the-counter NSAIDs such as ibuprofen, and cutting habits like jaw clenching, gum chewing, and nail biting. Mayo Clinic adds that heat or cold should be held on the face for 15 to 20 minutes several times a day — ice for sharp, acute pain, heat for chronic dull aching — and suggests resting the jaw with the tongue gently on the palate, teeth apart.
Beyond self-care, physical therapy with manual therapy can help relieve pain and improve function, stabilization splints may be tried, and prescription options range from NSAIDs to muscle relaxants, depending on the diagnosis. Our guides on tmj treatment options and how to relieve TMJ pain cover these steps in more depth.
When jaw pain needs prompt medical attention
Some symptoms call for care now rather than a treatment ladder. Seek prompt medical or dental evaluation — or emergency care where indicated — if your jaw locks open or shut, your face is swollen with fever, you feel facial numbness, a blow injured the jaw, or jaw pain occurs with chest pain. These signs can point to problems an injection would not fix and may be emergencies.
Frequently Asked Questions
Does a cortisone shot make TMJ go away?
No. There is no single cure for TMD, and a steroid injection only dampens inflammation in or around the joint for a period of time. Symptoms can return if the underlying habits or load on the jaw are not addressed.
How long does a cortisone shot in the TMJ last if it works?
Trial evidence tracks results at 1, 3, 6, and 12 months, and the strongest steroid comparisons showed pain benefits at one and three months. Individual response varies, and reviews stress that no steroid approach demonstrated a convincing advantage over saline flushing for jaw motion or daily life.
What is the difference between a cortisone shot and Botox for TMJ?
Cortisone is an anti-inflammatory steroid aimed at an inflamed joint, while Botox temporarily weakens overactive jaw muscles. NIDCR notes Botox type A is FDA-approved for some conditions like migraine but not for TMDs, with mixed study results; Cleveland Clinic reports its effects take from a day to a couple of weeks to appear and last about three to four months.
Who actually performs a TMJ cortisone injection?
Injections into the joint are usually offered by clinicians who manage jaw disorders after simpler treatment has not worked — the AAFP points to oral and maxillofacial surgery for refractory cases, with a physician, dentist, or ENT doctor often starting the referral path. No single type of clinician is required, so it is reasonable to ask a provider how often they perform the procedure.
What are the risks of a cortisone shot in the jaw joint?
The AAFP review flags potential destruction of articular cartilage from intra-articular corticosteroid injections as a reason they are not recommended. The network meta-analysis also noted that methylprednisolone may be more harmful than arthrocentesis for adverse effects. Like any needle procedure, a joint injection carries basic risks, which a clinician should explain in detail beforehand.
Should I get a cortisone shot or TMJ surgery?
Both are late-stage options. NIDCR recommends asking about simpler treatments first and notes there are no long-term research studies on the safety of open TMJ surgery or how well it relieves symptoms; surgery is mainly considered when the joint is severely damaged and other treatments have failed.
Will insurance cover a TMJ cortisone shot?
Coverage varies widely by plan, and insurers often split TMJ care between medical and dental benefits, which is where claims commonly stall. Ask whether the injection is billed as medical or dental, whether prior authorization is required, and what documentation supports medical necessity. Our page on TMJ doctors that accept insurance explains how to approach coverage questions.
References
- TMD — NIDCR
- TMJ disorders - Diagnosis and treatment — Mayo Clinic
- Temporomandibular Disorders: Rapid Evidence Review — AAFP
- TMJ disorders: MedlinePlus Medical Encyclopedia — MedlinePlus
- TMJ Disorders: Symptoms & Treatment — Cleveland Clinic
- Botox for TMJ: What To Expect — Cleveland Clinic
- Corticosteroids for the Treatment of Internal Temporomandibular Joint Disorders: A Systematic Review and Network Meta-Analysis — PubMed
Medical disclaimer
This article is not medical advice and cannot replace an examination by a qualified clinician. Talk with a dentist, physician, or other licensed provider about your specific symptoms before starting, changing, or stopping any treatment.
Reviewed by the tmjspecialistguide.com editorial team · Last updated 2026-11-01.