The longer pain is experienced in the temporomandibular joint, the greater the risk of this turning to chronic pain. This means that this pain can no longer be relieved with surgery, as the nervous system has become hypersensitive. This is also referred to as a "central sensitisation".  Patients who develop a "pain memory" like this only respond - if at all - to strong pain killers, known as opiates.

Many experts therefore believe that if after no longer than six months of conservative treatment there is no improvement, temporomandibular joint pain should be treated surgically, so that a pain memory does not have a chance to develop in the first place.