Jaw claudication is pain in jaw while chewing which disappears with rest. This pain can be moderate to severe sometimes radiating to ear. Jaw claudication is not a disease in itself, but it is a symptom of an underlying disease. Claudication is a medical term used when pain is induced in particular muscle area of the body caused as a result of obstruction in the artery.
Pain reduces once the physical activity of that part is stopped. In majority of cases it occurs as a result of blockage or occlusion of the artery.In case of claudication of jaw, carotid artery is occluded. Carotid arteries are main arteries that carry oxygenated blood from aorta to face and brain.
Claudication of jaw is particularly important and specific symptom of giant cell arteritis. If you are suffering from sudden severe pain while chewing which reduces with rest, you must consult your physician to rule out jaw claudication which is a treatable condition.
Causes of Jaw Claudication:
As mentioned in the beginning, jaw claudication is not a disease but a symptom of an underlying health condition. There are several conditions that may cause jaw claudication.The basic pathology involved is reduced blood supply to the muscles of jaw due to narrowing or occlusion of the arteries supplying blood to the jaw. Occlusion mainly occurs in carotid artery or its branches supplying the jaw. Here are some of the causes that may lead to painful jaw claudication.
- Giant cell arteritis: It is a chronic inflammatory autoimmune disease of artery. Giant monocyte cells infiltrate large and medium sized arteries to produce a systemic inflammation. The disease mainly involves carotid arteries. Classic symptoms of giant cell arteritis include; jaw claudication, headache, and mild fever. Patient is above the age of 50. Blood ESR is more than 50 mm/h and there is reduced pulse along with tenderness over head.
- Temporo-mandibular joint (TMJ) disorder: It is usually caused as a result of temporal arteritis. There is inflammation in the temporal branch of the artery. Pain appears to be similar to musculoskeletal pain. However, in this condition the maxillary artery becomes swollen reducing the oxygen supply to the muscles of jaw.
- Myesthenia gravis: It is a neuromuscular disease caused as a result of dysfunction of the immune system. Patient suffering from this condition suffers from decreased jaw strength and fatigue.
- Carotid Artery Stenosis: Occlusion of external carotid artery from emboli can produce jaw claudication.
- Rheumatoid Arthritis: It is an autoimmune disease affecting joint and various other organs of the body. Occasionally pain can complain of jaw claudication as its symptom.
- Infections: Viral and bacterial infection can produce pain in jaw, especially patients suffering from sinusitis may experience jaw pain while chewing and pain ameliorates with rest.
- Parotid Gland Tumor: Tumor of salivary gland can obstruct blood flow to the muscles of jaw leading to pain in jaw while mastication.
Treatment of jaw claudication depends on the underlying condition that is responsible for it. Hence management aim is to treat the underlying disease.
- In case of autoimmune diseases such as temporal arteritis, giant cell arteritis, rheumatoid arthritis, doctors generally prescribe steroids. Taking steroids for long time can make the bone weak. Hence, supplementary calcium and vitamin D is prescribed to the patient from time to time.
- Patient is also given blood thinning medicines so that blood can reach the jaw muscles adequately.
- Patient suffering from myasthenia gravis is treated with medications such as anti cholinergic drugs and immune-suppressants.
- If parotid tumor is the cause, it has to be removed surgically. Later on patient may also need chemotherapy and radiation as a part of treatment.
- Carotid endarterectomy surgery is performed if there is narrowing of the carotid artery. This helps to increase flow of blood to the jaw muscles.
- Bacterial sinusitis infection is treated with antibiotics.