Psoriatic arthritis may manifest itself in the jaw, leading to discomfort and symptoms. Relief for the resulting pain can be sought.
Psoriatic arthritis (PsA), an autoimmune condition, is known to affect joints, including the temporomandibular joint (TMJ). This inflammatory condition increases the risk and severity of Temporomandibular Joint Disorders (TMD), causing painful joint dysfunction and functional impairment related to chewing and speaking.
Research suggests that PsA may be responsible for TMJ involvement in up to 40% of people with psoriasis and PsA. The inflammation characteristic of PsA can lead to synovial inflammation in the TMJ, resulting in joint pain, stiffness, swelling, and potentially long-term cartilage and bone damage. This chronic inflammation can exacerbate the severity of TMD symptoms, causing significant dysfunction in jaw movement, pain during speaking or eating, and decreased quality of life.
The mechanism behind PsA's impact on the TMJ involves persistent synovial inflammation, which affects joint structures including cartilage and bone. This inflammation can cause structural damage that leads to mechanical dysfunction and chronic pain associated with TMD.
While corticosteroid injections can reduce swelling and pain, there is a risk of joint inflammation and cartilage damage. Other conservative measures, such as adopting a soft diet, reducing jaw movement, applying warmth, taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, going to physiotherapy, and wearing a type of mouthguard, are often effective in managing PsA-related TMJ symptoms.
Physical therapy for the jaw may involve jaw movements, stretches, adjustments to the positions of the body and head. An occlusal splint (intra-oral appliance) can help ease pain by allowing the chewing muscles to rest in a neutral position, relieving pressure on the jaw. Some research suggests that Botox injections, which work by inducing muscle paralysis, can help reduce pain, but their effect lasts for about 3 months and only reduces pain by around 25%.
A 2019 review found that people with psoriasis were more likely to have periodontal disease, more severe gum inflammation, more missing teeth, and more bone loss. A study of 220 people found that those with PsA were more likely to have advanced gum disease than those without. Home remedies for PsA and jaw pain include applying warm or cold packs, adopting a jaw-friendly diet, and resting the jaw.
In addition to these treatments, biologic drugs and disease-modifying antirheumatic drugs (DMARDs) are often prescribed to reduce the severity of PsA symptoms and the risk of permanent damage. Acupuncture or using a transcutaneous electrical nerve stimulation (TENS) machine may help relieve discomfort, but there is little evidence to support their effectiveness.
A study from 2017 suggests that psoriasis and PsA play a role in TMJ disorders. Physical therapy can help with TMJ symptoms and pain related to PsA. Reducing stress can help with PsA symptoms, including jaw pain, as stress can trigger psoriatic flares. Exercise can help reduce stress, improve sleep, and relieve PsA symptoms.
References:
1. Psoriatic arthritis's systemic joint inflammation includes TMJ involvement, causing increased prevalence and severity of TMD symptoms. 2. TMJ inflammation in arthritis leads to pain and functional impairments typical of TMD.
- Psoriatic arthritis, an autoimmune condition, is known to affect joints, including the temporomandibular joint (TMJ), leading to increased prevalence and severity of Temporomandibular Joint Disorders (TMD) symptoms.
- Research suggests that Psoriatic arthritis (PsA) may be responsible for TMJ involvement in up to 40% of people with psoriasis and PsA.
- The inflammation characteristic of PsA can lead to synovial inflammation in the TMJ, resulting in joint pain, stiffness, swelling, and potentially long-term cartilage and bone damage.
- While corticosteroid injections can reduce swelling and pain, there is a risk of joint inflammation and cartilage damage.
- Other conservative measures, such as adopting a soft diet, reducing jaw movement, applying warmth, taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, going to physiotherapy, and wearing a mouthguard, are often effective in managing PsA-related TMJ symptoms.
- Physical therapy for the jaw may involve jaw movements, stretches, adjustments to the positions of the body and head, and the use of an occlusal splint (intra-oral appliance) to help ease pain.
- Acupuncture or using a transcutaneous electrical nerve stimulation (TENS) machine may help relieve discomfort, but there is little evidence to support their effectiveness.
- Exercise can help reduce stress, improve sleep, and relieve PsA symptoms, including jaw pain, as stress can trigger psoriatic flares.
- A 2017 study suggests that psoriasis and PsA play a role in TMJ disorders, and physical therapy can help with TMJ symptoms and pain related to PsA.
