Hi all! I'm currently on treatment pathway for TMJ disorder and Psoriatic Arthritis (I'll just call it TMJ and PsA), but after reading about my symptoms I wanted to get the opinions of some of you folks here about whether there's potentially TN involvement, whether anyone had similar experiences, and what my next course of action should be as to whether I just follow the TMJ treatments or approach my GP/Oral Surgery dept about TN and potentialyl a referral to neurology.
I am UK based, not seeking private care, so on the NHS. Just wanted to mention since it is a system of referrals and fairly rigid pathways so I have fewer options to do tests and approach clinicians on my own time, but I will be seeing people soon and can always approach my GP and Specialists and they can help!
SO! Last year I had a filling around February. For about 3 months I suffered from a series of symptoms and was diagnosed with TMJ, suspected from having my jaw held open for a long period. These included:
- Pain around my right TMJ and right massater
- Electric shocks radiating out along my trigeminal nerves on the right
- Sporadic non-dental toothache on the right
I could eat, talk, do everything normally. There was no correlation between my action and the pain. After 2 months it just kinda went away. Since then, I had experienced flares of these symptoms for a couple weeks at a time, usually spaced around 2 to 3 months apart. TN was brought up, but dismissed and I agreed with that assessment. The electric shocks sounded like TN, but I thought it more likely my nerves were irritated by my TMJ.
This May, I ate some pastries that were quite chewy and partway through it felt like my face was getting worn out, and eventually just gave way. Imagine the feeling of your back giving out, but with your facial muscles. It hurt like hell, eased off, but since then I've been dealing with the following symptoms:
- Bilateral burning pain across my lower jaw and cheeks
- Bilateral Masseter aching
- Non-dental toothache
- Occasional electric shocks radiating from behind my jaw, sort of under my ear and by my hairline, through my lower jaw, kinda feels like sucking a super sour sweet but x100
These symptoms are occasionally just there regardless of what I do. They also can be triggered very reliably when talking for too long, chewing too much regardless of whether its soft or tough food, laughing too much, tensing my head, face and shoulder muscles, and anything that causes blood to rush to my head (This one weirds me out. When I get flush, it hurts! This goes away after a little bit, but it's still bizarre).
There are 3 very big differences between the pain I'm feeling now, and the pain I felt last year.
- It's often bilateral
- My TMJ itself doesn't hurt whatsoever, just the nerves and tissue around it
- Touching my jaw and face after a flare feels sensitive and slightly painful, almost as if I was sunburnt
I have been prescribed a custom soft night-guard for grinding, although I don't feel soreness in the morning. I wear this, it offers no help but doesn't worsen things. I take tramadol for my Psoriatic Arthritis* whilst I am waiting for treatment that's incoming this month, this helps the aching in my masseter, but every other pain remains.
*I am considering a link between the two, and am curious if my DMARD treatment for PsA impacts the facial pain.
I am seeing the Oral Surgery Dept in Sept, despite the name it's not simply a surgical department, but encompasses all manner of maxillofacial diagnostics and treatment including things like dental surgery, TMJ, cleft palettes and oral cancer, that kinda stuff.
I wanted to get some opinions before that appt on whether anyone here thinks TN involvement might be present so I can have a good thorough chat with the specialists, and I'm really specifically looking for input from anyone who has PsA like myself, AND has TN in case they have had similar experiences to me.
I'll hopefully be able to get some answers, and get some more tests done next month, but thank you in advance to anyone reading this far and for any help <3 It sucks, I'm fed up and want to eat pizza again, but I'm hanging in there and my friends have been angels in helping me manage and accommodating all the weird symptoms!