TMJ and MigrainesWhen Your Migraine Has Friends, Like TMJ
It is estimated that about 35 percent of people in the U.S. suffer from both migraines and TMJ. Of those figures, as many as four times as many women have these combined migraine headaches, head and neck and TMJ symptoms. The result is excruciating jaw pain, neck and shoulder pain as well as a migraine headache.
As a migraineur, I suffer from several different types of migraines and headaches. In fact, one of the biggest culprits of my migraines are tension headaches – and I can always tell when tension causes them because I also have a sore jaw from clenching it (although I don’t realize it until after the fact.)
However, a TMJ migraine is in a category all its own!
What is TMJ?
The temporomandibular joint (TMJ) connects the jaw to the skull. This joint allows the jaw to do all of the wonderful things it does, such as enjoy bite into an apple, chew the bite of chocolate cake, and talk with your loved ones.
When this joint is working as it should, there are no issues.
However, problems can arise when the joint is out of place or if the muscles that move the jaw get fatigued. When this happens, all sorts of issues can occur – shoulder pain, earaches, toothaches, and you guessed it, migraines.
The pain can radiate to the neck, shoulder and the overall jawbone and cheek area as well as affect the ears. The reason TMJ pain happens is believed to be caused by jaw clenching and teeth grinding, often done while we sleep.
So you may be doing this and not even realize it. The first clue might be the pain you experience, and the next might be your dentist noticing you have extra wear and tear on your teeth caused by grinding them.
TMJ Hurts Your Head Whether or Not You Get Migraines
There are many different types of migraines and headaches. Statistics say that the most common type of a headache is the TMJ headache, which is not a migraine in itself.
It has been estimated that this particular headache accounts for more than 90 percent of headache pain in adults. This kind of headache may vary from mild to very intense and can often be misdiagnosed as a migraine.
But migraines are different. Migraine headaches are caused by vascular swelling within the head and are typically felt like a unilateral throbbing pain of moderate to severe which may last a few hours or typically up to 72 hours.
They are usually accompanied by sensitivity to light and sound and can cause nausea. Some people with migraines experience a visual aura, which can appear as flickering objects at the periphery of their vision.
How Are They Connected?
What has been found is an indirect connection of people who clench or grind their teeth are more likely to be the same individuals who get migraines.
Researchers have found that migraines occur when the trigeminal nerve, which sends energy signals to the blood vessels and lining of the brain, becomes irritated. This causes a release of chemicals that result in the pain and throbbing of a true migraine headache.
The trigeminal nerve also works the same magic on the TMJ, jaw muscles, teeth, and sinuses and then joins with the nerves in the upper neck. Because of this, neck and jaw issues are often a huge trigger for migraine headaches.
As you may realize, this can compound the level and extent of pain felt by the sufferer, who can be experiencing both types of pain at the same time. Now researchers are looking at whether reducing the excessive stimulation of the trigeminal nerve can significantly reduce or eliminate migraines.
Next Page: Symptoms of TMJ and How It's Treated
Is it Really a Migraine, Though?
Some people do not think headaches caused by the temporomandibular joint are classified as migraines. After all, the headache is caused by the jaw, right?
According to Cleveland Clinic, by definition, “A migraine is a headache that tends to happen repeatedly. It can cause moderate to severe pain if left untreated."
So yes, if you suffer from TMJ headaches, you do, in fact, suffer from migraines.
How Do You Know If You Have TMJ?
There are a few symptoms of TMJ that you should report to your doctor. The most common symptoms may include:
- Headaches
- Jaw and facial pain
- Ear pain
- Your jaw clicks
- You grind your teeth
- Ear stuffiness
- You have limited opening of your mouth
- A general neck and shoulder pain
- Tooth pain
- Throat pain
- Difficulty swallowing
- Hearing a ringing in the ears (tinnitus)
- Dizziness
- Eye pain
- Unexplained sinus congestion
Treatment of TMJ Migraines
Treatment of TMJ migraines can be tricky. Why? Because it typically isn’t a permanent fix unless surgery is performed.
Surgery can be performed to fix temporomandibular joint disease (TMD). A surgical “fix" will correct joint abnormalities, thus fixing the problem. However, surgeries always have their own set of risks, such as infection, blood loss, even death.
However, there are coping strategies for coping with TMJ migraines. Colgate mentions the following strategies:
- Frequent gum – Chewing can inflame the joint, worsening symptoms. Instead of chewing gum, opt for mints or carry mouthwash. I know it’s hard – I am a habitual gum-chewer too, but your aching head will thank you!
- Figure out what is causing your anxiety – and deal with it! Stress and anxiety can cause us to clinch the jaw, which can exacerbate TMJ symptoms. Whether it is eliminating the stressor, getting exercise, going to therapy, taking breaks at work, or calling up a friend, dealing with the anxiety is important if this is one of the causes of your TMJ migraines.
- Massage can help – If muscle tightness if the cause of your TMJ migraines, massages can help loosen the muscles. You can try to massage the muscles yourself or go to a massage therapist. Massage of the TMJ muscles brings more blood flow to the area, which subsequently reduces inflammation and pain. However, if you don’t want to pay a professional for a massage, you can locate the TMJ (about three inches back from the corner of your mouth). Use three fingers and massage in a circular motion. Repeat as needed.
- Popping pills can also help – Over-the-counter medications typically are sufficient for TMJ migraines. Discuss first with your dentist or physician, but typically a medication such as ibuprofen or naproxen, both nonsteroidal anti-inflammatory drugs (NSAIDs) are effective at both relieving pain and decreasing inflammation.
Additional TMJ Migraine Treatments
Additionally, to the advice above, there are a few things you can do to ease your pain as well as medical treatments you can speak to your doctor about to see if they are right for you.
- Try eating soft foods during episodes of discomfort – Soft or blended foods allow the jaw to rest temporarily. Try to avoid eating extra hard, crunchy, and excessively chewy foods. Any food that is large and requires you to stretch your mouth, like corn on the cob, apples, or whole fruits should be avoided.
- You can also apply ice or moist heat to the jaw – This can ease swelling and soothe the pain.
- You should avoid cradling any telephone between your shoulder and your ear without the use of your hand to hold it there – This activity can irritate jaw and neck muscles.
- Your dentist can order you a plastic mouth guard to wear at night – It serves as a splint the keep your jaw where it is supposed to be and stops you from grinding your teeth in your sleep.
- It is believed that chiropractic treatment for TMJ can ease the pain by correcting the misalignment of the spine and nervous system – In addition, a chiropractor may use massage to relieve tight muscles in the back around the spine. This reduces the amount of stress put on the jaw so that other treatments to adjust the jaw will be more effective.
- Try sleeping on your side at night – This limits your ability to grind your teeth and eases tensing of the jaw.
Diagnosis of TMD
It may be helpful to understand how a diagnosis of TMD is made – just because your jaw is sore at times does not necessarily mean that you have TMD.
TMD, which is now actually called myofascial pain dysfunction (MPD) syndrome, although not commonly referred to like this, must have a certain set of symptoms to receive a diagnosis.
These TMD symptoms may include:
- Pain in the jaw that ranges in intensity
- Clicking or popping of the joint, which is accompanied by pain
- Abnormal motion of the joint
- Other conditions of the jaw
- Vertigo, dizziness, and ringing in the ears may also accompany these other symptoms, but these symptoms are not necessary to diagnose TMD/MPD syndrome.
In Conclusion...
Because a migraine is a caused directly by a malfunction of the jaw, traditional treatments such as abortive mediations and preventive medications may not be effective. This is why it is important to diagnose a TMJ migraine accurately so that appropriate treatment can be initiated.