The TMJ and Headaches
Headaches can be relatively common and for some people they have almost become “normal”. But there’s nothing normal about having headaches on a regular basis. Figuring out the source of your headache will dictate what can be done to reduce the intensity and frequency of pain, or hopefully eliminate them altogether.
Unfortunately, sometimes we can only track down the causes of headaches through a process of elimination. If you are being treated for headaches but you aren’t experiencing results, it could be that the true cause has not yet been identified. This is possible with with migraine headaches diagnosis. It has been established that people with TMD (dysfunction of the TMJ) are more likely to experience migraines, and having TMD may increase your risk of migraines by almost 60%.
Headaches could mean a problem in the jaw
Headaches stemming from dysfunction in the jaw are often one of the last causes people consider as the potential source and delay treatment.
The temporomandibular (TMJ) joints are located on either side of your head, just in front of your ears. These joints are the connection between your mandible (jawbone) and your temporal bone (skull). The TMJ is a sliding hinge joint that can rotate, move forward, backward and side-to-side.
The TMJ is a small but complex joint, containing a disc with a surrounding capsule. The disc stabilizes the joint, with surrounding muscles and ligaments keeping the joint in place and aiding in its motion. The jaw allows complex movements for frequent motions like chewing, swallowing, talking, and yawning.
What is TMD?
TMD stands for temporomandibular joint disorder and refers to dysfunction of the TMJ. Many people use the terms TMJ and TMD interchangeably. TMD occurs when the muscles and ligaments around your jaw joints become swollen or irritated. This can cause pain, headaches, tinnitus (ringing in the ears) and have a serious impact on your daily life. TMD can be due to a combination of factors, which include trauma to the jaw, head or neck, stress, poor posture, and arthritis. The TMJ is so closely related to our neck that indirect trauma to the neck (like whiplash or a fall), and even poor posture, can also cause TMD.
TMD is most common in people between 20-40 years of age and more common in women than in men. Some of the most common symptoms of TMD include:
- Jaw pain
- Pain in the neck and/or shoulders
- Difficulty opening your mouth wide
- Locking, clicking, popping, or grating sounds in the jaw with opening and closing
- Difficulty chewing
- Tinnitus, or ringing in your ears.
- Changes in the way your teeth fit together
- Swelling on the side of your face
- Tooth pain
Sometimes the associated headaches can be a direct result of TMD, or they can be secondary. The typical headache that occurs with TMD is a tight, dull aching headache. It is most commonly on the side where the TMD is worse but can be on both. There is also tenderness of the jaw and nearby muscles with jaw movement aggravating the symptoms while jaw relaxation can alleviate them.
Headaches can occur with TMD as swelling and inflammation in the TMJ travels to other muscles, ligaments, and tissues around the jaw. As it spreads, muscles become tight and inflamed causing spasms. This can result in headaches around the skull, face, and neck. Sometimes, headaches occur in TMD because of asymmetry in the jaw’s alignment. This creates joint and muscular stress that can cause tension headaches as well.
The Pencil Test
Here’s a quick test you can perform at home to suggest that TMD could be contributing to your headaches:
Next time you have a headache, gently hold a pencil between your teeth. If it changes the pain you’re feeling–either lessening it or increasing it–then it’s likely that TMJ is contributing to your headaches.
Putting it altogether
Our musculoskeletal (MSK) system is a complex biomechanical chain, and like almost any other joint in the body, several other structures influence the function of the TMJ. With TMD, the muscles of the jaw become too tight or out of balance causing poor mechanics, which can lead to pain and dysfunction. This dysfunction usually stems from dental issues or MSK problems like poor posture and/or trauma.
For a large portion of TMD headache sufferers, pain and clicking in the jaw is affected and influenced by the position of the head, neck, and upper body. Muscle tension and clicking in the TMJ mean there is likely dysfunction in your neck, shoulders, upper back, and even possibly your lower back. Chronic neck and thoracic misalignments, like those seen with poor posture, may feed a TMJ problem.
The jaw is an integral component of the postural system. The body functions at its best when all of the joints, bones, and muscles are properly aligned and when there is little to no tension on the nervous system. If you spend your day slouching in your office chair over a computer, you likely have less than ideal posture.
Neck pain and forward head posture are usually preceded by rounded shoulders with stiffness and tension in the upper back (thoracic spine). This hunched posture puts a lot of strain on the head and neck. When the upper back rounds over as your head and shoulders translate forward, the normal curvature in your neck is lost. The head is pulled forward and neck muscles get tight, including muscles surrounding the jaw and side of the face. This increased strain on your neck and head can put the jaw at a mechanical disadvantage, which in turn can lead to TMJ problems and headaches. Poor posture is one of the leading causes of TMD. The good news is that a workstation adjustment, frequent breaks, appropriate exercises/stretches, and regular chiropractic care can improve your posture and alleviate your TMD and associated headaches.
Your Chiropractor and Physiotherapist Can Help
Your health care provider will first assess the cause and source of your jaw pain with a comprehensive history and examination. Did an injury occur? Are you stressed, are you clenching your teeth? Is there degeneration in the joint? A complete evaluation of your posture, jaw movements, spine, and MSK system will be performed. This will provide the practitioner with important information. The TMJ is a complex joint affected by many surrounding tissues. Most TMJ conditions respond well to conservative care. Advice and recommendation regarding postural changes may be made along with home care exercises.
If you think your headaches could be a result of TMD, talk to your dentist, chiropractor, and/or physiotherapist. At CURAVITA, our team of chiropractors, physiotherapists, and registered massage therapists operate under a collaborative care model, providing custom, natural care that takes into account the unique needs of each individual. Dedicated to MSK health and wellness, we are committed to providing our clients with the highest quality holistic care and personalized experience.
If you think you have TMD and are not sure where to start, call the CURAVITA Health Group today to book a comprehensive assessment. Our model of patient-centred care in a collaborative multi-disciplinary environment will ensure you get the right care, at the right time and in the right place.