Migraine Headache

Migraine headache frequently is caused by the jaw joint or the upper neck, and not just something in your diet like smelly cheese or chocolate.

Interestingly, research shows that sufferers clench their temporalis muscles fourteen times more often whilst they are asleep than normal people. The reasons for this are complex, but without a doubt, TMJ anatomy has some of the answers.

The aim in prevention is to limit the amount of negative afferent input; that is, to limit your triggers to that huge trigeminal sensory nucleus in the upper neck. Even cold draughts to the face can be perceived as noxious stimuli, but certainly too much chewing, heavy massage of the muscles, and over stretching of the jaw also. Stress and conflict too have an effect which may cause grinding and gnashing of the teeth at night.

Over opening of the jaw in dental work, for example wisdom tooth extraction, may be a factor, particularly if done under general anaesthetic. 

This sets up a pattern where the sensory trigeminal nucleus starts to bombard both it's own motor complex, causing the jaw muscles to contract, especially while you are asleep, and those in the neck. Upper neck pain is often an accompanying symptom found along with jaw ache, temporalis discomfort and headache.

Migraine headache

Notice how this lady is massaging the temple region; that's where the very large temporalis muscle, a powerful closer of the jaw is located.

Facial pain

Facial pain is typical of a jaw joint related migraine headache.

That trigeminal nucleus may also bombard other cranial nuclei found close by in the brain stem, causing nausea, pulsating arteries, dizziness and sensitivity to light and sound, and pain in the neck.

Bruxism, or grinding your teeth we will consider on another page.

Notice in this next diagram three things about the trigeminal nerve.

  • In green the largest sensory cranial nucleus in the head. Cranial nucleus 5, is where all sensory information from the whole face, the jaw joints, parts of the ear, the mouth and meninges of the brain ends up.
  • The tiny Trigeminal motor nucleus of 5.
  • The Spinal Trigeminal Tract carrying pain and temperature sensory information from the face to the Spinal Trigeminal nucleus which lies, wait for it, in the upper neck.

One last important gem: this Trigeminal nucleus, running down into the neck, is then continuous with the dorsal column which travels right up the spinal cord, bring information from the whole body. And this feeds right into the motor nucleus of CN5 which drives the muscles of the jaw.

TMJ anatomy

Some understanding of TMJ anatomy may be beneficial is you are suffering from migraine headache. The pain frequently radiates from the jaw joint to one of the areas supplied by the trigeminal nerve.

Diagnosis of migraine headache

"When a patient reports
  • an intense pulsating headache lasting at least 4 hours, accompanied by either nausea, photophobia or phonophobia;
  • their daily activities are limited;
  • and all diagnostic tests are within normal limits,

then the diagnosis is migraine."


Migraine headache causes in the USA alone a staggering 17 billion dollars in lost productivity.

Midrin, a frequently used drug, contains Acetaminophen, the most common cause of liver failure. Do your uttermost to avoid medication with these AntiCholinergic side effects.

Cervical spine and the TMJ (jaw joint)

You'll notice that the upper cervical spine facet joints lie immediately approximate to the Trigeminal sensory nucleus in the upper neck. Whilst a jaw joint lesion may cause neck pain, it's likely that the opposite is true:

An upper cervical subluxation has an effect on the Trigeminal nucleus, firing pain in the face, jaw and side of the head causing the amongst other things the typical migraine headache.

In summary, cervical spine and TMJ anatomy encompasses a huge area involving your chiropractor. Face pain, neck pain, headache. It's very complex, and I'm not suggesting that Chiropractic has the whole, and simple answer. Clearly, nobody to date has all the answers, or even the majority of them. We live in a stressed society, which eats junk, chews gum, has motor accidents. We slap each other around so blows to the face and jaw are common.

The result? Pain. Chiropractic has a large role to play, but your doctor, dentist, psychologist, minister and marriage counselor should all be considered. And the oro facial surgeon should be your last port of call. TMJ surgery is not common.

Here's another insight from the chiropractic help coalface.

A patient under treatment for lower back pain arrived for a routine consultation last month, with a blinding migraine. She had just sat for three hours with her mouth wide open whilst her dentist worked on a crown. Not a headache sufferer, it was simply because of the stretch fibres in the jaw joints complaining bitterly. I worked on the jaw joint, very painful, but the headache was over the next day. And hasn't returned.

In general, rather have your wisdom teeth out in the chair, whether it's for crowding or infection. Under general anaesthetic, surgeons sometimes over open the jaw causing injury to the meniscus; the result is often years of blinding migraine headaches.

Some understanding of the TMJ anatomy will be helpful.

I'll never forget a lecture by a specialist surgeon on the subject who remarked: The norm is

Observe TMJ surgery, Do TMJ surgery, Teach TMJ surgery.

Cosmetic surgery

This jaw is certainly getting smaller as we chew softer foods from which the fibre has been extracted; that makes less room for the teeth. The resulting disfigured teeth and over or under bite have become a problem, particularly for girls.

Part of this is hereditary and there's little we can do about it; on the other hand teaching our children from a very young age is eating chunks of apples, the crusts of 100 percent whole wheat bread, chewy vegetables and legumes will ensure the condition doesn't become even worse in this generation.

Of course, even more important it will mean far less chance of colorectal cancer and all the conditions associated with constipation. Those who eat plenty of fibre also don't have problems with obesity and type 2 diabetes and don't have to be constantly fussing about diets.

It may be my imagination, but at the Chiropractic Coalface I have been seeing an increasing number of young women in particular suffering from migraine, facial and the TMJ pain - with a history of braces and sometimes surgery to reshape the jaw and align the teeth.

It begs the question; is a more beautiful alignment of teeth a worthy exchange for migraine?

I have seen no statistics for this doctor caused iatrogenic illness; perhaps it's an uncommon side effect of dentistry and oral surgery, but I'd ask your dentist for more information before embarking on corrective braces.


Chiropractic is one of the solutions to migraine headache, but it's such a complex subject other factors have to be considered.

Just this morning, our plumber came to help with a problem with our hot water geyser. He told me that his mother swears I fixed her migraine headaches many years ago; prior to that she lived with a bottle of painkillers next to her bed.

Mostly, though, if you've had migraine headaches for years, a course of chiropractic treatment, and then an occasional regular treatment, is probably what will be required.

An interesting statement from Mayo clinic states that "though migraine causes aren't understood, genetics and environmental factors appear to play a role." They include neck stiffness and yawning which stresses the TMJ as part of the prodrome, but there's no mention of chiropractic.

More about migraine headache, symptoms and causes from the Mayo Clinic.

Important considerations

› Migraine headache

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

Are you looking for a different slant on your pain?

Do you want to pose a question?


I'm starting with the vegetable sources, not because I'm suggesting you become a vegetarian, but because there's much research indicating we should eat less animal protein.

Vegetable protein

Green snap beans are nearly 2% protein.

Authentic hummus recipe  ... make it in 4 mins

Lentil protein ...throw a handful in whenever you cook rice.

Fish protein

Free-range Chicken

  • Free range cage free eggs

Guineafowl, pheasant, wild duck... if you can get it.

Red meat

A omega-3/ omega-6 ratio of almost 1 is excellent. Cornfed beef raises the omega-6 alarmingly creating an arthritic tendency.

We avoided pork in Europe. It has absolutely no taste... but if you can find free range pork... be prepared to pay extra, just eat less. Worth every cent.


  • Eggs Florentine ...
  • Foods to avoid high cholesterol ...

Interesting questions from visitors

CLS writes:

Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.