The album was recorded in 1993 at Chipping Norton Recording Studios in Oxfordshire, as well as RAK Studios and Church Studios, both in London. It had a melodically dark, metal-like sound. The album contains a cover of Isolation by Joy Division, which also became a single. The Therapy? version also incorporates many musical elements from Atrocity Exhibition. Troublegum is generally considered to be Therapy? at their musical and commercial peak and has since sold over one million copies worldwide. The album reached number 5 in the UK Albums Chart and was certified gold in the UK in September 1994, was also nominated as album of the year by the Mercury Prize of 1994. 
The album was released on 12” vinyl, CD and Cassette. In the UK, the album was released on limited edition green 12” vinyl. There was also a green Cassette and the original CD copies had a green tray. A remastered CD version of the album by Harvey Birrell was included in The Gemil Box, released on 18 November 2013. To celebrate the 20th anniversary of its original release, a three-disc Deluxe Edition version of Troublegum was released by Universal Music on 31 March 2014.
The album was rated the Top album of 1994 in the 1000th issue of Kerrang magazine in 2004.
The album was number 31 in Kerrang's 100 Best British Rock Albums ever!
The album was shortlisted for the 1994 Mercury Music Prize.
"Screamager" - 11 March 1993, on the Shortsharpshock EP with "Auto Surgery", "Totally Random Man" and a re-recorded version of "Accelerator" from Nurse. This single reached number 9 in the UK Singles Chart, number 2 in the Irish Singles Chart and number 16 on Billboard's Modern Rock Tracks chart.
"Turn" - 31 May 1993, on the Face the Strange EP with "Speedball", "Bloody Blue" and a re-recorded version of "Neck Freak" from Nurse. This single reached number 18 in the UK Singles Chart, and number 5 in the Irish Singles Chart.
"Nowhere" - 17 January 1994, with "Pantopon Rose", "Breaking the Law" (Judas Priest), and "C. C. Rider" (Elvis Presley). A second CD was released on 24 January 1994, with two remixes of the title track, provided by the Sabres of Paradise. The single reached number 18 in the UK Singles Chart, and number 6 in the Irish Singles Chart.
"Trigger Inside" - 28 February 1994, with "Nice 'n' Sleazy" (The Stranglers), "Reuters" (Wire), and "Tatty Seaside Town" (The Membranes). A remix 12" was released with two remixes of the title track, plus the two Sabres of Paradise remixes previously released on the single "Nowhere". This single reached number 22 in the UK Singles Chart, and number 16 in the Irish Singles Chart.
"Die Laughing" - 30 May 1994, with "Stop It You're Killing Me" (live), "Trigger Inside" (live) and "Evil Elvis" (The Lost Demo). A remix 12" was released with two remixes of the title track, provided by David Holmes. This single reached number 29 in the UK Singles Chart, and number 16 in the Irish Singles Chart.
"Isolation" (Joy Division) - 1994, with "Lunacy Booth" (string version) and "Isolation" (Consolidated mix). This single was a German only release.
"Femtex" - 1994, with "Pantopon Rose". This was a coloured 7" released only in the US and limited to 500 copies.
"Knives" - 1994, with "Knives" (kiddie version), "Pantopon Rose" and "Nowhere". This single was a US only promo release.