TMJ Headache, or as it is known – a Jaw Headache, is a secondary headache disorder. In other words, a jaw (TMJ) problem causes your headache.
What Does a TMJ Headache Feel Like?
TMJ Headaches is a common TMJ disorder. Sometimes TMJ headaches can be a direct result of TMJ dysfunction.
The typical TMJ headache is a tight, dull aching headache over the temple region. It is most commonly on one side, which correlates to your jaw joint issue. But, it can also be bilateral.
TMJ headache aggravates with jaw tension, clenching, stress or jaw movement. Typically, it relaxes your jaw. It also is usually associated with tenderness of the jaw and nearby muscles.
What Causes TMJ Headaches?
TMJ dysfunction may increase muscle tension in the jaw and masticatory muscles. e.g. temporalis, pterygoids. TMJ headaches are associate with jaw disorders. Abnormal jaw muscle tension can create TMJ disorders such as myotonic or articular disc derangements.
How is TMJ Headache Diagnosed?
Your TMJ physiotherapist will assess your jaw function and determine whether you are likely to be experiencing a TMJ headache. Correctly identifying the cause will lead to better treatment.
What About X-rays, CT scans and MRI?
OPG X-rays, CT scans and MRI’s are not diagnostic of a TMJ headache. However, they can identify oral and bite conditions, which may be predisposing you to TMJ headache.
How Do You Fix TMJ Headaches?
A TMJ physiotherapist has a particular interest in craniomandibular physiotherapy. They are your practitioner of choice for TMJ headaches.
The best fix for your TMJ headache is to normalise your TMJ function. Treatment normalises TMJ joint motion, muscle tensions, muscle timing and coordination. Your jaw physio treatment may perform jaw muscle massage, relaxation techniques, joint mobilisation, TMJ movement correction exercises, dry needling or other tools suited to your condition.
For more specific advice, please consult your TMJ physiotherapist.
Common Causes of Headache & Migraine
Specific Migraine - Headache Types
- Neck Pain
- Bulging Disc
- Wry Neck
- Text Neck
- Pinched Nerve
- Cervical Radiculopathy
- Facet Joint Syndrome
- Neck Sprain
- What Causes Cervicogenic Headache?
- How Do You Get Rid Of A Neck Headache?
- When Should You Be Concerned About A Headache?
What's Causes Cervicogenic Headache?
Your neck headache originates from a variety of musculoskeletal and neurovascular structures. These structures include the upper three neck joints, C2/3 disc, spinal cord coverings, and neck muscles. Dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).
Upper Neck Joints
The most likely source of your neck headache is a dysfunction of your upper neck joints. Your neck muscles or nerves become involved from pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.
The most common cause of a neck headache is the dysfunction of your upper three neck joints. The most common neck joints involved are your:
- atlantooccipital joint (O-C1),
- Atlanto-axial joint (C1/2), and
- C2/3 cervical spine joints.
In simple terms, your neck joints can cause a neck headache or pain if they are either too stiff or move too much (e.g. wobbly and unsupported by weak muscles) or locked in an abnormal joint position, e.g. a locked facet joint or poor neck posture. Once your neck joint becomes stressed and painful, the pain signals refer to the trigeminocervical nucleus in your brainstem. You start to feel a neck headache or, in some cases, face pain!
Your neck and headache physiotherapist can assess and correct neck joint dysfunctions that result in a neck headache. Their professional diagnosis and treatment are essential for neck headache sufferers.
Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse—this further demands your overworking muscles resulting in muscle fatigue-related symptoms. Your deep neck flexors are frequently weak or lack endurance. Your neck muscles work best when they have healthy resting tension, length, strength, power and endurance.
Your skilled physiotherapist assesses and helps you correct any muscle imbalances that result in a neck headache.
Cervical and Occipital Nerves
Nerves in your upper neck may become pinched by extra bony growths, e.g. arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in the neural motion known as neuromechanosensitivity or abnormal neurodynamics. Irritation of your upper neck structures refer to pain messages along the nerves and cause your headache. In simple terms, your neck is the "switch", nerves are the "power cords", and your headache is where the "light" comes on.
Your headache physiotherapist can assess your neuromechanosensitivity.
How Do You Get Rid Of A Neck Headache?
Quality neck physiotherapy can have a speedy and effective result for relieving your neck headache—the key to better treatment response in confirming your diagnosis. After your assessment, your physiotherapist will start you with treatment techniques that address your problems.
Your neck headache treatment may include all or some of the following techniques:
- Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or, in specific cases, a gentle and localised joint manipulation technique.
- Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
- Tight or overactive muscles may require muscle stretching, neck massage, acupuncture, dry needling, trigger point release or other relaxation techniques.
- Weak muscles may require specific strengthening exercises. This weakness may include your postural shoulder blade and neck muscles.
- Nerve dysfunction identified by your physiotherapist will depend upon your specific examination findings. Neurosensitivity is a common finding that needs addressing with attentive, professional care.
- Posture correction via specific posture exercises, posture awareness techniques, posture taping, or a brace.
- Provide helpful advice on preventing neck dysfunction in the future, e.g. workstation setup, ergonomics, awkward neck positions and postures to avoid.
Who Treats Cervicogenic Headaches?
In addition to relieving your neck headaches, your physiotherapist aims to address why you are experiencing neck headaches. After all, helping you to avoid future neck headaches is a crucial component of your rehabilitation. Chronic headache sufferers typically resolve their neck headaches within days or weeks.
Relief of your neck headache is quite often immediate! If a neck headache solely causes your trouble, it is common to experience instant relief as you walk out of the clinic.
Depending on the severity and the specific underlying causes of your neck headaches, most sufferers will experience a reduced headache after your initial consultation.
For more information, please consult your neck headache physiotherapist.
When Should You Be Concerned About A Headache?
Unfortunately, in a small percentage of patients, there is a sinister cause of your head pain, which require investigation. We call these Red Flags because they can be vital signs of more sinister underlying conditions such as brain tumours, aneurysm, stroke, meningitis and other systemic illnesses. If you experience any of the following symptoms, please seek the urgent advice of your healthcare professional.
You MUST thoroughly investigate any Red Flags!
Please check with your doctor to investigate further if your headaches have any of the following characteristics. Your headache is:
- History your worst ever headache or a different headache to your usual.
- Exertion triggers your headache (e.g. exercise, cough, sneeze or sex).
- Age is higher than 50 years.
- Despite treatment, your headache persists.
- Acute onset.
- Central nervous system findings. e.g. motor weakness, memory loss, slurred speech.
- HIV or another immune system compromise
- fEver or other systemic symptoms, e.g. weight loss, rash.
If you have any of the above HEADACHE Red Flags symptoms, we strongly recommend that you consult your doctor immediately.
Less Urgent & Severe Headache Types
Fortunately, most headaches do not require urgent medical investigation and should respond positively to treatment depending upon an accurate diagnosis.
For specific advice, please consult your doctor or headache physiotherapist.
What is a Primary and Secondary Headache?
The International Headache Society classifies headaches as Primary or Secondary.
Secondary headaches. Caused by an underlying problem and can include a post-whiplash headache, neck headache, jaw headache and drug withdrawal headache. “Ice cream headache” is a secondary headache caused by extreme cold within your mouth. In other words, a secondary headache is a symptom of something else being wrong rather than the cause itself. Treatment for a secondary headache involves treating the source, e.g. loosen some stiff upper neck joints or stop eating ice cream!
Mixed Headache-Migraine Types
You can simultaneously suffer one, two or more types of headache or migraine.
One type may cause another or overlap with another. For example, a painful neck can cause increased muscular tension, which will increase your blood pressure. In this scenario, you would be suffering a neck headache + a tension headache, + a migraine!
What Else Could Be Causing Your Headaches or a Migraine?
Your physiotherapist and doctor will be able to assist with your diagnosis and headache source. Sometimes specific tests can confirm your diagnosis. On other occasions, it can be by process of elimination.
Unfortunately, there is a sinister cause of your head pain in a small percentage of patients, which requires investigation. These can include brain tumours, aneurysms, meningitis and other systemic illnesses.
Your physiotherapist or doctor may recommend that you complete a headache or migraine questionnaire that will assist in your headache classification, diagnosis and treatment. Once you complete these questionnaires, please present your physiotherapist or doctor's results to help with your diagnosis and treatment.
Please consult with your healthcare practitioner for an accurate diagnosis and treatment pathway.
More info: Headaches & Migraines
Suffering a Headache or Migraine?
If you are suffering from a headache or migraine, it is appropriate that your first step is to consult your doctor. Your doctor will examine you and determine if a neurological opinion is required and whether a CT or MRI scan of your head is necessary. In the vast majority of cases, your scans will be reasonable. Occasionally, scans can identify significant but luckily uncommon headache sources such as an aneurysm or tumour.
If Your Scan is Normal?
Firstly, you should feel relieved. Scans will rule out the more sinister causes of headaches or migraines.
Discovering Your Headache Source?
We recommend that you should then commence a process of elimination, starting with the most commonly diagnosed and easily fixed sources.
Researchers believe that at least one in four headaches are neck origin. A thorough examination of your neck by a skilled headache physiotherapist is your next port of call. You'll have over a 25% chance that your physiotherapist will confirm and then relieve your headache at your first consultation.