Have you ever experienced facial or jaw pain during your migraine attack? If so, you are definitely not alone. While facial pain can be due to conditions such as trigeminal neuralgia, it could also be a temporomandibular disorder that is to blame. In this, the last of our current comorbidities series, we are going to look at temporomandibular disorders, with a focus on temporomandibular joint dysfunction (TMJ). Sadly, these disorders are all too common for people who live with migraine.
What Is A Temporomandibular Disorder?
According to the National Institute of Dental and Craniofacial Research, “Temporomandibular disorders (TMD) are a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement.” TMD involves the muscles we use to chew, and/or the temporomandibular joint. One of those disorders, Temporomandibular Joint Dysfunction (TMJ), refers only to medical issues with the temporomandibular joint itself; we have two of these joints, one on each side of the jaw in front of our ears.
Overall, there are three main classes of TMDs:
- Disorders of the joints, including disc disorders
- Disorders of the muscles used for chewing (masticatory muscles)
- Headaches associated with a TMD
My Experience With TMJ and Migraine
I was diagnosed with migraine in the 1970s, and in 1985 I started experiencing new symptoms. My jaw was popping and cracking when I chewed, and sometimes it would lock or get stuck. I clenched my jaw and it often felt “tired,” and I had constant stiffness in my neck. I mentioned these symptoms to my dentist, prompting him to ask questions and perform an exam. I was diagnosed with temporomandibular joint dysfunction (TMJ). Could TMJ be the cause of my migraine attacks, I wondered?
To help treat my TMJ I was given a splint (mouthguard), which is a removable dental device that fits over my top teeth. The purpose of the splint was to relieve my pain by relaxing my jaw, stopping the clenching, and allowing my jaw to move smoothly again. According to tmj.org, this is a standard treatment. You can purchase over-the-counter mouthguards, however, my splint was made by my dentist for an exact fit. I wore it when I slept and sometimes during the day if I had symptoms.
In my situation, the splint helped a lot, and my severe TMJ symptoms were gone in just under a year. However, I still have frequent migraine attacks!
TMJ Causes And Symptoms
Around 12% of people in the U.S. experience TMJ disorders at any one time. For some reason, women are affected by these disorders more than men. In fact, 9 women to every 1 man experience severe pain and restricted jaw movement.
It’s often hard to determine what causes TMJ. It could be a combination of factors like a jaw injury, arthritis, jaw clenching or teeth grinding. However, not everyone who clenches their jaw or grinds their teeth will experience TMJ. Autoimmune diseases, dental procedures, and various forms of arthritis can also cause TMJ.
Signs and symptoms of TMJ include:
- Pain, stiffness, or tenderness of the jaw
- Pain in the neck and shoulders
- Popping or clicking of the jaw when you open or close your mouth
- It’s difficult or painful to chew
- The jaw locks making it hard to open or close your mouth
- Face and head pain
TMJ Dysfunction and Migraine
According to tmj.org, studies have shown that 30 health conditions can coexist and are comorbid with TMJ, complicating both diagnosis and treatment. These conditions include asthma, chronic fatigue syndrome, sleep disorders, depression, anxiety, tinnitus, heart disease, and, of course, migraine.
A 2020 study published in the special issue Temporomandibular Joint Diseases: Diagnosis and Management demonstrated that people with TMJ have a higher risk of migraine. TMJ can raise the risk of getting a migraine attack by increasing brain sensitivity. Migraine attacks caused by TMJ dysfunction are generally treated with migraine-specific medications.
If you have any of these symptoms in addition to migraine, we encourage you to talk with your headache specialist, neurologist or pain management doctor. As a reminder, if you need to find a certified headache specialist, you can check out our free, easy-to-use physician locator HERE.
TMJ Dysfunction Treatments
In addition to treating the migraine attacks which may be triggered by TMJ with standard migraine therapies, there are hundreds of different types of splints available which vary in effectiveness. Unfortunately, a 2020 National Academy of Medicine report stated the data regarding splints in TMJ therapy is generally of poor quality and yields mixed results. However, the only way to know if this will help you is to give it a try for yourself. The good news for many people with TMJ is that it usually resolves on its own within a few months.
In addition to splints, other conservative treatments are recommended to help manage the symptoms, including self-care practices such as:
- Stress reduction techniques, relaxation training
- Anti-inflammatories, muscle relaxants, antidepressants, and antiepileptic agents
- Moist heat and ice packs
- Complimentary treatments such as acupuncture and massage therapy. (Note: it is important to find a massage therapist that is trained specifically in TMD/TMJ)
Let Us Know!
Did you know that TMD/TMJ and migraine can be connected? Do you have problems with your jaw, and if so, do you find that it triggers migraine attacks… or vice versa? Finally, we would love for you to share your experience with us and let us know if anything has helped you!