More than 12 million people have temporomandibular joint disorders (TMDs), which involve dysfunction of a joint in your jaw called the temporomandibular joint (TMJ) and/or the muscles around it. Women and people between the ages of 20 and 50 are most likely to experience TMD, according to a study published in the British Dental Journal. A number of other conditions, including migraine, are associated with TMD.

In fact, migraine and TMD often occur together, so you’re not alone if you’ve noticed some jaw issues along with migraine headaches. Here’s what you need to know about the connection between TMJ dysfunction and migraine, including overlapping symptoms due to a shared trigeminal nerve pain pathway, jaw muscle tension, and heightened central nervous system responses (central sensitization). We’ll also look at possible treatment options and strategies.

What Are TMJ Disorders?

When one or both of your temporomandibular joints don’t work properly or cause you pain, you may be suffering from TMD. The temporomandibular joints are located on each side of your face and help you chew, talk, and move your jaw.

TMJ disorder symptoms include:

• Jaw clenching and face pain
• Migraine or headaches
• Jaw locking or stiffness
• Clicking, grinding, or popping when moving your jaw
• Trouble opening or closing your mouth
• Ear pain or ringing in your ear (tinnitus)
• Tooth pain
• Neck or shoulder pain

Connection Between TMD and Migraine

Migraine and TMD seem to have a bidirectional association, meaning that one condition influences the other and vice versa, like a feedback loop. That’s not to say that if you are living with migraine, you will automatically have TMJ issues, but it is something to look out for.

Migraine headaches and TMJ pain can have the same triggers, such as stress, anxiety, repetitive teeth clenching or grinding, hormonal fluctuations, and poor posture. Both conditions also trigger each other. Researchers are trying to better understand the connection between TMD and migraine, including how having TMJ dysfunction can influence migraine attacks and vice versa.

One study published in the Journal of Manipulative and Physiological Therapeutics found that if you have severe migraine attacks, you’re more likely to have some form of TMD too. In fact, researchers noted that about 80 percent of people with episodic migraine (0 to 14 attacks a month) also have TMD, and 100 percent of those with chronic migraine (15 or more attacks a month) also have TMD. In particular, women with chronic migraine were more likely to have severe TMD, according to the study.

Here are some reasons why the two conditions are so closely connected.

Migraine and TMD Share the Same Pain-Processing System

Scientists believe that disorders like TMJ dysfunction and migraine are connected because they share the same pain-processing pathway in your body. Both migraine and TMD involve the trigeminal nerve (the primary nerve in your face).

Although the inputs from each come from different branches of the nerve, they come together as they travel to the brain. And because these pain signals activate the same pathway, one condition can influence the frequency and pain of the other. In other words, issues in your jaw could be sending signals that then trigger a migraine attack.

Your Brain Becomes More Sensitive to Pain

Part of the two-way connection between migraine and TMJ issues could be related to the fact that having one condition causes your body’s pain system to become more sensitive over time, resulting in the development or worsening of the other condition. In particular, researchers saw that jaw issues like TMD can make you more sensitive to migraine pain. Habits like grinding or clenching your teeth in TMD may also increase your chances of developing chronic migraine.

Shared Symptoms and Risk of Misdiagnosis

Migraine and TMD tend to both involve pain in the head and/or face. Because a migraine attack can sometimes cause facial pain, it’s not uncommon for people to assume the pain they’re experiencing is related to their mouth, teeth, or jaw in some way. But it’s also possible that what’s thought to be TMJ pain could actually be an underlying headache disorder like migraine, especially because symptoms and risk factors can overlap.

This overlap between TMD symptoms and migraine symptoms can lead to misdiagnosis of one or both conditions. There have been reports of people having teeth removed when really the underlying cause of their tooth pain was migraine.

Another study found that TMD was undiagnosed in 25 percent of people with a headache disorder, suggesting that TMJ pain could have been the true cause of their pain.

Overlapping Treatment Options

Because TMD and migraine can have overlapping symptoms, some treatments used for one condition may be useful in treating the other. However, to date, there are no established treatment plans that address both conditions, and research regarding integrating treatment options is limited.

What’s more, TMJ dysfunction and migraine are two distinct conditions that may require specialized treatment for each. For instance, people with TMJ issues may need mouth guards, physical therapy, and ultrasound therapy, while certain medications used to treat migraine, like triptans, are not usually used for TMD. That said, there is still an opportunity to address these conditions together because of how interconnected they are.

Treating One May Reduce the Severity of the Other

Some research has found that treatment for TMD can reduce the severity of migraine, decrease the use of painkillers, and reduce the number of migraine attacks. In fact, one study found that treatment for TMD resulted in 19 percent fewer headaches, while the severity of migraine headaches decreased by 17 percent.

Some healthcare providers may use botulinum toxin injections for both conditions when found together. This medication works by relaxing your muscles and is approved by the U.S. Food and Drug Administration to treat migraine, but research for its usefulness in treating TMD is limited.

Here are some other overlapping treatments that may be used:

• Nonpharmacological approaches — Healthcare providers may suggest approaches like cognitive behavioral therapy (CBT), relaxation techniques, mindfulness, reduction of jaw clenching, night guard use when appropriate, physical therapy, and headache hygiene.
• Pharmacological approaches — Sometimes certain medications will be prescribed to treat both conditions, like nonsteroidal anti-inflammatory drugs (NSAIDs), limited corticosteroids, muscle relaxants, tricyclic antidepressants, point injection therapy, and migraine-specific therapy.

When To See a Healthcare Provider

If you think you have TMJ issues, it’s important to talk with a healthcare provider, such as your primary care doctor or your dentist. They may refer you to an orofacial pain specialist, neurologist, or headache specialist, considering the symptoms of migraine and TMD can overlap.

If you happen to have both migraine and TMD, you will need separate treatment plans for each condition, though sometimes TMD symptoms will go away on their own without treatment.

Schedule an appointment with your healthcare provider if you notice the following symptoms:

• Facial pain that reoccurs or doesn’t go away
• Facial pain that happens alongside dizziness or vision changes
• Pain in your face, jaw, ears, or teeth
• Trouble opening your mouth
• Tenderness, locking, or clicking in your temporomandibular joints
• Trouble chewing or pain when you’re eating
• Unexplained headache, neck pain, or eye pain

Finally, keep in mind that the two conditions can have similar triggers. For instance, stress can aggravate both TMJ pain and migraine. So look for ways to manage your stress levels. Doing so may help reduce the number of migraine attacks you experience and help you manage TMD.

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