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Headache is a universal health ailment caused by various factors. Your jaw joint called the temporomandibular joint (TMJ) could be one of them. TMJ disorder is a condition that causes pain and dysfunction in the jaw joint and the muscles that control jaw movement. And this pain can manifest itself as a headache that often feels like a tension headache but is called TMJ headache.
It is difficult to estimate the accurate number of people affected by Temporomandibular Disorders due to challenges in collecting data, however, estimates range from 10 to over 35 million people in the United States who are affected by TMJ at any given time. The condition appears to be more common in women than men.
What Is The Temporomandibular Joint (TMJ)?
The temporomandibular joint connects the lower jaw, called the mandible, to the bone at the side of the head—the temporal bone. The easiest way to feel the joint is to place your fingers right in front of your ears and open your mouth. The jaw can move smoothly up and down and side to side because these joints are flexible, enabling us to talk, yawn and chew. Muscles attached to and surrounding the jaw joint control its position and movement.
The rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone when we open our mouths. The condyles slide back to their original position when the mouth is closed. A soft disc that lies between the condyle and the temporal bone makes this motion smooth. The repeated impact to the jaw joint from chewing, talking and other movements is absorbed by this disc.
Source: TMJ.org
The temporomandibular joint is different from the body’s other joints. The combination
of hinge and sliding motions makes this joint among the most complicated in the
body.
Muscles attached to and surrounding the jaw joint and therefore involved in TMJ disorders include lateral pterygoid, medial pterygoid, masseter, temporalis, and ligaments such as temporomandibular, sphenomandibular, and stylomandibular ligaments.
What Is TMJ Headache?
Headaches and TMJ disorders have a dual cause-effect relationship. TMJ disorder is a condition that causes jaw pain and dysfunction in the jaw joint and the muscles that control jaw movement.
TMJ disorder can be described as spontaneous, non-tooth related, and chronic pain. This pain is referred to the TMJ, teeth, muscles of mastication, and region around the ear. This pain is further exacerbated upon mandibular movements during chewing, which may lead to the onset of TMJ headache, limited mandibular movements, and TMJ clicking, indicating TMJ dysfunction.
(TMJ) headache is defined as head pain resulting from the pain that is first caused by tensing up of the jaw muscles then spreading to the TMJ muscles along the side of your cheeks and then reaching to the top of your head, ultimately causing a TMJ headache. Sometimes it can be hard to find the difference between a TMJ headache and a normal headache.
TMJ Headache Location
Other headaches affect the head area only. TMJ headache cause aches in your cheeks, ears, jaw, and other parts of your face, along with the top of your head. The TMJ headache may cause severe pain and discomfort in your neck and shoulders as well.
What Are The Causes of TMJ Headache?
Headache is the most common and significant symptom of TMJ disorders. The TMJ disorders develop as a result of interaction between multiple joints, muscles, and ligaments. These are broadly classified into myofascial and intra-articular disorders.
1. Myofascial disorders
Myofascial disorders include the muscles required for chewing. In myofascial disorders, these muscles are fatigued, tight, and painful. Muscular dysfunction is caused by psychological conditions including stress, depression, anxiety, autoimmune diseases, and parafunctional habits such as abnormal posture and bruxism. Fibromyalgia and other chronic pain conditions are also associated with the onset of TMJ disorders.
2. Intra-articular disorders
Intraarticular disorders include inflammatory and mechanical factors. The most common intraarticular disorder affecting the TMJ is articular disc displacement. Other factors are inflammatory diseases, trauma, hypermobility, trauma, osteoarthritis, and capsular inflammation.
What Are The Symptoms of TMJ Headache?
The subjective symptoms of TMJ disorders and associated headaches include the following. A lot of these symptoms are usually not experienced when your headache is due to other reasons.
1. Difficulty during the opening of the mouth
2. Fatigue and pain during biting and chewing; jaw movement triggering a headache
3. Pain in the TMJ, ears, and other parts of the face
4. Clicking and popping sounds during yawning, talking, and opening of the mouth
5. Teeth clenching, teeth grinding, and/or abnormality in bite
The clinical signs of TMJ disorders are as follows.
1. Myofascial pain
2. Subluxation
3. Myalgia
a. Pain in the masseter muscle
b. Pain in the temporalis muscle
c. Pain in the lateral pterygoid muscle
4. Arthralgia or pain in the TMJ
5. Pain in the submandibular area
6. Pain in the posterior mandibular area
What Is The Treatment of TMJ Headache?
The therapeutic approaches related to TMJ headache include the following.
1. Patient education
Patients are advised to avoid chewing hard foods like apples, carrots, and popcorn as well as rest the TMJ muscles
Patients are also advised to reduce the amount of stress as stress can lead to teeth clenching which can make TMJ disorders worse.
2. Physical therapy
This is the treatment of choice in TMJ disorders. Physical therapy includes the following techniques.
a. Application of ice or heat
b. Massage therapy
c. Exercise to improve range of motion, Activation relaxation exercises
d. Passive stretching
e. Acupressure, Laser therapy, or Electrical stimulation
3. Medications
Oral medications for the treatment of TMJ disorders include antidepressants, analgesics, antiepileptic drugs, non-steroidal anti-inflammatory drugs (NSAIDs) like Mobic or ibuprofen, muscle relaxants such as cyclobenzaprine, and oral steroids. Botox, local anesthetics, and corticosteroids are injected into the affected area. Tricyclic antidepressants are beneficial for the management of tension-type headaches associated with TMJ disorders.
The use of such medications to manage TMJ pain should only be short-term as they don’t provide a permanent treatment for TMJ disorders.
4. Splint therapy
Splint therapy can prevent dental and periodontal damage, decrease the activity of muscles of mastication during sleep, and stabilizes the alteration in TMJ structure.
Mouth guards can also help reduce night grinding and clenching. In addition, a mouth guard can gently correct a jaw or bite that is out of alignment. A “bad bite” or malocclusion where lower teeth and upper teeth do not meet properly when the mouth is closed can cause TMJ. Aligning the jaw can help heal and restore strained muscles that cause TMJ inflammation and pain.
5. Surgical treatment
If lifestyle changes and medications are not effective in curing the TMJ headache, orthodontic surgery is an option. These surgeries permanently alter the shape of your bite. However, orthodontic surgeries cannot guarantee a permanent TMJ headache treatment. None of these treatments have been proven to be effective.
You should be extremely cautious when considering a permanent treatment for TMJ headache pain. It can be very challenging to find an orthodontist with experience in treating TMJ pain and headache as there is no board certification in TMJ disorders in either medicine or dentistry.
Conclusion
Headaches are a common occurrence in patients suffering from TMJ disorders. The common symptoms include TMJ pain, limited range of movement, and clicking sounds during movement. TMJ disorders and associated headache is self-limited. However, the resolution can be accelerated by managing the symptoms and the underlying factors. It is important to ensure that the right diagnosis is made so that the right treatment can be administered for TMJ headache relief.
Frequently Asked Questions
Can TMJ cause a headache?
Yes, TMJ disorder is a condition that causes pain and dysfunction in the jaw joint and the muscles that control jaw movement. And that dysfunction can cause TMJ headaches.
What does a TMJ headache feel like?
TMJ headache cause aches in your cheeks, ears, jaw, and other parts of your face, along with the top of your head. The TMJ headache may cause severe pain and discomfort in your neck and shoulders as well. Other headaches affect the head area only.
How long do TMJ headaches last?
TMJ disorder and associated headache is a self-limiting condition and may resolve within an average of 7 years after the onset.
How do I distinguish between TMJ headaches and other types of headaches?
The International Headache Society has created criteria for the diagnosis of TMJ headaches. The important features of these diagnostic criteria are mentioned below.
a. The onset of recurrent pain in ≥1 region of the face and/or head.
b. TMJ disorders are indicated by MRI, x-ray, and/or bone scintigraphy.
c. Evidence of association of pain with TMJ disorders includes the following.
i. Pain exacerbated on mandibular movements, particularly during mastication of tough food.
ii. Irregular and reduced range of jaw movements.
iii. Clicking sounds on jaw movements.
iv. Unilateral or bilateral joint capsule tenderness.
d. No recurrence after treatment and the headache may resolve within three months.
How do I relieve TMJ headaches?
Following are some ways you can use to relieve TMJ headaches. Massage your jaw, avoid stressful situations and teeth clenching, perform jaw exercises to relieve TMJ pain, incorporate healthy lifestyle changes like avoiding chewing gum and eating hard foods, and take pain medication such as ibuprofen or Advil. If TMJ headaches persist, you should consult a medical expert.
References
https://www.ncbi.nlm.nih.gov/books/NBK554510/
https://www.ncbi.nlm.nih.gov/books/NBK551612/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379086/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756792/
https://americanmigrainefoundation.org/resource-library/temporomandibular-disorders/
