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Jawbreaker

Jawbreaker

Long ago, on a pretty autumn morning, I woke with a miserably aching right jaw. My first thought was that I had a toothache–a terrible thought indeed, because I’ve always been ridiculously phobic about dentists. Talk about a bummer!

But a few seconds later it was clear my achy jaw had nothing to do with my teeth. I was glad until I tried to open my mouth. The ache turned into a thunderbolt of pain that centered where my lower right jaw connected to my skull, just in front of my ear. The bolt shot down into my chin and up the side of my head to my eyebrow. It was so sharp, so shocking, I cried.

Does RA cause jaw pain?

I’d been coping with severe rheumatoid disease for a couple of years when this happened. While I’d never dreamed it might affect my jaw–of all places–in that moment I realized that yes, my jaw was a joint, too. Why wouldn’t it cause a flare there, too?

I was a bit frightened. How in the world could I eat or even talk like this? But I went to work anyway. I spoke as little as I could get away with throughout the day. I couldn’t eat (I couldn’t chew), but I had my coffee in the morning and heated some chicken broth in the office microwave for lunch. Dinner at home that night was smashed peas with mashed potatoes and gravy.

Jaw flares

I had flares in that joint two more times that year–and have never had another one. I’m very grateful for the reprieve.

It wasn’t until many years later that I learned that RD often attacks the jaw, or more precisely, the temporomandibular joint (TMJ). It hinges to the skull in front of the ears. (Press your fingers there and open your mouth—you’ll feel it move beneath the skin.)

The jaw joint

The TMJ is a synovial joint, like the knee, but it works differently. The knee bends in one directly only, like a hinge. The TMJ hinges, but it also rotates and slides forward and back as the mouth opens and closes. It moves sideways, too, so we can grind food up between our teeth. When we speak, we form many different sounds with our tongue thanks to the articulate movement of this very complex joint.

A thick, soft disk of cartilage cushions the joint where it attaches to the skull. A synovial capsule encloses it, filled with nourishing and lubricating synovial fluid. And just as it does with the other joints it attacks, it’s here, in the synovium, that RD does its dirty work.

It tricks the body’s immune system into attacking that protective capsule of tissues. It causes inflammation, swelling, and pain. The synovial fluid thickens. It can harden over time into a substance called pannus; the cartilage and bone slowly erode away. Over time, the joint starts to deform, causing dental and other problems, such as overbite, uneven tooth wear, headaches, and facial pain.

I used a heating pad to soothe my flared-up jaw, once I got home from work that first time. Cold packs can help, as well. It almost goes without saying that resting the joint and eating soft foods while it’s inflamed helps, though doing so is mostly instinctive. Gentle massage and relaxation techniques like meditation can also help you cope with the pain.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. TMJ Disorders. (2014, Feb. 2) Medline Plus, National Institutes of Health. Retrieved on November 4, 2015 from http://www.nlm.nih.gov/medlineplus/ency/article/001227.htm
  2. TMJ Disorders. (2013, Aug.) National Institute of Dental and Craniofacial Research, National Instititutes of Health. Retrieved on November 4, 2015 from http://nidcr.nih.gov/OralHealth/Topics/TMJ/TMJDisorders.htm
  3. TMJ Disorders. (2012, Dec. 13) Mayo Clinic. Retrieved on November 4, 2015 from http://www.mayoclinic.org/diseases-conditions/tmj/basics/definition/con-20043566
  4. Arthritis of the Temporomandibular Joint. (2014, Dec.) Merck Manual. Retrieved on November 4, 2014 from http://www.merckmanuals.com/professional/dental-disorders/temporomandibular-disorders/arthritis-of-the-temporomandibular-joint-tmj
  5. Nordahl, S., et al. Radiographic Signs of Bone Distruction in the Arthritic Temporomandibular Joint with Special Reference to Markers of Disease Activity. A Longitudinal Study. (2001, Jan. 16) Oxford Journals: Rheumatology. Retrieved on November 4, 2015 from http://rheumatology.oxfordjournals.org/content/40/6/691.full
  6. Wolfe, F., et al. (2005, Dec.) Jaw Pain: Its Prevalence and Meaning in Patients with Rheumatoid Arthritis, Osteoarthritis, and Fibromyalgia. Journal of Rheumatology. Retrieved on November 4, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/1633177

Comments

  • Grannie55
    3 years ago

    My jaw was with my onset of RA. I was miserable and ended up on prednisone. I worked in a dental office and a new dentist joined the practice who was/is excellent with TMJ issues. He felt a hard splint (like a mouth guard) would benefit me. I had a pre-auth sent to my medical insurance and they approved it as a physical therapy appliance for my RA. It has been several years and I am on my second splint and no longer on prednisone. I wear it only at night. Just an idea that might work for others.

  • melody123
    3 years ago

    I have had this in the past. At first I thought it was an earache. I would go to my dr and he would say he doesn’t see anything. After about 3 times he sent me to an eye ear nose and throat dr who evaluated the cause as RA. She tested my hearing and it was good. Shortly after that I went on Orencia and have not had that happen again. Also I have found that flexeril is a help during the day. I have been taking one every night per dr order and now the sleepiness is gone as a side effect so I can take it during day too. Thank you for dr suggestion.

  • Wren moderator author
    3 years ago

    Hi, Melody123!
    I’m delighted to hear that you had a sharp physician correctly diagnose the RD flare in your jaw, and that you’ve been prescribed drugs that work well to keep it quiet and under control.
    Thanks so much for taking the time to comment. It’s good to know that we’re not alone as we confront and cope with the ongoing puzzles RD presents to us. I hope to hear from you again.
    Be well! 🙂

  • ChloeScarlett
    3 years ago

    I am so relieved to hear this. Had this pain first about 6-8 weeks ago, but my jaw slipped out and dislocated. It now seems because of sporadic swelling and my hypermobility, the disk that you speak of is damaged and not supported properly by the ligaments at either side. Going to get a hard tooth guard to wear at night, to stop it dislocating which is happening every time I go to sleep, possible botox injection and maybe surgery if none of that works. Thanks for this article.

  • aksimmo
    4 years ago

    I am always surprised which aches and pains are attributed to my RA. I had jaw pain exactly like this a couple if months ago. I at first though it was my tooth and I thought I might have to have it pulled until I realized it was my jaw. I used heat packs to control the pain which lasted 4-5 days and its been fine ever since. I appreciate your articles so much. They give me a better understanding of my recently diagnosed disease.

  • Norreen Clark
    4 years ago

    TMJ is so much fun. I thought mine hurt pretty bad. Took naproxen for it which helped a lot, and have not had a return of it for a while now. I found myself grinding my teeth together even during the day. I believed it was stress. You see I have had RA for some 36 years but I have a husband with failing health also. Now I’m finding out my body shakes. When I go to bed and lie down I can feel it, but not during the day when I’m moving around.

  • Joy
    4 years ago

    Relieved to read your story regarding jaw pain. The same happened to me during my first RA attack. The pain was horrific and it prevented me from opening my mouth enough to eat. This only lasted a couple of days and then it was gone as though it had never happened.Not knowing what was happening to me – my shoulder was so exquisitely painful I needed helped getting dressed,my wrists felt like they were going to explode and my hands tingled – I saw my internist who quickly diagnosed RA and sent me on to a rheumatologist.

    When I related these details to the rheumatologist, rattling off the list of joints attacked by this jolting pain, he said my jaw pain had to be due to a pre-existing condition, not RA. I dismissed what he said then, and I’m strengthened in my conviction by the story you’ve related. Thank you for sharing. I believe sharing our stories makes all of us stronger.

  • Cassandra Bird
    4 years ago

    Thanks Wren, my jaw was the last part of me to succumb to rheumatoid arthritis. In the early days when it was just my hands and feet and knees affected I used to joke that as it was spreading so fast that I would soon end up a mute immobile miniature elephant and that I would go crazy inside my own head. By the time it hit my jaw and every other joint in my body, including blood, eyes and lungs, it wasn’t such a joking matter. Such fun…not! Ha-ha I’m glad I’m not alone, though I wouldn’t wish this on anyone. So glad for the better days x

  • androidmaker
    4 years ago

    I am sorry to hear about your jaw. I also have pain in my right jaw, at times I cant even make my back teeth touch. the good thing is I have lost nearly 100 pounds in the last year thanks to my jaw involvement. Have you had any problems with your voice yet? at times I can’t speak louder than a whisper thanks to the RD.

  • Wren moderator author
    4 years ago

    Hi!
    Thank you for your kind words, androidmaker. I haven’t had jaw pain for many years (knock wood), and I’m grateful for that. I was about to say that weight loss might be a silver lining for some of us, but of course it’s a terribly painful and unhealthy way to lose a few extra pounds. Your 100-pound loss is breathtaking. Are you doing OK?

    I do occasionally get hoarse (today is one of those times) and I have to force my voice to be audible. I’m sorry you’re struggling with that, as well.

    Thank you for taking the time to comment! 🙂

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