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."


Productivity

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

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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