Signs of Temporomandibular Disorders in Migraine Patients

Clinical Journal of Pain:
June 2010 – Volume 26 – Issue 5 – pp 418-421

by Stuginski-Barbosa, Juliana DDS

Objectives: To identify signs of temporomandibular disorders and cervical pain in individuals with episodic and chronic (transformed) migraine (CM), relative to controls without headaches.

Methods: In this prospective, controlled, double-blind study, we examined 93 individuals divided in 3 groups: episodic migraine EM, (n=31), CM chronic migraine (n=34), and controls without migraine (n=28). We recorded signs of temporomandibular disorders, and of pain in the neck, after the protocol of Helkimo (1974). We calculated the odds ratio (OR) and confidence intervals (CI) of symptoms as a function of headache status. Data from all groups were paired and compared using the χ2 test. The level of significance was 5% in 2-tailed tests.

Results: Relative to controls, participants with EM and CM were significantly more likely to have tenderness in the masticatory muscles [controls=28%, migraine=54%, (OR=3.0, 95% CI=1.1-8.9), CM=73% (OR=6.9, 95% CI=2.3-21.2)], and in the temporomandibular joint [controls=25%, migraine=61%, (OR=4.7, 95% CI=1.5-14.5), CM=61% (OR=4.8, 95% CI=1.6-14.5)]. They were numerically (but nonsignificantly) more likely to have limited lateral jaw movements (CM=34%; EM=26%; NP=18%), joint sounds (CM=44%; EM=29%; NP=28%), and tenderness in neck muscles (CM=64%; EM=51%; NP=35%).

Conclusion: In a tertiary care population, individuals with EM and CM are more likely to have tenderness at the temporomandibular joint and on the masticatory muscles, relative to controls. Studies are needed to investigate whether treatment of 1 disorder will improve the other.

As you can see in the studies results, there is a relationship between Chronic Migraine and Temporomandibular Joint Disorders (TMD) in many cases. Here at AZ TMJ, we have found that when we treat a patients’ TMJ problems they have significant relief from their Chronic Migraine symptoms. Dr. Stan Farrell is continuing to research this relationship and develop further non-surgical treatments. Visit our website for more information,