Methotrexate with severe toothache and earache - NRAS


34,726 members43,169 posts

Methotrexate with severe toothache and earache

Jane76 profile image
24 Replies

Been on methotrexate since early part of this year, after the first 3 months I started getting toothache on and off. Got to the point where I went to the dentist . She took X-rays and said there’s nothing wrong. Maybe just sensitive teeth. Been using sensitive toothpaste. Since then it’s got worse and now in agony. It seems to be all my teeth on one side. And really bad earache the same side. Having bad headaches constantly. Doctors checked my ear too, any nothing wrong. Painkillers of any kind do not help. This reduces me to tears and I’m no wimp, my pain threshold is very high. Even stopping me sleep now. Not sure what to do anymore and nobody has any answers. Does anyone else suffer like this? I’m going back hospital next week. I’ve also stopped taking the methotrexate a couple of weeks ago hoping that it will help with my teeth and ear and headaches 😢 feeling very miserable. And no sympathy at home doesn’t help.

24 Replies
medway-lady profile image

Ring the RA nurse as its possible to get RA in the jaw and if you've stopped the MTX it might be worse. I really don't know but worth a try. Toothache is horrid and the ear too, that does sound so awful. Could be worth trying ice to relieve the pain and has anyone asked about Neuragia tI'm not sure but believe that can affect the face but then again surely your GP would have checked for that. So I really hope your feeling better soon. x

Jane76 profile image
Jane76 in reply to medway-lady

Thank you x

helixhelix profile image

Yes, agree with ML, start to hassle your rheumatologist. You can get RA in the temporomandibular joint in the jaw and it can make teeth and ear painful. An x-ray of your teeth won't show it, neither will looking in your ear..... so push to make sure they treat you seriously as stopping MTX won't help.

AgedCrone profile image

Have you had your frontal sinuses looked at? You can get referred pain that feels like tooth ache in your upper jaw plus earache, if there is a sinus problem.

I had my upper Wisdom teeth removed before it was discovered my sinuses were the problem.

I'd continue with the Mtx if I were you.....if the toothache is RA related it will help rather than hinder.

Hope you get some sort of diagnosis soon.

nomoreheels profile image

As you've ruled out tooth & ear problems I'd have your Rheumy check it out. RD can affect the TMJ joint (TemporoMandibular Joint), there are two actually but can affect just the one side. It's considered a syndrome that can cause continual pain... headache, earache, tooth pain, neck pain, shoulder pain, even back pain in some. As simple as it seems NSAIDs help, they ease the muscle pain (neck, shoulder & back pain), prescribed pain relief as well. Trying your best to relax helps too, as I've said if you're tensing the muscles it affects other parts, neck, shoulders, back. You could try a cold or heat pack or cold/warm flannel, see if that eases it any. If it was me I wouldn't stop my MTX, certainly not without seeking advice, because the inflammation will be being kept in check somewhat even though you won't think it is. It sounds a little as though you're blaming the MTX? I'd not be surprised if you hadn't have been taking MTX it would be worse, even though you probably can't imagine that it could be.

This is all supposition of course, but I'd be trying my best to get in to see my Rheumy, or at least my Nurse Specialist. I hope the pain subsides soon Jane, I can imagine it's keeping you awake, the headache can be related to a migraine so quite debilitating. x

I used to get cracking headache and earache on it; stopped about 3/4 weeks ago (awaiting something else) but still get odd shooting headache. I hadn't even thought about it being RD itself, blamed MTX but who knows? I'd ring specialist nurse or rheumy like others have said. Sorry you're in pain x

Jane76 profile image
Jane76 in reply to

Thanks, it’s strange how we all react differently to these meds.

Did you just stop taking mtx yourself or did they tell you to? X

in reply to Jane76

I’d been on it for a year at varying doses, nausea biggest problem. I saw lovely registrar last time, she said come off it & put me in for biologics; I’m told they have less side effects 🤞would say it definitely helped with joint pain tho’ as starting to notice that again.

Kings1 profile image

Hi. Do you have RA. I understand that you can get arthritis in Jaw, can't remember what bone it's called. Teeth can be perfectly healthy but pain from this jaw bone cane give pain and also affect the ears. Well worth speaking to your rheumatologist about this. Take care and hope you get the help you need. I also would not stop taking your MTX unless advised to do so.

jomojo profile image

Hi Jane. I'm sorry your having bother with ears and teeth. I was not on MTX at the time and I had been getting toothache and ear pains. I've been checked out by the GP and dentist and given the all clear there too. I have a painful jaw on the same side as toothache (RA ?)

Having suffered with reoccurring sinus problems It is possible mine could be that? It still comes and goes and usually accompanied by a sore throat too.

I put it down to another RA immune response.

Take care.

Debbiecoops profile image

Poor you Jane , i can relate . I get no sympathy at home either. My husband and 2 grown up daughter's even change the subject or walk away if I mention my pain. I have severe osteoarthritis and rheumatoid as well as giant cell arteries. I try and stay positive but some days the pain takes over 😣

Jane76 profile image
Jane76 in reply to Debbiecoops

Oh my!! Debbie, You do suffer then!

Yes I think my husband thinks I make it up and exaggerate my pain. On the other side if he’s in pain.... I’m more than sympathetic.

Cheylann profile image
Cheylann in reply to Debbiecoops

U can't expect someone who doesn't have these conditions to understand and empathise all the time. They don't get how exhausting the constant pain can be and in their defence why would they. It must be boring as only so much sympathy they can give. Just looking at it fm their point of view.

Debbiecoops profile image
Debbiecoops in reply to Cheylann

I do understand what your saying, when I was a teenager. My dad was going through the same thing as me . I thought the whole thing was boring and wished he would stop moaning and go back to work. But now I'm going through it , i feel awful that I wasn't more supportive . But I guess like you said , i didn't fully understand what he was going through. When i''ve had a really bad day , i guess I just what some comfort from my loved ones . When they act like that, it's makes me feel very unloved. Silly I know , but constant pain makes people feel very low.

Cheylann profile image

Well if u stopped MTX a few weeks ago then it can't be that. Maybe it's arthritis in your jaw. What are u doing for your arthritis now? It sounds awful. Sorry u r in such pain and hope u get some answers.

Ajay575 profile image

Sometimes the methotrexate stays in the system for a good while when i came off it i was not right for upto a year i blamed methotrexate for it

Cheylann profile image
Cheylann in reply to Ajay575

I can't believe MTX stays in system for a year. What do u take when u come off it and why do u come off it? Just interested.

Jane76 profile image

Update- been to the doctors again and she believes it’s Trigeminal Neuralgia. And now waiting for the chemist to get the meds in for me. Never known pain like it.

Thank you all for you help and kind words.

nomoreheels profile image
nomoreheels in reply to Jane76

But I thought the pain was constant, or your headaches are? Trigeminal neuralgia cases shooting pains, a little like electric shocks, on & off. At least you can restart your MTX. Which meds has she prescribed? I hope they work & you get some relief at last.

Jane76 profile image

My headache is constant and now my face, teeth and ear are in agony as soon as I eat or drink but also sometimes it just starts on it’s own. She’s prescribed carbamazepine.

nomoreheels profile image
nomoreheels in reply to Jane76

It's the recommended med for trigeminal neuralgia so it will/should work if that's what you're suffering from. Hope so.

Jane76 profile image
Jane76 in reply to nomoreheels

Thank you . I hope so too 😕

Golfnuts profile image

I see this was 4 years ago, I am experiencing the same symptoms, did you stop MTX and if so how long did it take for your pain to go away?

Nana2eight profile image


Exactly the same problem! I started MTX injections and immediately have left jaw pain. I knew it had to be the problem with no issues previously. It must be the TMJ joint causing the problem. I wore a splint which was for previous grinding issue and it didn’t help. Warm liquids are all I can tolerate. I use the heating pad on my face for comfort. You are correct not much helps. I take a CBD pill in the morning to get moving but it wears off at bedtime. I cannot take them and get to sleep. I do have to take magnesium to sleep at night or it doesn’t happen. At 20 mg MYX I still have enormous discomfort in my joints.

You may also like...