Headaches need little introduction. From people aged five to people aged 80, headache disorders are one of the three most common neurological conditions. There are many common, well-known causes, such as stress, disrupted sleep patterns, certain foods and, famously, alcohol.
However, many may overlook the importance of the temporomandibular joint (TMJ) as a risk factor for headache disorders. Recent awareness has grown after Zoe Ball, a BBC Radio 2 broadcaster, stepped down because of chronic headaches relating to a temporomandibular disorder (TMD).
Headaches occur when inflammatory substances are released around the nerves and blood vessels of the head, causing that splitting sensation. Headache disorders affect approximately 40% of people, whereas TMD symptoms, such as jaw pain and stiffness, can be experienced by 40-70% of the general population.
The bidirectional connection between TMD and headaches creates a painful cycle: TMD may be the original cause of a headache and may worsen existing ones, whereas a headache may trigger or aggravate TMD.
This comorbidity makes the relationship hard to pinpoint – headaches originating from TMD can be caused by pain in the temporalis muscle, the masticatory muscles or in the TMJ. Another part of the connection between the two can be attributed to the trigeminal pathway, where nerve activation is thought to play a major role in headache and facial pain disorders.
Whilst more research is needed to define the link, there is evidence that it does exist: 82.8% of painful TMD patients reported headaches and 59.3% of headache patients had TMD.
One of the most prevalent subtypes of a primary headache is a migraine, often triggered by nausea, increased sensitivity, external stimuli, and TMD. Able to last anywhere between 4-72 hours, with 71% feeling that migraines affect their mental health and 60% finding that their relationships are impacted by them.
43 million days of work are lost each year due to migraines, and 52.7% of migraine sufferers have disrupted sleep patterns. Between sick leave and insufficient sleep, migraines can impact workplace productivity, leading to higher levels of stress that can exacerbate the migraines further.
As awareness of the relationship between TMD and headaches grows, patient education is essential to eliminate concerns and reduce symptoms. At-risk patients, such as women aged 20-50 or patients who are in stressful jobs, should be encouraged to rest the masticatory system. This can reduce the risk of headaches or facial pain.
To alleviate pain, applying heat or ice to sensitive areas is recommended. For a lasting change, physical therapy is crucial for chronic TMD patients. Motion exercises decrease pain and improve function, assisting patients in their journey to restore quality of life.
A great device for at-home therapy is the OraStretch® Press Jaw Rehab System. A simple yet reliable user-operated system, it stretches the mouth open to mobilise the jaw. As well as enhancing function, the system treats pain and swelling, limiting the prevalence of headaches. Patients can follow the recommended daily exercises to rehabilitate their TMJ, improving quality of life and containing regular migraines to a one-off occurrence.
For more details about Total TMJ and the products available, please email info@totaltmj.co.uk
i World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
ii Glynn, P. (2024). Zoe Ball left with ‘awful headaches’ by jaw condition. BBC News. [online] 28 Nov. Available at: https://www.bbc.co.uk/news/articles/c9wr95njpzpo.
iii World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
iv World Health Organization: WHO (2024). Headache disorders. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/headache-disorders.
v Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
vi Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
vii Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
viii Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
ix Pankaew Yakkaphan, Elias, L.-A., Priya Thimma Ravindranath and Renton, T. (2024). Is painful temporomandibular disorder a real headache for many patients? British dental journal, 236(6), pp.475–482. doi:https://doi.org/10.1038/s41415-024-7178-1.
x The Migraine Trust (2021). Impact of migraine. [online] The Migraine Trust. Available at: https://migrainetrust.org/understand-migraine/impact-of-migraine/.
xi The Migraine Trust (2021). Impact of migraine. [online] The Migraine Trust. Available at: https://migrainetrust.org/understand-migraine/impact-of-migraine/.
xii Awaki, E., Takao Takeshima, Yasuhiko Matsumori, Hirata, K., Miyazaki, N., Takemura, R., Satoshi Osaga, Yoshinori Tanizawa and Komori, M. (2024). Impact of Migraine on Daily Life: Results of the Observational survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study. Neurology and Therapy. doi:https://doi.org/10.1007/s40120-023-00569-3.
xiii Yakkaphan, P., Smith, J.G., Chana, P., Renton, T. and Lambru, G. (2022). Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. Cephalalgia Reports, 5, p.251581632210973. doi:https://doi.org/10.1177/25158163221097352.
xiv Oral Health Foundation. (n.d.). Jaw problems and headaches. [online] Available at: https://www.dentalhealth.org/jaw-problems-and-headaches.