Migraine treatment and relief depends on identifying the cause of the headache, and research has shown that issues affecting the jaw have a prominent role to play in many patients. The temporomandibular joint (TMJ) can have an impact on your migraines, for a number of reasons.

What is the TMJ?

The temporomandibular joint is the hinge connecting the lower jawbone to the skull, which enables us to move the jawbone as needed for talking, yawning and eating. The joint gets its support from muscles located underneath the jaw in the throat area, the cheeks, on top and at the sides of the head. These are connected by tendons to muscles in the chest and shoulders. In patients with malocclusion or a “bad bite” the TMJ might be out of alignment, which causes strain on the adjoining muscles. When the muscles in the face and head are affected by the strain, the patient can develop a migraine headache attack.

Symptoms of a TMJ Disorder

How do you know whether your headaches are related to TMJ pain, or if the two just happen to occur simultaneously? It’s essential to determine whether you’re showing any of the signs of typical TMJ disorder. Watch for symptoms such as:

• Jaw clenching or grinding. Even if this is barely noticeable, the touching or occlusion of your teeth for no good reason is called parafunction, and the amount and intensity of parafunction you experience has bearing on whether migraine pain develops.
• Pain and tenderness, either in the jaw bone or in one or both of the TMJ joints.
• Pain that resembles ear ache, in and around one or both of your ears.
• A facial ache, or pain while you’re speaking or eating.
• Stiffness or a sensation of locking in the joint, which makes opening and closing your mouth difficult.
• Clicking or grating sounds accompanied by pain when you move the jaw during chewing or speaking.

If you have any of these indications as well as headaches, even if you don’t experience them simultaneously, you could have a TMJ disorder triggering your migraines.

Reasons for TMJ Problems

The temporomandibular joint works like a sliding hinge, and the bones are covered with cartilage and separated by a small disk that acts as a shock absorber. If you sustain an injury to the joint or suffer from long term teeth grinding or clenching, the disk can move out of alignment. Other risk factors for TMJ disorders include various forms of arthritis including osteoarthritis and rheumatoid arthritis or connective tissue diseases. All of these break down the cartilage and reduce its protective capabilities.

Why TMJ Disorder Affects Migraine

Migraineurs suffer from a disorder of the trigeminal nerve, which produces chemicals in response to stimulation. The nerve typically only responds when it senses a need to protect itself, but when it does the chemicals released can cause swelling around the brain and sinuses, resulting in migraine headache pain. If you get frequent migraines, the trigeminal nerve is likely responding to lower stimulation than normal. Unusual clenching of the teeth and jaw during sleep or any other time can impact your trigeminal nerve system and make you more susceptible to migraines.

Treating TMJ Disorders

If your doctor diagnoses you with a TMJ disorder and identifies that it could be a migraine trigger, your first step is to resolve the joint problem. For TMJ pain caused by clenching or grinding, treatment could be as simple as an oral splint or a mouth guard for sleeping, combined with a muscle relaxant for a few days to reduce the tension in the jaw.

Since both TMJ disorders and migraine attacks can be triggered by stress, anxiety or depression, treatment recommendations could include:

• Tricyclic antidepressants, which have a dual effect of relieving both pain and depression.
• Massage therapy combined with education and counseling for stress management.
• Alternative remedies such as acupuncture, biofeedback or techniques to help encourage relaxation.

If the TMJ disorder is a result of arthritis or other disease, effective migraine relief will need to include treating the underlying condition causing the TMJ, as well as providing pain relief through over-the-counter medications and NSAIDs. BOTOX or corticosteroid injections are also an option for pain relief, and to prevent the cramping of muscles surrounding the joint.

The most complex TMJ disorders occur when the joint is physically damaged. These could require arthroscopy or arthrocentesis, which are procedures designed to examine or irrigate the joint and “clean out” debris.

For patients suffering from both a TMJ disorder and migraine attacks, there’s always the risk that one has nothing to do with the other. Your migraine doctor will have a good chance of determining whether the two are connected or not, however, and if so, treating the TMJ problem might well help to reduce your migraine frequency.