TMJ “Temporomandibular Joint” Headaches

TMJ Symptoms: Tension Headache and Jaw Pain

Temporomandibular joint disorder, or TMD, causes jaw pain that may be mistaken for recurring tension headaches according to a recent study of TMJ symptoms. Jaw pain due to TMJ symptoms will not respond to tension headache treatment. Instead, such pain must be treated in the same way traditional TMJ symptoms.

The Temporomandibular Joint:

The TMJ, or temporomandibular joint, is the joint that connects the lower jaw to the skull. Actually, two temporomandibular joints are located just in front of the ears, one on each side of the jaw. The TMJ joint allows you to move your lower jaw so you can talk and chew. Disorders of this joint may be referred to simply as TMJ or as TMD (temporomandibular joint disorder).

In healthy people, the lower jaw that forms the TMJ joint are rounded and called condyles. When we open and close our mouths, the condyles glide along the TMJ joint sockets. To prevent wear and tear, a small disc acts as a shock absorber between the condyles and the socket.

TMJ Symptoms:

Damage to the temporomandibular joint, either through trauma or daily wear and tear, can result in TMJ symptoms, including jaw pain and tension headaches. Additional TMJ symptoms can include:

• clicking sounds when moving the jaw
• difficulty chewing or biting
• ear ache
• facial pain
• fibromyalgia
• “grating” feeling while chewing
• less range when closing / opening the mouth
• tender jaw

Between five to ten percent of the American population suffers from TMJ symptoms that require some form of treatment.

TMJ Symptoms and Fibromyalgia:The jaw pain associated with TMJ symptoms is similar to the joint pain associated with fibromyalgia, a condition often seen in women with sudden hormone changes (including menopause). Because TMJ and fibromyalgia often occur simultaneously in woman, doctors think a connection exists between the two.

Other conditions often seen with jaw pain and TMJ symptoms include:

• atypical facial pain
• cardiovascular diseases
• chronic fatigue syndrome
• equilibrium (balancing) disorder
• irritable bowel syndrome
• migraine headache
• multiple chemical sensitivity
• smell and taste disorders
• speech and hearing disorders
• trigeminal neuralgia (a painful facial nerve condition).

Tension Headache and TMJ

A recent study conducted by the University of Buffalo’s School of Dental Medicine researched the possibility that TMJ symptoms were being mistaken for tension headache symptoms. The study was led by Richard Ohrbach, an associate professor in the Department of Oral Diagnostic Sciences.

The study’s intent was to examine the difference between TMJ joint pain versus tension headaches in clinical examinations. However, the focus of the study wasn’t limited to tension headaches. It also examined migraines, mixed migraines and sub-clinical headaches.

All 583 participants in the study displayed TMJ symptoms. Because women are nearly twice as likely as men to display TMJ symptoms, women comprised 82.3 percent of the participants.

Ohrbach and his research team discovered that, in 82 percent of cases, they could reproduce tension headache symptoms by performing standard clinical examinations of the temporomandibular joint. Consequently, the process of diagnosing TMJ symptoms, as set forth by the Research Diagnostic Criteria for Temporomandibular Disorders, was compared to tension headache diagnosis process.

The study found that both patients and examining physicians may mistake tension headache caused by TMJ symptoms and jaw pain for classic tension headaches. Ohrbach notes that this is unfortunate, as “TMJ is very treatable, but if a jaw disorder is ignored, then treatment for the headache may not address all of the factors contributing to the headache.” Although TMJ symptoms were present in all participants, 152 were diagnosed with tension headaches, based on standard International Headache Society guidelines for tension headache diagnosis.

As a Doctor of Chiropractic I would like to note that Chiropractors do have some training in diagnosing and adjusting the Temporomandibular Joint, but I would always caution any patient to thoroughly interview and ask how much experience your Chiropractor may have with this disease. 

Resources:
Medical News Today. (16 May 2006). Study suggests tension headache may actually be TMJD.