Jaw disorder intensifies chronic migraine pain
If you suffer from migraine attacks you know how debilitating it can be. The one-sided throbbing kind of headache affects 15 per cent of the population out of which women are disproportionately affected by it.
A new study from the University of São Paulo’s Ribeirão Preto School of Medicine (FMRP-USP) in Brazil finds that the more frequent your migraine attacks are the more severe will be the symptoms of TMD or temporomandibular disorder.
The findings of the study showed that women with chronic and episodic migraine were more likely to exhibit symptoms of TMD compared to the healthy controls.
Both TMD and migraine are co-occurring disorders. But, while people who suffer from migraine are predisposed to have TMD, people with TMD will not necessarily have migraines.
TMD and migraines also have similar pathological mechanisms both resulting in pain.
The temporomandibular joint acts like a sliding hinge which connects the jawbone to the skull. When there are problems with the jaw and muscles that control it, it results in TMD.
TMD is stress-related as well as caused by muscle overload and sufferers will display symptoms such as joint pains, reduced jaw movement, clicking or popping of the joint, join tension and difficulty in chewing. People with TMD will also develop muscular conditions such as muscle pain and fatigue and /or radiating face and neck pain.
Previous studies have shown that migraine is associated with pain in chewing muscles. But this is first study to consider the link between frequency of migraine attacks and TMD.
Researchers conducted this study to investigate the magnitude in the severity of TMD in women who suffer from episodic or chronic migraine.
The study included 31 women with episodic migraine and an average age of 33 years, 21 chronic migraine sufferers with an average age of 35 years and a control group of healthy women with an average age of 31 years.
The findings of the study showed that women with chronic and episodic migraine were more likely to exhibit symptoms of TMD compared to the healthy controls.
The prevalence (observation of signs and symptoms) of TMD in healthy controls is likely to be 54 per cent while it is 78 per cent for episodic migraine sufferers. But for women who suffered from chronic migraine (more than 15 days per month) the prevalence of TMD was 100 per cent.
The study showed that chronic migraine sufferers are at a greater risk of severe TMD symptoms than patients with episodic migraines.
The association between frequency of migraine attacks and severity of TMD can be due to central sensitization, according to the researchers.
The repetition of migraine attacks can increase sensitivity to pain which may predispose patients to TMD. The researchers believe that TMD can be considered as a potential perpetuating factor for migraine attacks as it acts a constant nociceptive input causing pain – caused by a painful stimulus on special nerve endings called nociceptors. This contributes to central sensitization and abnormal pain processes.
This shows that TMD may increase the frequency and severity of migraine attacks, even though it does not directly cause migraine. TMD however, does increase the severity and intensity of migraines.
Healthcare professionals should examine migraine patients for TMD symptoms based on this study to help find the best possible treatment.
While this is not good news for migraine sufferers it sheds some light on other associated disorders like TMD which can be investigated and perhaps treated to help alleviate associated pain.
Source: Journal of Manipulative and Physiological Therapeutics
