A therapeutic arthroscopy is usually the next step. Arthroscopy involves using anendoscope to examine inside the joint. This is often done for diagnosis but it also allows introduction of surgical instruments to treat the problems that are found as part of the same procedure.
Arthroscopy to investigate and treat TMJ disorder requires a specialised and very tiny arthroscope, only 1.2 mm in diameter. This is less than half of the size of the smallest general orthopaedic arthroscope. The treatment can therefore only take place at specialist centres that have the correct arthroscope and the TMJ consultant available to use it.
Even when a patient is in significant discomfort, using arthroscopy to see what is going on in the joint and then simply washing it out to remove debris can ease symptoms greatly. It is also possible to have anti-inflammatory injections directly into the joint, which work well for many people.