Headaches & Jaw Pain
There are over 150 types of headaches. While the pain is always in the head, the presentation varies between one headache and another. While headaches and jaw pain may not be 100% related, they are commonly seen in TMJ patients. In other words, your headaches may not be related to your jaw pain and vice versa. But if you have TMJ, chances are you suffer from both. And since headaches and jaw pain are independent of each other, treating one doesn’t mean the other will resolve spontaneously. The only reason headaches go away or improve when treating jaw pain is that they are secondary to jaw pain. Here we will focus on a group of headaches that are collectively referred to as “primary headache.” Their implications to TMJ patients will also be reviewed.
Migraine Headaches
Migraines roughly affect 15% of the population worldwide. And they are on the top 10 list of disabling disorders. They seem to have a genetic component as they run in families. Migraine sufferers have it the worst when it comes to headaches and their impact on their quality of life. Migraines are headaches that make you want to find a dark, quiet place to go and lay down. These headaches are so painful and debilitating that they have become a common household term. Over the years medicine has discovered a connection with neural (nervous system) and vascular (blood flow) components to migraine headaches. The triggers for migraines are not known, however, the symptoms of migraines are quite unique.
Migraine headaches are confined to one side of the head. They can last anywhere from 2 hours up to 3 days. They have a pulsating, pounding quality (i.e. as your heart beats or pulsates, your headache pounds). As expected, physical activity such as climbing stairs makes it worse. Nausea is often present but vomiting might not be. These patients also report hypersensitivity to light and sound. About one third of migraines are preceded by “auras” which are different kinds of visual or tactile sensations. Migraines are seen more in women than men (3 to 1 ratio). The age group when this condition most often starts is the 30s.
Migraines are the number one headache type seen in TMJ patients. There seems to be a two way connection between these groups of patients. Meaning, TMJ patients are more likely to develop migraines and migraine sufferers have a higher risk of TMD.
Treatment for migraine patients usually involves a combination of pain medications and lifestyle changes. In dealing with migraines it is important to understand that treatment is aimed at the management of the symptoms.
Cluster Headaches
Cluster headaches are like clockwork. They start suddenly at about the same time every day. They also seem to have a seasonal (spring, autumn) pattern. Not unlike migraines, cluster headaches don’t seem to have any triggers. However, they are at times misdiagnosed as a migraine because of their one-sided location. There is a strong correlation between sleep disordered breathing (SDB) and cluster headaches. This is especially important because treating the SDB will help resolve the headaches as well.
Patients rate the pain as severe and describe it as having a hot stick poke thru their head or eye socket. There is usually tearing and drooping of the eyelid on the same side. They occur every day, several times a day. The attacks can last anywhere from 15 minutes to 2 hours. The majority of the headaches occur at night time, typically 1-2 hours after falling asleep. Due to the severity of the pain, these headaches affect the patient’s quality of life and can lead to depression, agitation and a number of other behavioral changes.
Risk factors for Cluster headaches are gender (males usually), age (mid 20’s), smoking, and genetics. Some patients on Nitroglycerin report experiencing Cluster headaches as well.
Treatment for these headaches are mostly medicine based. These are broken into 2 broad categories. One is for stopping a headache that is already started (abortive) and the other is for prevention of a anticipated headaches (prophylactic). Follow this link to learn more about cluster headaches from WebMD.
Sinus Headaches
Sinuses refer to air-filled pockets (or voids) located within the skull. The surrounding bony walls of the sinuses are lined by a thin membrane. There are multiple sinuses and they are located in particular areas (i.e. behind the forehead, cheekbones, and the ridge of the nose.) The purpose of the sinuses (we think) is to help with the drainage of excess fluid from the nasal and upper airway regions. Sinuses can become inflamed because of sickness, infections, allergies, or injuries. As the sinuses become inflamed, their drainage system doesn’t work as well. This leads to a build-up of fluids and an increase in pressure in these regions. As the pressure builds up, it can lead to pain.
Sinus headaches cause deep constant pain in the cheekbones, forehead, or the bridge of your nose. The number of locations involved and the severity of the pain depend on the level of inflammation. The pain is intensified when the head is moved suddenly or when the patient strains. Other symptoms are usually present: a runny nose, difficulty breathing thru the nose, swelling of the face, toothache in the upper jaw, change in bite, fullness feeling of the ears, and fever.
Treatment is aimed at reducing inflammation to aid in clearing up excess fluids. Also, the underlying cause needs to be determined so necessary precautions and/or treatments may be undertaken. Home remedies include the use of a humidifier, nasal saltwater spray, and drinking more liquids. Antihistamines (decongestants) and antibiotics may be necessary to alleviate the symptoms but can only be safely used for a short period of time (3 days or less) due to their side effects. An ear, nose, and throat (ENT) specialist should be consulted in determining the source of the sinusitis.
To learn more about Sinus headaches, visit this page on WebMD for headaches.
Tension Headaches
Tension headaches are the most common type of headache affecting over 120 million people in the United States alone. These headaches are sometimes referred to as “stress” headaches because of their association with the person being stressed. These headaches are muscle based, meaning the action of muscles increases the pressure on the skull, therefore, causing a headache.
Tension headaches cause a mild to moderate dull pain around the forehead, neck, shoulders, and the back of the head. Patients report it’s like having a clamp or strap tightening around the head and squeezing the skull. Other common symptoms are mild to moderate pressure around the forehead, and sides of the head and neck. The key difference between tension headaches and migraines besides the pain level are that they affect both sides of the head and are not affected by heart rate or exercising. Patients report feeling tired and having trouble focusing and sleeping. Other symptoms include irritability, muscle aches, and jaw pain. The pain may start in one area (e.g. back of the head or the jaw) and then spread to other parts (e.g. sides of the head). Tension headaches and jaw pain are commonly seen in TMJ patients.
Treatment is aimed at reducing muscle tension in the head and neck region. Sometimes a poor posture of other structural issues like a curve in the spine may be contributing to the over-activity of the muscles. Some patients have clenching or grinding habits which may be the primary reason for the headaches or a secondary muscle group involved as the tightness spreads. Specific TMJ mouth guards can help prevent and reduce the over-activity of the muscle groups involved in moving the jaw. Cognitive behavioral therapy seems to be very promising.
Follow this link to WebMD to learn more about Tension headaches.
If you’re tired of your tension headaches you are not alone. Contact us immediately so we can schedule you for your consultation and to start getting you healthy and headache-free.