IJV Compression and Degenerative Joint Disease in TMJs

Hi All,

It’s been a while since I’ve posted. Ive been focusing on my jaw issues the last few months as I learned my jaw joints have significantly deteriorated in the last couple of years (been diagnosed with osteoarthritis in both of my TM joints since 2018) and that I need to get bilateral total joint replacements.

In January I was able to schedule a consult with Dr. Hepworth here in Denver (where I live). One of my newer symptoms was a clicking/snagging in my neck/throat when I turn my head. I suspected it is my hyoid bone because my styloid is actually rather small, though a cm in the middle of the ligament is calcified, and that it could be due to the fact my lower jaw is moving backwards and up due to the deterioration in my condyles. My plan was to keep my consult with Dr. H so I could establish care and also ask him about the hyoid bone and the clicking. I thought maybe it would get corrected by TJR since it will give my lower jaw more projection.

I finally had my consult with Dr. H this past week! He is as great as everyone has said he is. Sarah, his PA who I saw a few days before my appt with Dr. H, ordered a jugular ultrasound. The ultrasound showed my left IVJ is pinched, and Dr. H said my right one may be as well even though the velocity isn’t as high as my left IJV. (I get tingling in both hands and can lose my ability to raise my right arm to 90° or higher). He ordered a CTV and prescribed me blood thinners. We scheduled a follow up in 6 weeks.

Dr. H recommends we do surgery in December, which is probably much sooner than I will be able to get TJR surgery for my jaw. I’m still meeting with surgeons for consults and working with my insurance since the TM joint is excluded from my coverage huge eye roll and will likely need to get braces before surgery so they can move my teeth around to where they need to be.

I feel validated by the IJV compression diagnosis but also overwhelmed. I honestly hadnt prepared myself for the possibility of having to get two very serious surgeries in the next couple of years.

Has anyone here also been diagnosed with degenerative joint disease or condylar resorption? I am curious about your experience treating both.

Also curious if anyone can take a look at my ultrasound results. Is it the case the compression is occurring in two places on the left side? My acupuncturist did a test for TOS when I saw him yesterday and he said he could barely feel my pulse on my right side even in the “neutral/baseline position. He said he had never seen that before. My left side wasn’t as bad, which I thought was interesting since the compression appears worse on that side.


Since your blood flow velocities are high at C1 & base of neck on the left, it appears you may have two constrictions on that side. It looks like compression on the right is mild as your velocity at C1 is somewhat elevated.

Your right arm symptoms & lack of pulse in that arm could be symptoms of TOS. I’m sorry you may be looking at yet another surgery to resolve that although there is a small possibility getting ES/IJV & your jaw joints taken care of could reduce the TOS symptoms. It’s kind of crazy how interconnected our body parts are.

I’m sorry I can’t answer the TM joint degeneration question. I know my TM joints are both in bad shape but the pain from them went away after my styloids were removed so I haven’t pursued care. I did have braces in my late 40s/early 50s to realign my bite which was helpful for several years with stopping my jaw from locking open.

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Thank you for your response.

Hi Rlr286,

recently I wrote about TMD here in the forum. It can be a consequence of ES.

Ongoing Myoarthropathy can cause degenerative TMJ problems, as I read in german Dentist Textbooks.

Hope that might help you a little.

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We have had a few members with TOS & ES; some have found whichever surgery they do first can alleviate the other symptoms, others have had to have surgeries for both…just another thing to add into the mix!
Again with the jaw joint some find that surgery has worsened it due to the positioning/ intubation during surgery (if you do opt for surgery with Dr H it’s certainly worth mentioning), others as @Isaiah_40_31 says have found it improves…
I’m UK, TMJD is not something which seems to be as commonly diagnosed here!

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Hi, based on my own jaw surgery experience I’d say do not rush in to jaw surgery if guards/physio or other less invasive methods could help. I’d focus on JV decompression first and recovery time. Then reassess next steps. Take care. D

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