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Jaw Pain With Ankylosing Spondylitis: Causes and Management

Posted on March 14, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Kate Rix

The pain that’s a hallmark of ankylosing spondylitis (AS) typically affects the back and neck. However, it can also impact other parts of the body, including the jaw. Experiencing jaw pain can impact a person’s quality of life, making it difficult for them to swallow, eat, and open their mouth.

Jaw pain is a common complication for people with ankylosing spondylitis and other types of arthritis. Some researchers estimate that about 15 percent of people diagnosed with AS experience inflammation and pain in the jaw. Others report that as many as 35 percent of people with the condition experience jaw pain.

Many members of MySpondylitisTeam report jaw pain. Some members report that their AS jaw pain developed into temporomandibular disorder (TMD) — sometimes referred to as temporomandibular joint (TMJ) syndrome. The temporomandibular joints are located on either side of your face, directly in front of your ears. They connect your lower jawbone to your skulls and help with eating and talking.

“OMG! The jaw pain! Does anyone else have it?” one member wrote. “It goes from side to side, and just won't quit! I have spent a fortune with the orthodontist getting mouth pieces I wear day and night. They help, but it still hurts!”

Recognizing jaw pain in ankylosing spondylitis and understanding what causes it can help you find better ways to manage it.

What Does Ankylosing Spondylitis Jaw Pain Feel Like?

Along with pain in the back, neck, hips, and shoulders, a lot of MySpondylitisTeam members describe experiencing pain in their jaw. This pain is chronic, and it varies from person to person: For some, it’s mild and for others, it’s very severe. Often, it’s worse in the morning upon waking. Some members share that the pain is in both sides of their jaw or moves from one side to the other.

Here are some examples of how MySpondylitisTeam members describe their jaw pain:

  • “I’m tired and my jaw is very tender.”
  • “My jaw and neck are tight and sore.”
  • “The pain and swelling in my jaw persist.”
  • “I’m having pain in my ear into my jaw and nothing’s helping.”
  • “Jaw and ear pain and my entire upper back will spasm as well as my neck.”
  • “... My throat is hurting and I can’t really open my mouth because my jaw is so inflamed.”

Others say that the jaw pain is accompanied by headaches and sometimes trouble maintaining balance. “I have TMJ in my jaw,” one member shared. “My balance has not been great either. I never related that before, but my hubby says I walk into him while walking but don’t mean to.”

What Causes Jaw Pain in Ankylosing Spondylitis?

According to one study, females diagnosed with AS who grind their teeth (bruxism) may be more likely to develop jaw pain due to TMD. The study also found that men with the following factors are at higher risk of developing TMD in ankylosing spondylitis:

  • Having measurably severe symptoms
  • Being an active smoker
  • Having a neck disability

How Ankylosing Spondylitis Causes Jaw Pain

The places where joints, ligaments, and tendons attach to the bone are called the entheses. Inflammation of the entheses is a hallmark symptom of AS and may occur in multiple parts of the body. These places are called “hot spots.” When the jaw joint becomes inflamed, it becomes swollen and tender.

Research shows that the inflamed tissues in the entheses may swell enough to put pressure on the nerves in the area, causing pain.

Managing Jaw Pain in Ankylosing Spondylitis

Many MySpondylitisTeam members have discussed the available strategies for alleviating AS-related jaw pain. Following are some of the nonsurgical medical treatments that members have reported to be effective.

Before trying any of the options below, or others you hear about, talk to your doctor. With their approval, experiment with different methods until you find approaches that work for you.

Medications

Many members take nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, to relieve AS-related jaw pain. NSAIDs are considered first-line treatments for jaw pain and have proven effective in easing the symptom.

People whose jaw pain is resistant to NSAIDS are often prescribed other anti-inflammatory medications. These include steroids, disease-modifying antirheumatic drugs (DMARDs), and pamidronate. Humira (adalimumab) is effective for many people with spondylitis-related jaw pain. It can help reduce inflammation and alleviate pain. Some members report that Rinvoq (upadacitinib), a biologic medication that reduces inflammation, helps relieve their jaw pain.

A doctor may also prescribe symptom-management medications. “Muscle relaxers at night help some. It’s throbbing into the ear, eye, and neck that really pushes my limits,” one member shared. “Sometimes heat and ice help as well.”

Complementary and Alternative Medicine

Other members report that using CBD oil — derived from marijuana — relieves jaw pain.“I struggle with so many issues like AS, spinal fusion, spinal stenosis, and scoliosis. I take CBD oil in the morning and at bedtime because we all know the night is worse. Thank goodness the CBD has helped so I can sleep,” one member shared.

Other complementary and alternative medicine treatments for AS-related jaw pain include acupuncture (when administered by a trained professional) and yoga.

Biofeedback and Splint Therapy

Some people experience severe jaw pain that prevents them from opening their mouths completely. Biofeedback therapy — a non-drug treatment involving electical sensors — can help: Through the therapy, people learn to control muscle tension.

Some people also find relief through splint therapy, which involves wearing a mouth guard custom-made by a dentist.

Physical Therapy

The muscles in the jaw, and the jaw joint itself, often responds to physical therapy approaches, which include:

  • Exercises to strengthen the jaw muscles and improve range of motion.
  • Heat, in the form of heating pads and gargling warm water, to improve blood circulation.
  • Cold, in the form of ice, to reduce pain and swelling.
  • Massage to reduce muscle tension.
  • Correct posture and jaw alignment.
  • Transcutaneous electrical nerve stimulation, or low-level electrical current applied to the jaw joint (from the outside). This technique may reset the body’s pain signals and help muscles to relax.

Be sure to get a referral from your doctor for a physical therapist with experience treating TMD.

Surgery

Surgery is rarely required to treat jaw pain. However, in severe cases, a doctor may recommend replacement of the jaw joint. Early prosthetic options for jaw replacement were often uncomfortable, but research has led to improved, custom-fitted protheses that are more comfortable after surgery.

Several MySpondylitisTeam members report having had jaw surgery. “I have been dealing with TMJ for about 40+ years,” wrote one member. “I’ve had three surgeries and have a headache every day!” Another wrote, “I was diagnosed with spondylitis back in 2007, after my jaw became dislocated from eating an apple. I had no prior issues with my TMJ, but it literally disintegrated. Fourteen surgeries in five years with a total joint replacement in my jaw.”

Lifestyle Changes

People with AS-related jaw pain may find relief — and improve their overall health — by making certain lifestyle changes, including the following:

  • If you smoke, consider stopping. Giving up isn’t easy, but it’s possible with support and the benefits are enormous.
  • Obesity, as calculated by the body mass index (BMI), can put pressure on joints and make pain worse. If you are overweight, consider following a weight-loss plan.
  • Exercise (gently) for 150 minutes per week.
  • Eat well to keep other conditions, like diabetes and high blood pressure, under control.

Find Your Team

MySpondylitisTeam is the social network and online support group for people with spondylitis and their loved ones. Here, more than 74,000 members come together to ask questions, give advice, and share their experiences of living with spondylitis.

Do you experience jaw pain with spondylitis? What are your go-to tips for managing the pain? Share your tips in the comments below or by posting on MySpondylitisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kate Rix is a writer based in Oakland, California. She earned her master’s in journalism from University of California, Berkeley. Learn more about her here.

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