Neurologists and dentists are specialists who can help diagnose and treat TMJ and migraine symptoms.
If you have frequent migraine headaches, you might be surprised to learn that temporomandibular joint (TMJ) disorders and migraine pain are connected.
The TMJ connects your head and the side of your jaw. Temporomandibular disorders (TMD) — or TMJ disorders — refer to disorders that cause joint issues and pain in the jaw, head, neck, and surrounding areas.
The pain from TMD disorders often contributes to headaches, including migraines, and can trigger them. There are three classifications for TMD disorders, with one classification dedicated entirely to headaches associated with TMD. While most TMDs will go away over time, if they don’t, the issue can become chronic (long-lasting), resulting in chronic headaches and TMD pain.
The temporomandibular joint allows you to chew and talk. You can feel your TMJs (one on each side of your head) when you put your hands behind your ears and open your mouth.
There are three classifications of TMD disorders.
People with TMJ disorders experience various symptoms that affect the muscles, jaw, and nerves. These may include:
These symptoms may occur on both sides of the face and neck or only on one side. They may make it hard to speak or eat.
The exact cause of TMJ disorders is unknown, but some potential causes may include:
Many of the triggers of migraine headaches, such as stress and hormonal changes, can also trigger TMJ symptoms. TMJ symptoms may occur at the same time as a tension headache (a common type of headache, often associated with muscle tightness) or migraine. Sometimes, one can trigger the other or make the pain worse.
Migraines are often associated with other symptoms, such as auras.
Along with classic migraine symptoms such as one-sided throbbing head pain, a TMJ migraine or headache may feel like a shooting, traveling pain. It might also get worse when you try to chew or talk.
Headache pain related to TMJ disorders might also involve more parts of your body — such as your shoulders or ears — than other kinds of migraine headaches.
For people with TMJ-associated tension-type headaches, the temporalis muscles are responsible for this band of tightness around the head (which the person associates with a headache). These fan-shaped muscles run along the temples. The trigger points for the pain are easily identified around this area.
Because TMJ disorders and migraines have a range of potential causes, you may need to see more than one specialist for diagnosis and treatment. Talk to your primary healthcare provider (PCP) or dentist about a referral for TMJ symptoms and/or migraines.
Here are some of the specialists who might be able to help you with TMJ headaches.
With a physical exam, imaging tests, and an assessment of your medical history, a neurologist can diagnose your migraines accurately. They can also help rule out any other possible medical conditions that could be causing your TMD symptoms and/or headaches.
A neurologist can also help you pinpoint and avoid possible triggers, in addition to prescribing medication and suggesting exercises and behavioral changes.
Some clinicians believe that bruxism (teeth clenching) and misalignment of the teeth and jaw may contribute to TMD.
Using X-rays and other diagnostic testing tools, a dentist can evaluate your jaw and teeth for signs of any injury or disc displacement. To treat your symptoms, a dentist may suggest jaw exercises, medications, a night plate or bite guard, or orthodontic treatment. In severe cases, they may also refer you to an oral surgeon.
Some research suggests that regular chiropractic care can help with TMJ headaches and pain. A chiropractor can perform manual adjustments to release tension in your jaw, neck, and shoulders.
A chiropractor is a complementary medicine professional who focuses on the spine and spinal manipulation to address health concerns, especially pain in the back and neck.
To treat TMJ disorder, a physical therapist will begin with an assessment. They will review your medical history and symptoms, physically examine your jaw, and evaluate your posture and the range of motion in your jaw, neck, or both.
Based on their evaluation, a physical therapist can treat your symptoms with methods such as heat or ice application, massage, postural instruction, TMJ mobilizations, and exercises.
Some research suggests that therapeutic ultrasound, when used by a physical therapist in conjunction with home exercises, can lessen pain and improve mobility in people with TMD.
Many people with TMD have co-occurring mental health disorders, such as anxiety and depression. Because stress is a common trigger for TMJ headaches, a psychiatrist or psychologist may be able to help treat the underlying causes of your symptoms.
Some clinicians might prescribe anti-anxiety medications, antidepressants, or other drugs that can help with co-occurring mental health conditions.
Others may assess your patterns of tension with biofeedback, a technique that uses sensors to monitor your heart rate, breathing, and muscle contractions. This can help you learn to stop tensing the muscles in your jaw.
Many TMJ headaches and other TMD symptoms can be effectively managed with home care and alternative methods. However, medical intervention is often necessary to relieve pain.
There are several ways to get rid of a TMJ migraine, such as stress management, medications, physical therapy, and additional treatment options.
Because stress is a common trigger for both TMD and migraines, it’s important to practice self-care with ongoing stress management techniques. These might include:
Alongside stress management, cognitive behavioral therapy (CBT) and biofeedback devices may help with TMJ pain and headaches.
For example, a biofeedback device can let you know when you’ve tightened or clenched your jaw so you can learn to relax it.
Making some simple changes in your everyday behavior and habits can help to ease TMJ headache symptoms. Some of these minor changes can include:
There are also some habits you should avoid to prevent TMJ headaches, including:
Your doctor may prescribe or recommend certain medications to alleviate pain, inflammation, muscle spasms, and other symptoms of TMJ migraines.
Over-the-counter (OTC) medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen), can also help with temporary pain relief.
Botox (botulinum toxin type A) is injected into the muscles in small amounts to make them relax.
Botox has been approved by the Food and Drug Administration (FDA) for the treatment of chronic migraines (defined as headaches on 15 or more days per month). It’s not FDA-approved for the treatment of TMD.
Some essential oils might be applied topically (on the skin) to help with TMJ migraine pain management. Peppermint oil, for example, has potential pain-relieving properties. Frankincense oil may reduce inflammation, while lavender oil may help with muscle tension.
It’s important that you dilute essential oils in a carrier oil (such as coconut oil) before applying them to your skin or they may cause irritation. Discuss their use with your dentist or healthcare provider.
There is limited evidence for the overall effectiveness of essential oils, but they may provide temporary pain relief.
A physical therapist may perform manual therapy, in which they use their hands to stretch the soft tissues and muscles around the TMJ joint. This may help to relieve some pain.
A physical therapist may also teach you exercises you can do at home to improve your jaw’s function and relieve pain.
Your dentist may recommend an intraoral device, also known as a nightguard, bruxism (teeth grinding) splint, and other names. These devices fit over your teeth and are thought to help reduce teeth grinding and clenching.
However, there isn’t great evidence that these tools are useful.
There are several surgical interventions for TMD disorders. However, there are little data to back up invasive procedures. Additionally, many procedures could worsen the issue instead of fixing it.
Consider asking your healthcare provider about less invasive options to try first or seek a second opinion if surgical interventions are suggested first.
