Living with TMJ – a painful, lesser-known arthritis

You may not hear about it often, but if you suffer from TMJ disorder, it will never be far from your mind. This painful form of arthritis affects everyday essential movements such as chewing, smiling, talking, and yawning, and unfortunately, it is often most painful at night when it can seriously disturb sleep.

TMJ disorder (more formally known as ‘temporomandibular joint disorder’ or simply ‘TMJ’), impacts the ‘sliding hinge’ joint connecting your jaw to your skull. While it can affect those of various ages, it is of particular concern to seniors, for a number of reasons. As we age, conditions such as osteoarthritis and rheumatoid arthritis break down the cushioning cartilage around joints, causing bone to rub against bone, creating painful inflammation. Seniors are also likely to have experienced loss of teeth, poorly fitting plates and dentures, and possibly years of tooth grinding. A life time of sporting injury or knocks and falls may have inflicted injury on the temporomandibular joint. It is these stresses and injuries that can contribute to arthritic problems down the track.

The pain from TMJ can be significant, extending beyond the affected joint, and into the teeth, mouth, ears, neck, and head (especially the temples). As well as this pain, and tenderness in the jaw itself, sufferers of TMJ often experience pain when chewing, sometimes hearing a ‘popping’ sound as their jaw moves. In some cases, this pain when chewing means jaw movement becomes restricted.

TMJ is often (at least at first) mistaken for a range of problems such as an ear infection, dental issues, or persistent migraines. In fact, it is often not diagnosed without a physical examination performed by a TMJ specialist (who is often an oral specialist working in the field of dentistry). X-rays, CT or MRI imaging will usually be used to confirm the diagnosis.

A number of options exist for TMJ pain relief. They include over-the-counter medications such as Panadol and ibuprofen, and prescription medications such as Gabapentin. Relief may also be found by restricting jaw movement through consuming softer food, or raw foods, such as apple, cut into small segments. Remembering not to yawn widely, can help, as can practising relaxation techniques. Some specialists recommend wearing a specially designed mouth guard at night to help prevent teeth clenching. Alternating hot and cold packs on the affected region brings relief for some sufferers. As TMJ pain is often worse at night, medications which promote sleep can be helpful. Some sufferers find the use of prescription medicinal cannabis products can assist with pain relief as well as sleep. Gentle massage may also help. Although there is no research, as such, to support it, sufferers have reported relief by experimenting with different pillows until they find one that suits, plus listening to soothing music as a distraction from pain.

In some cases, surgery may be considered an option for TMJ, but only after all other methods of pain relief have been exhausted, and then, only with great caution. Surgery can involve washing out the joint to reduce inflammation and improve movement, removing scar tissue around the joint, or more invasive surgery to deal with bone growths and severe arthritis. This surgery is not without risks, as symptoms can be made worse by some forms of intervention.

TMJ may not be the most common form of arthritis, yet it still affects between 5-12% of the New Zealand population. To learn more about TMJ, head to the University of Otago’s temporomandibu disorders page.