When it comes to arthritis, the most talked about joints are probably knees and hips. But, aside from my ankles, my most troublesome joints are my TMJs. In fact, I don’t know many people who talk about TMJ arthritis, but these are joints that I have a LOT of experience with. I figured that it was time for me to share my extensive experience with others! 

In this post, I’m going to explain key information about TMJ arthritis, including answering your questions about it; I’m going to share the full details of my extremely messed up TMJs; and I’m going to talk about TMJ arthritis treatment, both what doctors recommend and what I do for my flares.

I am not a doctor! I am a patient and speak to my own experience. When I describe facts, I always source them. I indicate the source by writing (x) at the end of the sentence and then linking that x.

TMJ Arthritis: Key Information

What is TMJ?  

When you say “TMJ,” most people think that itself is a condition. Not true! 

As the Mayo Clinic says, “The temporomandibular (tem-puh-roe-man-DIB-u-lur) joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull” (x). So while many people think “TMJ” is the name of a condition, it actually stands for the name of the joint. Mayo explains, “You have one joint on each side of your jaw. TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement” (x).

What do those joints look like? Well, one orthodontist practice describes it as: 

“The two TMJs that connect your lower jaw, the mandible, to the temporal bone of the skull on either side, are actually very complex joints that allow movement in three dimensions. The lower jaw and temporal bone fit together as a ball and socket, with a cushioning disk in between.” (x) 

What most people think when you say “I have TMJ” is temporomandibular joint and muscle disorders. The NIH says, “Temporomandibular joint and muscle disorders […] are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement” (x).

The TMJ Association says: 

Scientists have found that 85% of patients with TMJ also suffer from other conditions – pain and non-pain conditions in other parts of the body. These conditions include allergies, chronic fatigue syndrome, chronic headache, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, neck and low back pain, sleep disorders, and vulvodynia.

In addition, connective tissue disorders and autoimmune diseases that can affect the TMJs include: rheumatoid arthritis, juvenile rheumatoid arthritis, juvenile idiopathic condylar resorption, psoriatic arthritis, ankylosing spondylitis, Sjogren’s syndrome, systemic lupus erythema, scleroderma, mixed connective tissue disease, etc.  As a result, multiple systems are usually involved.

TMJ Association

Is TMJ Arthritis? 

Arthritis is one of many conditions that fall into the TMJ category. So not everyone with a TMJ disorder will have TMJ arthritis, but everyone with TMJ arthritis has a form of TMJ. 

Other kinds of TMJ disorders are myofascial temporomandibular disorder, internal derangement of the TMJ, tendonitis, and more (x). TMJs are joints, so if you can have trouble with any other joint, you can have it with your TMJs. As Penn Medicine says, the TMJ is “a synovial joint similar to the knee or hip” (x).

What Does Arthritis Pain Feel Like? 

Do I Have TMJ? 

Unless you have artificial TMJs, you have 2 TMJs 😉 . That being said, if you’re wondering if you have TMJ as in one in the group of temporomandibular disorders …

First things first: the best way to figure out if you definitely have TMJ is through seeing a doctor of some kind. Depending on what your primary symptom is (affecting your teeth versus your face, for example) I would suggest starting with a dentist or your PCP. If you already have an arthritis diagnosis, start with a rheumatologist. 

Medicine.net says, “A doctor may send the patient to an oral and maxillofacial specialist, an otolaryngologist (also called an ear, nose, and throat doctor or ENT specialist), or a dentist specializing in jaw disorders to confirm the diagnosis” (x).

When I was diagnosed with TMJ arthritis, I started with my dentist, who decided it was a joint issue and not a teeth issue. My dentist referred me to an orofacial pain specialist, who did the x-ray that showed the arthritis. That doctor helped get me off the MGH rheumatology wait list – which resulted in my RA diagnosis – but he is also the one that helped me recover from my jaw arthritis flare. (Keep reading if you want to read more about my experience!)

Seronegative Rheumatoid Arthritis Diagnosis: What I’ve Learned

Does TMJ Arthritis Worsen As You Age?

The short version is not necessarily, but it really depends on what type of arthritis you have. 

If your TMJ arthritis is because of osteoarthritis, it could worsen over time, but even that’s not really due to age. Heathline says, “Osteoarthritis of the jaw is characterized by the destruction of the hard and soft tissues around the jaw joints. This can change the shape and functioning of the jaw” (x). Obviously you use your jaw constantly, even if you try to rest it. I mean, chewing and talking are both using your TMJs. So you can’t truly rest it like you could rest a knee or hip. Osteoarthritis is “associated with joint overuse,” so since you have to keep using your jaw, it could keep getting worse over time (x).

When it comes to autoimmune forms of arthritis, your TMJ arthritis will probably get worse so long as you’re not treating your arthritis. 

The thing about autoimmune arthritis is that your immune system attacks the rest of your body like there’s a virus that it needs to fight (x). That’s why we take immunosuppressants. So if your autoimmune arthritis isn’t treated – in whatever way that works for you and your body, whether by choice or because there isn’t a treatment available that you respond to – then there is the chance that your TMJ arthritis will get worse over the years. 

But that isn’t necessarily because of aging. It’s more because of disease progression.

What Is the Difference between Osteoarthritis and Rheumatoid Arthritis?

My Experience with TMJ Arthritis 

I have been in pain for a very very long time (this September will be 20 years), but it took a long time for me to be diagnosed with autoimmune arthritis. As I mentioned, I was finally diagnosed with arthritis because of my TMJ arthritis.

In 2009, I had major foot surgery on my left foot. (The surgery on my right foot in 2018 was for the same thing.) Over a year later, I was still dealing with a lot of pain, and my foot surgeon was positive that it was something for rheumatology. In May 2010, I was put on the waitlist for Massachusetts General Hospital’s rheumatology department because they’re an incredible hospital and had a long, long waitlist. 

In July 2010, I woke up and couldn’t open my mouth more than 8 mm. 

Not “this hurts too much to open!” 

My mouth physically wouldn’t open more than that.

It was excruciatingly painful. 

I went to the dentist because I didn’t know who else to see. They determined that I needed to go to, like I mentioned, an orofacial pain specialist. 

With a lot of tears, that doctor managed to take an x-ray of my TMJ joints. Like described above, those joints are supposed to be in the shape of a round ball within a socket. 

In July 2010, the part of the joint that is supposed to be ball-shaped was completely and totally flat. On both sides of my face.

These were flat due to arthritic damage. Given the amount of inflammation I had around those joints, what the damage looked like, and that I didn’t grind my teeth or have an accident or something else that would indicate osteoarthritis or could cause such intense damage at 20 years old, it was definitely autoimmune. 

Beginner’s Guide: Rheumatoid Arthritis Flare Up

This got me off of the MGH rheumatology waiting list incredibly quickly. 2 days later, I was diagnosed with autoimmune arthritis and, counting my TMJs, over 50 of my joints were affected by it. 

It took a full 8 weeks for my TMJ pain to recover. I had to go to physical therapy, stop drinking any and all caffeine for that period of time, and I was on a full soft food diet for a long part of that. 

I have been extremely fortunate that, in the 11 years since I had that first episode, I haven’t had too many jaw flares. And I’ve never had one just like that 2010 one because, when I can feel a flare coming on, I start being careful with what I eat. Plus, if I really need it, I’ll increase my steroids. 

I’m currently at the end of my most recent jaw flare. I’m trying to have a smoothie as a meal 5 days a week and have soft foods when I can. I’m at the point where I could be almost recovered or I could easily slip back into a flare. 

I haven’t had an x-ray of my TMJs since 2010, and I really don’t want to know what my TMJs look like now. If they were completely flat 11 years ago, as since my health overall has gotten a lot worse since then, they’re probably curved but in the wrong way now. 

The biggest way I’ve been able to avoid dealing with these flares is through treating my RA overall. I can’t completely avoid dealing with this damage, but I can reduce how bad that damage is by reducing the chances of my immune system attacking me.

Arthritis Glossary: Frequently Used Words

Treatment for TMJ Arthritis

TMJ Arthritis Treatment in General

First and foremost, the best way to treat TMJ arthritis is through treating the arthritis at the heart of the issue. Arthritis (other than osteoarthritis) is a whole-body illness. If you’re not treating your autoimmune arthritis, then it will be harder for your jaw arthritis to improve. 

What that treatment is will depend on what type of arthritis you have, what types of treatment you respond to, etc. It will truly depend on each individual person. 

However, the goals of treatment are the same: improve functionality, reduce pain, and prevent further damage (x).

Heathline says, “A 2017 review of studies about jaw arthritis reported that initial conservative measures resolved pain symptoms in more than 80 percent of people with jaw arthritis” (x). 

“Conservative measures” means not going really intense right off the bat. This includes things like resting your jaw, taking NSAIDs (non-steroidal anti-inflammatory drugs) like Advil or Aleve, or physical therapy (x). 

The Mayo Clinic says that some other treatments include muscle relaxants, which are “sometimes used for a few days or weeks to help relieve pain caused by TMJ disorders created by muscle spasms” (x). Basically, inflammation in the TMJ joints can cause your muscles to spasm around the joints, which is why muscle relaxants can help.

Other things that might help are topical ointments, steroid injections, heat or cold (depending on whether your main pain is coming from the inflammation or muscle spasms), or acupuncture (x and x).

How Is Arthritis Treated? | Why You Must Track Symptoms of Your Chronic Illness + Freebie To Help

What I Do When My TMJ Arthritis Flares

Eat soft, non-chewy foods – This is definitely part of the jaw rest mentioned above! It’s also the first thing that I do when I start feeling a flare coming on. I try to have a smoothie for one of my meals at least 4, if not 5, days a week. Just reducing my jaw usage by doing that helps a lot! Additionally, I try to avoid foods that require a lot of chewing, as that irritates my jaw a lot. 

When I had my first jaw flare in 2010, I had to go on a full soft food diet for a number of weeks. That flare was so awful that it was at least 3 weeks until I could stand to chew even a little bit. 8 mm is not a large space, and I couldn’t even get a spoon in my mouth for several weeks. 

I never want to go through that again, especially as my disease is a lot more active now and I imagine that if it happened again it would be even worse. So avoiding that is my main focus when it comes to dealing with a flare.

Talk to my rheumatologist about adjusting my steroids – I desperately want to be on as low a steroid dose as possible, but there’s a reason that I’ve used them for so long: they work. So if it’s a flare that I can’t reduce by other means, I’ll talk to my rheumatologist about adjusting my steroid dose. 

If you are having a TMJ arthritis flare, you should talk to your rheumatologist about the best way to proceed. But this is especially true if you think that you need to increase your steroids.

Use a jade roller on my facial muscles – As has been described several times, even if your TMJ problem is arthritis, you can still have your muscles tighten up around the joints. I got a jade roller for skincare, and it has been extremely helpful for loosening my TMJ muscles. 

Go to my chiropractor – First things first: chiropractors can vary widely across the profession. They’re not all good or great, but some are. It’s important to find one that you can trust, as chiropractic care requires you to be calm and loose-limbed so they can adjust you properly. I would make sure to find one who is used to helping people with arthritis, especially different types of arthritis.  

Problems from My Inflammatory Arthritis + How To Deal with Them

What is your experience with TMJ arthritis? 

Like this post? Share it! Then check out: 

How Arthritis Affects the Body, My Rheumatoid Arthritis Treatment + How I Got There, What’s In My Tool Box for Dealing with Chronic Pain, What You Need To Know about Living with Chronic Pain in the Winter