How Are Migraines Associated With Jaw Pain?

Can problems with your jaw cause a migraine?

The short answer is: Yes. Migraines and migraine-like headaches can indeed be caused by problems with the jaw, even though you feel pain at the top or side of your head. You may, of course, also have pain in your jaw and/or your ear.

What is the temporomandibular joint?

You have one temporomandibular joint (TMJ) on each side of your head. This joint moves your jaw and allows you to open the mouth. It is further up than most people think it is, right in front of your ears, and you can feel them if you place a finger in front of your ears and then open your mouth.

Like all joints, your temporomandibular joint can develop some problems and issues.

What causes a TMJ headache?

A TMJ headache can be caused by several conditions that impact, primarily, the temporomandibular joint. These can range from tooth grinding to joint hypermobility. Overall, TMJ headache is a pain that radiates from the jaw to other parts of the head.

It can be very hard to distinguish a TMJ headache from other headaches. In some cases, migraines may cause jaw pain by radiating down into the jaw, usually only on one side.

Signs that your TMJ is causing your headaches

So, how can you tell whether your temporomandibular joint is causing a headache? Here are some signs and indicators.

Pain after jaw activity

TMJ is possibly causing your headache if you're experiencing pain after jaw activity, especially after eating crunchy or chewy foods. This kind of pain would be experienced regardless of the ingredients in the food, unlike food reaction headaches, and is generally a faster reaction.

Clenching teeth before, during, or after headaches

If the headache happens after you clench or grind your teeth or realize your jaw is tight and clenched during the headache, it can be a sign. It can also indicate that the headache is causing joint pain.

Ineffective conventional headache care

Regular medication may not always work, and migraine medication, generally designed based on the assumption that your headache is vascular, may not work. If you have migraine symptoms and migraine meds don't work, it's worth having your TMJ looked at.

"Pencil test"

If you suspect having a TMJ-related headache, open your jaw and hold a pencil between your teeth. Do not bite down or clench. Just hold. If your headache becomes noticeably better or worse, your TMJ is likely involved.

Other TMJ symptoms

These include clicking or popping sounds when you move your jaw, jaw stiffness, ringing in the ears, or a change in your bite (the way your teeth fit together).

If you have these signs, you should talk to your dentist about having your TMJ looked at. Dentists deal with oral health and are the best qualified to treat TMJ problems.

Treatment

If a TMJ issue causes your headaches, it needs to be treated. Many disorders of this joint are temporary and can be treated with conservative measures.

Here are some treatments for TMD:

Lifestyle changes

In many cases, temporary lifestyle changes are all you need to resolve a TMD, meaning:

• Eat soft foods

• Apply heat or cold to the face

• Perform stretching exercises for the jaw muscles

• Use over-the-counter medications

• Reduce habits such as jaw clenching, nail-biting, or gum chewing where therapy may be required

Your dentist or doctor may also recommend physical therapy, meditation and relaxation techniques, and behavioral health approaches. Biofeedback can work well for some people with TMJ problems, especially if they are caused by clenching your jaws. 

In many cases, people don't know they are clenching their jaw, and biofeedback techniques can make them aware of this and help them unlearn the habit with the help of a therapist. Being referred to therapy does not mean your problems are "all in your head," but it is a real way to improve your condition.

Doctor-prescribed treatments

Your doctor or dentist may prescribe or recommend medication. Most commonly, this includes over-the-counter NSAIDs to reduce pain and headache frequency.

You may be prescribed anti-anxiety medication or antidepressants if your symptoms are caused by mental disorders or stress. Again, it does not mean you made it up, and you should not consider it a bad thing if you need psychiatric drugs. In some cases, antiseizure medications might be used to prevent spasms in your jaw muscles.

If pain is severe, you may be prescribed a course of opioid medication. Opioids can lead to addiction and should not be used as a long-term solution.

Some dentists prescribe oral appliances to stabilize your joint. These should not be used to induce permanent changes in your bite but rather for short-term pain relief and improvement of jaw function. Splints are also sometimes used to prevent tooth grinding and similar habits.

Surgical treatments

Surgery to fix TMJ problems is rare. When it does occur, it is typically relatively non-invasive. Two procedures are used:

Arthrocentesis

A needle is used to push liquid into the TMJ, flushing out adhesions and substances which cause inflammation. Unfortunately, the effects of arthrocentesis do not last long.

Arthroscopy

A similar technique uses an instrument with a camera to remove adhesions. This can also reposition the joint's disc. This generally has a moderate result.

Open surgery is resorted to only as a last resort if there are severe symptoms after trying other treatments or if there is extreme damage to the joint. Few studies have been done on open surgery for TMDs.

When to visit a doctor

If you suspect TMJ contributes to your migraines or other headaches, you should get evaluated by a dentist. Dentists typically handle TMJ-related problems, although you should also talk to your primary care physician.

While most TMJ issues can be resolved through conservative treatments, getting the advice of a dentist can help you know how to handle things moving forward. If you need surgical treatments, these will typically happen at a dental hospital.

The lowdown

In some cases, migraine headaches can be directly associated with jaw pain, whether by the migraine radiating into the jaw or, more commonly, by issues with your TMJ.

If you have migraine-style headaches that don't respond to other treatments and are also experiencing other TMJ-related symptoms, you should go to your dentist to evaluate your TMJ.