Hi peter,
the degenerative part of the mri readings bothers me the most. It sounds like arthritis or osteoarthritis and there's really nothing that can be done about that. I have heard of the botox treatment that bedwards mentions in his post. I believe it is like a numbing agent versus "fixing" anything, but anything that will take away the pain is worth looking at. The surgery that bedwards had is called arthrocentesis. I've heard good and bad. My impression of it is that it doesn't "fix" anything really but can help for a short time, especially depending on what is wrong in the joint.
It's also interesting that you have a cyst. They can be removed or left alone. They won't really harm anything except for maybe a rubbing pain if it is in a certain location. Did the mri show exactly where the cyst is?
You probably need to find a dentist/doctor who is much more familiar/educated with tmj to determine if the cyst is in a location that it should be removed or not. I think there is a Dr. Schames here on one of the tmj health boards who answers questions over the internet if you can't find anyone in your area to ask about the cyst.
i don't want to bore or waste your time anymore. There are many different ways to try and cope with tmj pain, but I don't think we tmjers will ever be able to discard medications if we have had tmj for any length of time. I think our age also depends on using meds or not. I didn't touch any type of medication in my 20's or 30's. It wasn't until I got older that when the pain flared up, I took anything to get rid of the pain. Sometimes it worked and too often it didn't. It wasn't until a few years ago in my late 40's that the fight was just too much and I started looking for pain doctors for stronger meds. Other than vicoprofen, I have not found anything to help yet, but my new pain guy just put me on lyrica. Don't know yet.
There are some "tricks" that all tmjers do to cope with the pain as you have found out. Personnally I find heat, ice, and regular massage therapy to be the very best.
I hope you are able to find out what helps you. It also sounds like you need a new tmj doctor/dentist. They can be hard to find, but you have to do it. Bite splints have been good for me, but I still have tmj and pain, so you and your doctor have to determine what's best for you. I do advocate bite splints. They are supposed to take off pressure of the jaw joint and the ones I have used have done that most of the time, but I have also read many people complain about them. Remember this - there are several different types of bite splints for different types of purposes, and a bite splint is as good as its bite splint maker.
God bless...
Carol