The first step in getting the right treatment for your condition is getting an accurate diagnosis. But if you have headaches and/or TMJ, you are unlikely to get that, according to an article recently published in the Journal of Oral Rehabilitation. Researchers looked at the diagnostic and clinical criteria for headaches and concluded that there was too much overlap between the two conditions, which may lead to diagnostic confusion and potential problems in treatment.
Similar Pathophysiology and Presentation
Researchers started out trying to find out more about the connections between headaches and TMJ (which they describe as “Myofascial TMD”). However, when they began to delve into the conditions, they found that it wasn’t just that the conditions were related, they had so much overlap it was hard to distinguish between them.
They talked about core mechanisms that were shared by the two conditions: sensitization, impairment of pain pathways, and referred pain.
Sensitization is one of the controversial causes of TMJ and other chronic pain conditions. In this explanation, people with TMJ experience pain not because they have dysfunction but because nerves begin experiencing normal sensations as pain. This sensitization may occur in the brain (called central sensitization) or at the point of pain (called peripheral sensitization).
A related cause is impairment of pain pathways. In this potential cause of TMJ or headaches, chronic pain occurs because the body loses the ability to reduce pain signals coming from minor chronic aches. Thus, while many of us will wake up in the morning and feel a little sore in our jaw or a slight headache, people with this condition will experience an excruciating level of pain, even though the cause is similar, such as minor stress in the jaw or slight dehydration.
Another mechanism that ties these two conditions together is referred pain. In referred pain, we experience pain in one place even though the cause of that pain is in another place. For example, this is why people with a heart attack might experience pain in their arm in addition to or instead of pain in the chest.
With these mechanisms muddying the water between TMJ and headaches, researchers wonder whether it’s likely that most people diagnosed with one condition actually have the other–or both.
Getting Accurate Diagnosis and Treatment
Because no treatment can be truly effective without an accurate diagnosis, researchers recommend that doctors should form a diagnostic team to address TMJ. The team should include several TMJ specialists (hopefully including a TMJ dentist) and a neurologist with a focus on headaches. While the team assembles for diagnosis, researchers recommended that once diagnosis is complete, treatment should be referred to the appropriate expert.
This is in slight disagreement with the team approach to TMJ treatment that some research seems to recommend.
However, it’s clear: if you’ve been diagnosed with TMJ or with headache, you can’t just accept that the diagnosis is accurate. Instead, it’s important to seek a second opinion from someone who is experienced in treating both conditions. And potentially accept that the overlap and intersection between the two conditions is real and might require simultaneous treatment.
If you’ve been diagnosed with a headache but aren’t getting good results with your headache treatments, you may have TMJ. To learn whether TMJ is causing your headaches in the Orlando area, please call (407) 834-6446 today for an appointment with TMJ dentist Dr. Michael L. Weinstock.