When Candace Primack of Scottsdale, Arizona, started to feel a sharp pain in her left ear in her law class one day, she didn’t know what to do. All she knew was that the slightest movement made the pain that much worse.
After consulting with multiple otolaryngologists (ear, throat and nose doctors) who could not provide any meaningful insight into her condition, she realized that the unanswered questions had also baffled a majority of medical professionals she had been seeing. It wasn’t until she was referred to a dentist who specialized in the temporomandibular joint (TMJ) that the cause of her pain was found – a cause that shocked Primack: psoriatic arthritis (PsA).
TMJs are the joints that connect the jawbone to the skull. PsA can affect the TMJ, just like any other joints in your body. An estimated 35 percent of people with PsA will experience symptoms in their TMJ. Despite those high numbers, there still seems to be quite a bit of confusion when it comes to treating PsA in the jaw.
Finding Out Too Late
Primack experienced this confusion firsthand, as it took several years of seeing specialist after specialist in her 30s before her PsA was diagnosed in 1997. “The biggest problem was that it took a long time for someone to diagnose me with PsA,” says Primack. “As a patient, it is frustrating to live with pain and not be able to find a doctor who can help you.”
By the time the cause of her pain had been determined, in some ways it was already too late. Primack gave up her legal career because of the pain medication she took for her then-undiagnosed PsA. “I did not feel comfortable practicing law because of the pills I needed,” Primack says. “Sometimes I forgot words because of my medication and my memory was very bad.”
Further, her left TMJ cartilage found between the two joints had completely deteriorated, causing ankylosis, which is the fusion of two joints into one solid joint. This made everyday activities like talking and eating difficult. “My mouth will only open a limited amount,” says Primack. “So I can’t eat big things, like hamburgers.”