Pain. Clicking. Popping. These are some common symptoms of temporomandibular disorders (TMD), which is comorbid with migraine.[1] TMJ disorders can trigger migraine attacks or make a migraine attack worse due to muscle tightening. On the reverse side, some migraine triggers can also trigger TMJ symptoms. As with migraine and many other comorbidities, TMJ disorders are more common in women as in men—by two to five times.[2] An estimated 11-12 million people in the US experience TMJ pain, so it is a fairly common disorder.
Symptoms and Causes
The temporomandibular joint (TMJ) connects the head to the side of the jaw and enables people to chew and talk. People who live with TMD can have additional symptoms including:
- Limited movement in the jaw and neck (sometimes called lockjaw)
- Tenderness and inflammation in the face, jaw, and neck
- Upper and lower teeth that do not close properly
- Shoulder pain
- Dizziness, ringing in the ears and/or hearing loss
- Shoulder pain[3]
- Difficulty chewing and talking
The exact cause of TMJ disorders is not known, but possible causes include:
- Genetics
- Hormone imbalances
- Increased sensitivity to pain (central sensitization)
- Arthritis
- Jaw injury
- Teeth clenching or grinding[4]
Seeking Help
Since migraine and TMJ disorders can be tricky to diagnose, it may be necessary to seek out the services of several specialists. These can include:
Dentists: For many people, a dentist is the first person they would contact for jaw pain—especially if it’s likely caused by bruxism (teeth grinding and clenching). Imaging diagnostics such as x-rays, and treatment options such as a bite guard or jaw exercises, may be suggested. The dentist might also recommend softer food choices and hot or cold compresses for pain relief.
Neurologists: People with migraine may seek out a general neurologist, certified headache specialist, or sleep disorder specialist, to help them find a correct diagnosis. Neurologists can also help determine what’s causing the TMD symptoms.
Mental health practitioners: Many people with migraine and TMD also suffer from anxiety and/or depression. Therapists can help pain and symptom management with talk therapy or cognitive behavioral therapy. In addition, a mental health specialist might prescribe biofeedback services, which can help patients control their breathing, physical reaction to stress, and anxiety reduction.
Physical therapists: Heat, ice and/or ultrasound may be employed to ease symptoms of both migraine and TMD.
Pain clinics: Going to a pain clinic that includes integrative treatments could also help provide a way forward for people who live with both TMD and migraine.[5] Some of these clinics will include physical therapy, mental health sessions, biofeedback, occupational therapy, medication, and more.
Lifestyle Changes
According to National Institute of Dental and Craniofacial Research, when treating TMD, less medical intervention is often the “best” medicine[6] and we know that for migraine it is important to have a holistic approach to disease management. Using self-care techniques, stress relief, and lifestyle changes is important. These can include a regular sleep schedule, mindfulness, yoga, biofeedback, meditation, a healthy diet, and regular gentle exercise. Some people have success using essential oils applied to the skin to help minimize pain, although it’s important to bear in mind that essential oils can be a migraine trigger for some people. Overall, when dealing with both migraine and TMD, taking good care of yourself is of the utmost importance.
Let Us Know: Do you have TMD and migraine? Have you made lifestyle changes to deal with both conditions? What has worked best?
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756792/
- https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941
- https://www.nidcr.nih.gov/sites/default/files/2017-09/less-is-best-tmj.pdf