I have used a mouthguard for 25 years. I clench with little grinding. I change mouthguards every 2 weeks. I also have chronic, intractable migraines. In addition to using medications, I find solace looking at the ocean. I do this when I go to MA to visit our families. I also go to accupuncture every other week. I get relief only on that same day. I receive botox every 12 weeks. The botox keeps a good lid on my average pain level of 8. I also gain about 4 days My anesthesiologist gives me botox in TMJ joints, as well as in my face, scalp, and neck. It really helps with facial pain. I also use heat on my joints. I go to a new dentist, one with incredible machinery and computers. Try and find a dentist who does not rely solely on those blue strips when checking your bite or fit of a new mouthguard. There are newer, better ways to deal with TMJ. My new dentist diagnosed arthritis in my TMJ and chin via an orbital x-ray. We followed up with neuro and pain clinic about my condition. This adds to the chronic migraine pain. It prompted additional scans and xrays. Turns out I have problem areas in my spine. I had nerve ablation, and I will go for another shortly. I go to physical therapy twice a week, and she goes in my mouth with gloved fingers and manipulates facial muscles, etc. It feels great! I do not recommend a chiropractor. The neck is very tricky, and the chance of triggering a stroke is high in migraineurs. My PT can bring on a migraine and then take it away. It is amazing what PT can do. Another therapist uses e-stim (electric stimulation of nerves.) It does not hurt, and your stiff and unused muscles and nerves, such as ears and jaw, really get a work out. It feels great and weird. I struggle with biofeedback, but that is ok; I try and try to get good results at home, but I need the therapist to show me over and over. I can't wait until 2018, when the new migraine-specific meds come out. At that time, I will also try nerve modulation, such as Cefaly. I did violate my pain contract at the hospital, when last spring I traveled to Colorado to try medical marijuana. I got uncomfortably high, but it didn't heal my pounding brain. Please be sure you avoid any street drugs, as well as the newer versions, if you get them off the street and not from your doctor. I go to the ER once or twice a month. Depending on the specific headache and the doctor assigned to me, I receive either two ketamine infusions or a migraine cocktail. Cocktails are unique to the individual and based on past experience. My cocktail is benadryl, Compazine, toredol, decadron, and hopefully, 1 mg dilaudid. Doctors are withholding opiates around the world. Dilaudid is usually given to me now only if I have dangerously high blood pressure. I try to be happy and grateful for the infrequent days when my pain level is low. Many young people are stressed out during these chaotic times. Social workers at an in-patient facility can help anyone with firm but gentle expectations and empathy. Alternatively, the PT van and its first crew of students recycling who are summer vets can use both the cans for recycling, and pans. In the Boston 'burbs be sure to listen for the bell on hot days! The ice cream truck is on its way! I should point out that I take benadryl intravenously in the ER; I also take benadryl nearly daily, along with supplements and vitamins of all kinds. I trust my Irish twin brother, Paul, and my Polish husband, Rich, with my medical proxy. This is all documented, and your doctor should have similar papers in the office; within the have signed a contract and I try to be a better person by helping others and being generous with my time and treasure.