Do women with migraine have higher prevalence of temporomandibular disorders?

Keywords:  Temporomandibular disorder, TMD, headache, migraine, head pain, and physical therapy

In Brazil, a study was recently conducted regarding Temporomandibular Disorder (TMD) and migraines.  The treatment of TMD and migraines is a passion of Dr. Stan Farrell, who has spent a significant amount of his medical career treating such disorders and improving the lives of patients with these types of head pain.  TMD and migraines are chronic diseases with very similar characteristics such as duration and severity of pain.  The severity of TMD is often compared to the severity of migraine headaches.  Migraine is an extremely common disorder, most common in women, 18%, compared to only 6% in men.  It is most common in women between the ages of 25 – 55. Migraineurs experience extreme levels of pain and disability.  About 90% of migraineurs report that they are unable to function normally during their headaches.  

The association of headaches and TMD has suggested that both conditions are influenced by similar predisposing factors, or that they share common peripheral and/or central mechanisms.  Most studies, however, inferred TMD based only upon their symptoms, and few studies used objective tools for the diagnosis of this condition.  Farrell, who is a Diplomate of the American Board of Orofacial Pain and is one of the best-qualified doctors in the country for identifying and treating head pain, and treats all of his patients in his state-of-the-art facilities in Scottsdale, Arizona.  Dr. Farrell focuses on non-surgical treatment methods that include splint therapy, trigger point injections and physical therapy modalities.  If you experience face pain or pain associated with TMD symptoms, migraines or headaches, schedule an appointment for a consultation with Dr. Farrell at 480-945-3629.


Objectives:  The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD), using the Research Diagnostic Criteria for TMD (RDC/TMD) in women with episodic and chronic migraine (M and CM), as well as in asymptomatic women.

Method:  Sample consisted of 61 women, being 38 with M and 23 with CM, identified from a headache outpatient center; we also investigated 30 women without headaches for at least 3 months (women without headache group – WHG). Assessment of TMD was conducted by a physical therapist who was blind to the headache status.

Results:  The prevalence of TMD, assessed through the RDC, was 33.3% in the WHG, 86.8% in the M group and 91.3% of the CM group. Differences were significant when comparing M and CM groups with WHG (p<0.001), but not when comparing M and CM (p>0.05) as well as higher risk for TMD [odds ratio (OR)=3.15, 95% confidence interval (CI) 1.73-5.71 and OR=3.97, 95%CI 1.76-8.94].

Conclusion:  Women with migraine are more likely to have muscular and articular TMD, suggesting that both disorders might be clinically associated, which demonstrate the importance of physical therapy assessment in the multidisciplinary team. (Rev Bras Fisioter. 2012 Nov 2. pii: S1413-35552012005000054)