Yikes, it sounds like you are one of the patients I treat in my urgent care. Unfortunately, many of your questions I cannot directly answer without more information. Presume by TMD you mean TMJ? inflammation of your jaw joint. Tingling in the tongue is not something I have routinely heard described but TMJ I have and it is very difficult to treat. Wearing a bite guard at night is one way to help, reducing your consumption of tough, chewy foods, gum and similar products is another. It is always important to get an MRI of the Maxilla and Mandible to evaluate for TMJ dislocation and joint laxivity, though this is not routinely done. Unfortunately, as you pointed out, narcotics like Norco and Tramadol will only palliate the symptoms, not treat the problem. Physical therapy, physical activity in low gravity environments like water (swimming), trigger point injections with lidocaine and newer anti-inflammatory agents like serafin, some reports even for plasma based therapies like Platelet Rich Plasma (Prolotherapy) have reported positive outcomes for TMJ and inflammation of the neck muscles to alleviate discomfort. Gabapentin is helping for neuropathic pain, as are other medications like Lyrica. Unfortunately, you are also taking an anxiolytic medication Klonopin, which is another addictive and dangerous medication to take for prolonged periods. How much do you weigh? Losing weight is helpful for reducing pain in the neck attributed to gravity and a degenerative spine. Posture related activities like Yoga are helpful. There are clinical trials your orthopedic surgeon can refer you to as well for new, alternative therapies. Alternative therapies also include Acupuncture, massage therapy, and chiropractice adjustments. If your pain is very severe, you should ask your doctor about epidural injections to alleviate your pain rather than taking narcotic based medications. This is a difficult condition to treat and involves a multi-disciplinary approach. It also helps to have a counselor to discuss the stress and emotional burden with a degenerative spine. Please keep us informed of your progress.