TMJ Headaches and TMJ Migraine Headaches

TMJ Migraine Headache pain.

Does this sound like you?
You feel as if your head is about to split open, like someone has hammered a spike into your eye, your temples throb,you are nauseous,you have tooth pain, your neck and shoulders and back hurt, then it is more than likely you have TMJ.  
Whether your headache is a severe migraine headache or a tension headache and you have tried various treatments to no avail and no-one has suggested TMJ as a diagnosis it is because your practitioners you have been seeing have not been schooled in the relationship between head pain and TMJ.  In fact, there are many practitioners and specialists that are skeptical of the relationship between TMJ and head pain. The good news is that there are TMJ specialists out there who can diagnose your TMJ and recommend or provide the correct therapy for your TMJ disorder.
Now you may be someone who already knows they have a TMJ disorder and that your headaches are merely a symptom of that disorder or you have suffered from migraine headaches for some time and are now discovering that TMJ is the cause.  Whichever it is you can be sure there are treatments available for your headaches. But first, let us look at the different types of headaches and how to recognize them by their symptoms.

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Headaches types.

So you have TMJ and one of the symptoms is headache or migraine headache.  This type of headache is known as a secondary headache.
Secondary headaches are recognised as being caused by an underlying condition.  In this case, the underlying condition we are discussing is TMJ.

According to the Mayo Clinic there are three common headache types:
   Tension headache, which can last from twenty-five minutes to an entire week and manifests as dull pressure on both sides of the head and sometimes also the neck and may also include fatigue and a feeling of a rigid band circling the head with pressure and tightness.  Tension headaches can reoccur daily to very infrequent.

  Migraine headache, which can last from four to seventy-two hours and is moderate to severe throbbing pain and can be located  on one side or both side of the head. The frequency of recurring migraines varies greatly. Symptoms can include nausea,vomiting,sensitivity to light, smell and sound and pain will increase with physical activity.

   Cluster headache, which is sharp, severe pain that develops suddenly over a matter of minutes and is located on one side, often around the eye or behind the eye and can last anywhere from fifteen minutes to three hours. Included symptoms are runny nose, nasal congestion, teary eye on one side, red eye and feeling agitated. The frequency of this type can be one or more every day during "clusters".

Why do TMJ Headaches Happen?

TMJ Headaches are due to the involvement of the trigeminal nerve which is located on the side of the head is one of the most powerful and complex nerves in the human body. It innervates the jaw, teeth,eyes,tongue, palate lips, sinus and face so it it has a close association to the TMJ. Certain areas of the brain are also innervated and controlled by the trigeminal nerve.  In fact, it is estimated that the brain uses an astounding 40% of its energy figuring out the messages from the trigeminal nerve and sending messages back through the nerve. The trigeminal nerve is also linked to other nerves that control sensation and function of most other muscles in your thoat, neck and head; the vagus, facial and hypoglossal nerves.  A disturbance in any one of these four nerves will end up distrubing the other three.  Along with TMJ symptom of headaches it is not uncommon to experience issues like burning tongue, burning thoat, blurry vision, problem swallowing and difficulty breathing.

When is Your Headache NOT TMJ related?

While doctors are beginning to realize that most tension headaches are caused by TMJ it is still very important with any type of headache that you see your doctor for a diagnosis.  If a physical examination does not reveal the cause of your headaches then you should have a neurological examination to rule out critical conditions such as West Nile virus.

A sudden, severe headache can be due to brain tumor or cerebral aneurysm or meningitis or virus.  Please seek immediate medical attention!

Headaches are also a symptom of flu, fatigue, hypertension, eyestrain, fever, sinus problems and ear problems. So get a diagnosis so that you can eliminate receive the dangerous disorders and receive the proper treatment for your headache.

Home treatments for TMJ headaches.

As soon as you feel a TMJ headache coming on try these remedies.

Lie in a dark, quiet room that is free of any odors that can aggrevate your headache.

Lie on a cold pack placed at the back of your neck for 10 to 15 minutes.  A hot compress at the back of the neck will reduce muscle tension.   I have even tried both hot and cold simultaneously; cold to back of neck, heat to forehead, temples.  That is my preference.  You can switch it around if you prefer.

Try to relax your face and jaw by yawning.  If you pretend to yawn trust me you will eventually yawn for real.  It will reduce muscle tension.  Do your jaw or TMJ exercises.

Essential oils such as peppermint oil or lavender oil rubbed at the temples or on neck can help you to relax and breathe freely as sinus and breathing problems often happen at the same time as your headache.

If you feel up to it and you have someone you trust, try having them give you a massage.  Focus on neck, shoulders, back and temples.

In case you are dehydrated drink some water.

Practise relaxed breathing and do a systematic "tense and relax" routine on your body starting with your feet.  As you lie quietly tense up your feet and toes as much as you can for 4 seconds then let go the tensed muscles and relax the feet until you feel them comletely relax.  Work your way up your calves, thighs, hands, arms, abdomen, shoulders, neck and face doing the same "tense and relax"
procedure.  This is a great way to relieve yourself of stress at any time and it can be done to help you fall a sleep at night.

Drink a strong cup of coffee.  Caffeine can help to relieve headaches as it reduces blood vessel swelling and that is the reason it is an ingredient in some pain medications.

Take an over-the-counter medication.  Talk to your doctor about which is best for you and how often you can take the medication since prolonged use of analgesics can cause stomach problems and bleeding and even increase the risk of heart problems. Four such analgesics are Acetaminophen (Tylenol), Ibuprofen (Advil, Motrin), Aspirin, Naproxen(Aleve).

You can also read the list of possible home remedies to try on Tips for Treatment of TMJ.

Medical Treatments for TMJ Headaches.

Medications: - Your doctor can prescribe a medication that will work to either prevent a migraine or headache as it starts or prescribe a medicine to reduce the number or frequency of your headaches.
Triptans are a group of drugs used to prevent the onset of a migraine headache and they target seratonin. They include brand names such as Imitrex, Zomig ,Amerge, Maxalt, and Relpax.
If the triptans do not work for you then there are other drugs your doctor may prescribe such as Cafergot, D.H.E. 45 injection, Migranal Nasal Spray, Midrin, Compazine and Phenergan. 
If you suffer from severe migraine pain your doctor may prescribe a narcotic such as Vicoden or Tylenol with Codeine No. 3.

Botulinum Toxic (Botox)  is now being used to successfully relief headaches.

Physical Therapy
Acupuncture

IMS (Intramuscular Stimulation)

Mouth Splint or night guard or NTI.

Things You Can Do to Reduce TMJ Headaches.

Get plenty of sleep.
Stop smoking.
Eat healthy meals.
Drink plenty of water.  6 to 8 glasses of water per day.
Learn Yoga or relaxation techniques.
Avoid stressful situations.
Do regular jaw exercises.
Practice good posture.
Try a soft food diet.


Resource Links

American Headache Society

Academy of Neurology

International Headache Society

Migraine-Headache Resource Center

National Headache Foundation

National Institute of Neurological Disorders and Stroke

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TMJ AND IMS: My Success Story

TMJ and Me.


I am a TMJer. At 57 years of age I consider myself to be lucky. Why?

Because I haven't had severe or chronic TMJ problems and have been pain free relatively speaking for many years. I say "relatively speaking" because in hind sight I realize that frequent migraines, headaches, neck pain, shoulder pain and head and jaw pain came from my TMJ disorder.  My TMJ causes were mainly stress and poor posture so I consider myself lucky not to have any trauma  or degenerative joint or dislocation of the joint or arthritis of the TMJ joint.

A Little of my TMJ History

I never knew I had a TMJ problem until the early 70's when I was barely in my twenties and I began to have severe sharp pains in my right ear. My immediate thought was that I had an ear infection but the sharp pains would come and go. I had always known that my jaw didnt open and close evenly but it didn't give me any discomfort and so was just a fleeting thought that I had a mild physical oddity. As quickly as I noted it I forgot about it.

Then came the ear aches. Acute and for seemingly no reason. I felt well enough so how could I have an infection? After a few days of off again on again pain I visited my doctor. I was examined and checked for fever and he looked in my ears. Finding nothing the matter he referred me to an ENT (Ear, Nose and Throat) Specialist.

I don't recall his name but I do recall how quickly he arrived at a diagnosis. Of course he had my GP's report, so he put his fingers in my ears and asked me to open and close my mouth slowly. As I did this he said I had a dysfunctional something or other. He talked I listened but I guess I looked somewhat skeptical. He asked me to put my fingers in my ears and open and close my mouth as before. I felt that old uneven feeling as my chin performed an 'S' curve only this time it was fingers getting the full impact of my faulty jaw. For a brief instant I thought to myself .... Oh yeah I know I have that!....And then the realization that this was what was causing my ear aches was somewhat astounding. I was also very relieved that I didn't have an infection.

I bet you TMJer's out there are wishing right now that an infection was all you had; at least it could be cured with antibiotics. I understand completely.

It was then the doctor gave me a set of exercises to do and I still do them today. I am no expert but in the last little while I have watched videos and read up on TMJ exercises that appear to be as ineffective as they are ridiculous. Why, you ask? My reasoning ( and I am taking full writers license here) is that the jaw has about a force of 300 to 400 psi give or take. That's a lot of force and the exercises I have seen have you placing two fingers against your cheek and moving your jaw against them with pressure applied. I am sorry but that doesn't seem an effective exercise or a relative one to me. Not when you realize that the jaw can apply some incredible forces when clenching, chewing.

I have had success with the exercises given to me over thirty years ago by the ENT specialist and which I wrote about in detail on my first page" Treatments for TMJ".
Those exercises have proven valuable to me and I perform them any time I feel TMJ pain.

Major TMJ Flare-up
I cannot move my head


So it was just before Christmas and I was getting Christmas preparations underway for the visit from our daughter and our two grandchildren. As well as that, I was spending many long hours at my computer on projects that were causing me stress. So much so that I didn't notice how bad the pain was getting in my face, neck and shoulders. I admit to sitting badly in my chair. My posture is usually the first thing I forget when I am stressed.  Stress and bad posture are two major causes for TMJ jaw disorder.

With no time to spare I barreled ahead with my projects and Christmas chores. What a shock when I tried to get out of bed one morning and I could not lift my head off the pillow, there was so much pain. It wasn't just my neck that hurt, I had a pulsating pain on the right side of my head and the right side of my face felt bruised. Did I mention I was biting my nails quite a bit. Naughty me. When I finally managed to stand up by rolling over and dropping my feet on the floor I found I could not turn my head even an inch without awful pain.

IMS to the rescue.

IMS stands for Intramuscular Stimulation and I am fortunate to live in Victoria, B.C Canada and have qualified Therapists in clinics nearby.

Immediately, after one treatment I had nearly full range of motion moving my head to the right and just small amount to the left. During the week I continued to get better, the pain in my neck and shoulder decreased and then I could feel pain in my jaw and teeth I had not felt before because my neck was so bad. One week later I had my second treatment and a week after that I was almost back to normal. No jaw pain, just some soreness in my neck. I didn't need a third treatment.

I am so thankful I discovered IMS . It worked on my back when I was diagnosed with a spinal stenosis and it worked on my TMJ.


Read below the excerpt from Author Robin Shepherd of
The Institute for the Study and Treatment of Pain
IMS Practitioners in the United Kingdom

What is intramuscular stimulation (IMS)?

Intramuscular stimulation (IMS) is an effective treatment for chronic pain of neuropathic origin (see below). IMS was developed by Dr.Chan Gunn while he was a clinic physician at the Workers' Compensation Board of British Columbia. Dr.. Gunn, is currently a clinical professor and teaches IMS at the University of Washington's Multidisciplinary Pain Centre in Seattle and the University of British Columbia's Medical School. IMS is also taught and utilised at many centres around the world.

IMS is effective and has few side-effects; the technique is also unequalled for finding and diagnosing muscle shortening in deep muscles.

Although IMS uses implements adapted from traditional acupuncture, it is based on scientific, neurophysiological principles. The acupuncture needle used is very thin (much thinner than the hollow needle used to inject medicine or take blood samples). You may not even feel it penetrating the skin, and if your muscle is normal, the needle is painless.

However if your muscle is supersensitive and shortened, you'll feel a peculiar sensation - like a muscle cramp. This is a distinctive type of discomfort caused by the muscle grasping the needle. Patients soon learn to recognise and welcome this sensation. They call it a "good" or positive pain because it soon disappears and is followed by a wonderful feeling of relief and relaxation. The needle may still be in you, but because the muscle is no longer tight, you no longer feel it. What has happened is that the needling has caused your abnormal muscle shortening to intensify and then release. It is important that you experience this sensation in order to gain lasting relief.

Neuropathy - what happens when nerves start to go wrong...
Doctors usually have no difficulty in treating pain caused by injury (a fracture, for example) or inflammation (such as rheumatoid arthritis). They are perplexed however by pain that shows no sign of tissue damage or inflammation.

This type of pain, known as neuropathic pain, typically occurs when nerves malfunction following minor irritation. Nerves and nerve endings become extremely sensitive and cause innocent, harmless signals to be exaggerated and misinterpreted as painful ones.This characteristic is known medically as supersensitivity). The result is pain, even when extensive medical tests show there is "nothing wrong". Until recently, supersensitivity has received little attention in medical circles.

The effects of IMS
The effects of IMS are cumulative- needling stimulates a certain amount of healing, until eventually, the condition is healed and the pain disappears. Some patients treated with IMS have remained pain-free for over 20 years.

Frequency of treatments
Treatments are usually once a week (but can be spread out to two weeks) to allow time between treatments for the body to heal itself. The number of treatments you require will depend on several different factors such as the duration and extent of your condition, how much scar tissue ther is (this usually increases after surgery) and how quickly your body can heal. The rate of healing depends on the condition of your nerves(young people usually heal more quickly although his is not always the case). If the pain is of recent origin, one treatment may be all that is necessary. In published studies of patients with low back pain, the average number of treatments required was 8.2.

Treating neuropathic pain
Supersensitivity and muscle shortening cannot be operated on and "cut away". "Pain killers" and other analgesic pills only mask the pain. The goal of treatment is to release muscle shortening which presses on and irritates the nerve. Supersensitive areas can be desensitised and the persistent pull of shortened muscles released.

The shortened muscle syndrome
An important factor in neuropathic pain is muscle shortening, caused by muscle spasm and contractor. Muscle shortening produces pain by pulling on tendons, straining them as well as distressing the joints they move. Muscle shortening also increases wear and tear and contributes to degenerative changes such as tendonitis and osteoarthritis.

These conditions are customarily regarded as "local" conditions and may not receive the appropriate diagnosis or treatment.

IMS Practitioners

See a listing of IMS Practitioners at : http://www.istop.org/membersusa.html

TMJ and You
Dont Despair, Options are Here.

There are many TMJ treatment options for you to consider. Start with the conservative approaches and work your way through them. Give yourself lots of time to see if the treatment is working and be honest with yourself about the effort you are putting into following the treatment program.

Take care, TMJers. Wrap up with your gel packs and heat bags and find the treatment that works for you. Ask lots of questions and get several medical opinions before having any surgery.

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Dental Procedures for TMJ

TMJ and the Dentist Chair

Make the Pain Stop

The American Dental Association estimates there are as many as ten million Americans with TMJ disorders.

To the poor TMJer's who brave the Dentist office looking for relief you have my greatest admiration and my deepest sympathies.

When I was very young many moons ago, I lived and went to school in a small town in New Zealand.
On the grounds of most city schools was a small brick-built one or two-chair dental clinic. Young Dental Nurses employed by the Government fresh out of a rigid two-year course attended to the dental health of rosy-cheeked school children up to the age of thirteen.

I have such fond memories of those antiseptic smelling clinics, the nervous nurses and the cheery sound of the drill. Yep I am lying! The bloom went out of cheeks pretty fast I can tell you when I had to visit the Dental Nurse. As much as I didn't like the smell, sound or FEEL of that drill ( I am told it was powered by electricity but in a power outage it could be foot-operated!) I didn't know what I was in for until at the age of thirteen I had to go to the family dentist.

This guy was a close family friend. I figured my parents must have owed him a ton of money or run over his dog and having me in his chair was his chance at retribution. I think he used saline in the needles. His drill had these mammoth drill bits and he liked to run the drill really slowly.

I thought the juttering vibrations would cause me and the chair to crash through to the first floor. Hey, maybe that is where my headaches and TMJ started; from this heavy handed Dr of Misery. I feared this man and his evil equipment and on my visits to him I would deal with the pain by citing a poem over and over again in my head.

Well that was then and this is now. I love modern dentistry, sort of. Well it has improved tremendously with all the great new anesthetics and supersonic what-nots and I think the College of Dental Surgeons screen now for maniacal masochists. Yes, Dentistry has definitely come a long way.

So my TMJers what can it do for you?

Mouth Splint

Don't talk with your mouth full.

Dentists like splints because they are the most popular non-surgical means to treat TMJ pain in the jaw. The Occlusal splint is a removable dental appliance made from either hard acrylic resin or a soft resilient plastic. It is possible to buy a generic mouth slpint for your TMJ over the counter at some stores but it is alway wise to seek advise from a TMJ specialist first.

There are several distinct types of Occlusal splints.

Stabilization or flat plane splint. Designed to reduce teeth grinding and relax jaw muscles it fits over all the upper teeth.


Modified Hawley splint. This splint fits on the upper jaw and makes contact with only the six lower front teeth. Only worn at night it keeps the teeth from grinding and clenching.

NTI-tss (Nociceptive Trigeminal Tension Inhibition Suppression System. (Try saying that while you are wearing one.) It doesn't sound like it but it is small and fits on the front upper teeth and is designed to prevent tooth clenching and grinding. However, because it fits on only a few teeth, it places a great deal of stress on them and that can be harmful to those teeth. There is also a danger of this small device being swallowed if it comes off at night.

Repositioning splint. A more invasive form of splint treatment this device is used to move the lower jaw either forward or backward into a new position permanently.



Questions you should ask your Dentist about splints.

• Why are you recommending this type of splint to me?
• Are you recommending this splint to decrease my pain, reposition my bite or both?
• What are my other options?
• What happens if my pain gets worse while wearing the splint?
• What happens if I develop an open bite (teeth no longer touch)?
• What proof do you have that this splint will help?
• Do I wear the splint during the day, night, or both?
• How long do I have to wear the splint before I feel significant improvement?
• If the splint doesn't help, what's next ?
• Will follow-up treatments be required, how many and how much each visit cost?
• Will insurance cover the cost of the splint and the follow-up treatments?
• Must I sign a financial contract with you to begin treatment?

Dentists who treat TMJ disorders will administer X-rays and prescribe a splint. They may also have you get other treatments such as massage to help you get relief from TMJ and ease the wearing of a splint.

After the Splint what are the Options?

Since many splints can change the bite and the teeth-jaw relationship, it is advised that patients exercise caution when beginning treatment, and seek a second (or third) independent opinion before consenting to irreversible treatments like these.

Splints may only work for a short term period and may even change your bite. If a splint fails to work, your dentist may recommend options for re-alignment of your teeth.

If simple techniques fail, more invasive treatment can be considered.

This could be Orthodontics or veneers, crowns and bridges. Perhaps even reshaping (grinding) of the teeth.

• Please note that these treatments are IRREVERSIBLE (so they are permanent even if they do not work).

Surgery is considered a last resort by most TMJ experts.

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