The connection between arthritis and jaw pain might not be immediately apparent because we often associate arthritis with pain and stiffness in the hands, elbows, or knees. But if you’ve been noticing pain on the sides of your face, arthritis could be the reason.
“By jaw pain, we mean pain in front of the ear, up as far as the top of the ear, as low as the back part of the jaw and even into the cheek,” says Vivian P. Bykerk, BSc, MD, FRCPC, a rheumatologist at Hospital for Special Surgery in New York City. “It can feel like tooth pain and you might even think that is what it is.”
You may also find it hard to open and close your mouth, or that it hurts to eat. “It wants to lock,” Carrie G. told us on Facebook about her jaw pain. “It makes it hard to chew or even get food in.”
Another arthritis patient, Anne M., has also experienced jaw pain. “I’ve had that once upon a flare — it lasted a good while too, like two weeks or so,” she told us on Facebook. “The worst was in the morning; I remember I dreaded ‘opening’ it first thing.”
Although jaw pain from arthritis can affect your quality of life — not to mention your enjoyment of food — there are some things you can do to minimize the impact of jaw pain from arthritis.
The joint responsible for jaw pain is the temporal mandibular joint (TMJ). “This is where the lower jaw hinges at the level of the ear,” Dr. Bykerk says. Responsible for talking as well as eating, the TMJ is the most frequently used joint in the body. This frequency of use also makes the jaw susceptible to different kinds of arthritis.
“Like other joints, the TMJ is at risk for osteoarthritis, along with other types of arthritis such as rheumatoid arthritis,” says Lauren Levi, DMD, dentist at The Mount Sinai Hospital in New York City. “Osteoarthritis is the most common type of arthritis that affects the TMJ.”
Some people may be more at risk for arthritis in the jaw than others. “Macro or microtrauma, through grinding or clenching, along with decreased lubrication in the joint may increase the risk for developing arthritis,” Dr. Levi says.
Stress and chronic pain in the body, such as may occur with arthritis elsewhere, can cause clenching; so in a vicious cycle, jaw pain and arthritis may become a “chicken or the egg” scenario, Dr. Bykerk says.
“People will clench if they have pain, if they are stressed, or pain can result if they clench too much or grind their teeth, called bruxism,” she says. “If bruxism and clenching go on too long the TMJ can wear out, the cartilage in the joint can break down and degenerative arthritis occurs.”
Pain conditions including autoimmune or inflammatory diseases like rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis are consistently associated with TMJ disorders.
You can also feel pain in the jaw from causes that are not related to arthritis. “Pain most commonly results due to muscular and soft tissue tension, such as problems with the myofascial tissue around the jaw,” Dr. Bykerk says. Poor teeth alignment or poor posture, which can put the head in an awkward position, can also put pressure on the jaw, causing pain. In addition, injury, infection, or past surgery may be the reason for experiencing jaw pain.
The joint itself can also ache without actual damage to the bone or cartilage. “Arthralgia, which is an extremely common condition that affects the TMJ, is characterized by a painful joint without any osseous [bone] changes,” Dr. Levi says. “Arthritis, by contrast, accompanies osseous changes that can be visualized on imaging.”
The underlying causes for jaw pain can be hard for doctors to suss out, as the TMJ is a very complex joint with multiple factors affecting it. Your rheumatologist or dentist may recommend a specialist who deals with TMJ disorders, called an oral and maxillofacial surgeon. “A thorough comprehensive evaluation and history taking is crucial to accurately diagnosing the etiology [cause] of jaw pain,” Dr. Levi says.
“Osteoarthritis is often diagnosed based on symptoms and imaging, and is commonly is associated with joint sounds, known as crepitus,” Dr. Levi says. “Osteoarthritis is also often associated with morning stiffness, jaw tightness, and decreased range of motion of the jaw.”
Jaw bone and cartilage changes due to arthritis may be seen on imaging tests such as an X-ray, CT scan, or MRI. “Changes that can be visualized on imaging include condylar beaking or flattening [damage to the rounded end part of the bone], and decreased joint space,” Dr. Levi says.
“Other forms of arthritis, such as rheumatoid arthritis, may be diagnosed with help from blood tests,” Dr. Levi says. With inflammatory or autoimmune diseases, you will have elevated inflammatory markers like c-reactive protein or erythrocyte sedimentation rate; many rheumatoid arthritis patients also test positive for antibodies such as rheumatoid factor and anti-CCP.
But if you have inflammatory arthritis, chances are jaw pain won’t be your first symptom; and if you’ve already been diagnosed, your doctor will have an indication that jaw pain may be due to your condition.
Luckily, you may find relief with non-invasive measures to resolve the jaw pain. “Almost always conservative treatment will be tried first,” Dr. Bykerk says. This may include:
- Physical therapy to provide gentle exercises to help loosen your jaw and strengthen the muscles around the joint.
- A mouth guard fitted by a dentist to help with teeth grinding and clenching overnight. “I have been wearing a night guard for years,” Karin D. told us on Facebook.
- Relaxation techniques to manage chronic pain and reduce stress and tension in the joint.
Your doctor may also give some relief with steroid shots, which Karin also says she’s had. “If the TMJ is inflamed it can be injected with cortisone,” Dr. Bykerk says. In addition, your doctor may advise over-the-counter medications. “NSAIDs are often prescribed to decrease inflammation and thus help decrease pain,” Dr. Levi says.
Making sure inflammatory arthritis is well-managed can improve jaw pain due to the condition. “For rheumatoid, psoriatic arthritis, and other forms of systemic arthritis, it is important to control the underlying disease,” Dr. Levi says.
In very severe cases, surgery to the jaw may be recommended, but this is a “last resort” option.
You can also try a few simple treatments and behavior modifications to treat jaw pain, and reduce your risk of having it in the first place:
- Eat softer foods
- Apply heat and/or ice. “Ice tends to help me numb it out,” Hannah M. told us on Facebook.
- Keep up with oral hygiene
- Try an arthritis pain cream. “I put a bit of Tiger Balm on the tip of the jaw near the front of the ear, that where it was the most sore,” Hannah said on FB. (Check with your doctor before using topical treatments.)
- “Don’t chew gum,” Karin says. Repetitive chewing motions, like chomping gum or biting your nails, put too much strain on the jaw.
Fibro Women Blogs
Chronic Woman Blogs
Chronic Illness Blogs
Official Fibromyalgia Blogs