Researchers at the University of São Paulo in Brazil have found that more frequent migraine attacks lead to more severe temporomandibular disorder (TMD). The temporomandibular joint (TMJ) acts like a sliding hinge connecting the jawbone to the skull, and when the disorder of it occurs, there is often difficulty chewing and joint tension.
Previous research studies have indicated that migraine is associated with pain in the temporomandibular joint. This specific research was the first to consider the frequency of migraine attacks when analyzing the connection with TMD. The researchers included 84 women in their early to mid-thirties with 21 suffering from chronic migraine, 32 episodic migraine, and 32 had no history of migraine serving as controls. Chronic migraine means that there are headaches for 15 days per month.
Signs and symptoms of TMD were found in 54% of participants serving as control, 80% of participants with episodic migraine, and 100% of participants with chronic migraine. The researchers feel that central sensitization may explain the association between the frequency of migraine attacks and the severity of TMD. The repetition of migraine attacks may increase sensitivity to pain. The researchers hypothesize that migraine acts as a factor that predisposes patients to TMD. On the other hand, TMD can be considered a potential perpetuating factor for migraine because it acts as a constant nociceptive pain input contributing to maintaining central sensitization and abnormal pain processes.
Migraine affects about 15% of the population and about 2.5% have chronic migraine. TMD is stress-related and also has to do with muscle overload. Patients with TMD have joint symptoms including reduced jaw movement, joint pain, and clicking or popping of the TMJ. Patients with TMD also develop a muscular condition, including muscle pain and fatigue, and/or radiating neck and face pain.
Migraine patients are more likely to have signs and symptoms of TMD than the general population, but the reverse is not true. There are many patients with severe TMD who do not suffer from migraine headaches. The researchers believe that TMD may increase the frequency and severity of migraine attacks but note that it does not directly cause migraine. Even so, having TMD may increase the intensity and severity of migraine headaches. The association with TMD is less frequent in patients with rare or episodic migraine as opposed to those with chronic migraine. The researchers feel that doctors should look into possible signs and symptoms of TMD in any patient who is known to suffer from chronic migraine headaches.
Source: Lidiane Lima Florencio and et al., Association Between Severity of Temporomandibular Disorders and the Frequency of Headache Attacks in Women With Migraine: A Cross-Sectional Study, Journal of Manipulative and Physiological Therapeutics, vol. 40, issue 4, 2017.