Causes and treatment of everyday headaches

What is it? Headaches and face pain are almost always a result of an injury or dysfunction involving muscles, ligaments and joints you may have a temporomandibular disorder – TMD. We will examine the range of muscles and measure jaw movement when moving your jaw from side to side and on full opening of the mouth. We will computer analyse the information and correct your jaw position to help treat headaches, facial pain, TMD pain, and other related problems.

Why is it done? We are also able to find the root cause of the Headaches and Migraines and treat the problem and prevent the cycle from continuing. Treatment varies according to the extent of the problem and will usually involve splint therapy to correct bite problems.

TMD can be associated with the following:

• Persistent headaches that may start in the front of the head, along the sides, or in the upper part of the neck. The pain may be mild to severe and radiate to all other areas.
• Ear pain, ear pain when chewing, ear stuffiness or ringing in the ears.
• Pain above or “behind” the eyes, blurred vision.
• Jaw pain or facial pain and/or tightness. Clicking jaw joints in it is not an indication for treatment.
• Neck pain and shoulder pain and pain to move the head.
• Restricted ability to open the mouth.
• A jaw that deflects to one side or the other upon opening

Why do bite problems cause headaches?
If your bite is unbalanced muscles of your head/jaw/neck may hold your jaw in unnatural positions. This can overload the muscles which results in discomfort in the muscles and eventually lead to headaches.

What does the treatment involve?
Initially this would involve a detailed history of your headache and associated problems.  I would then perform the comprehensive examination which is a detailed analysis of the whole masticatory system. Once a bite problem is diagnosed the usual treatment is splint therapy.

Splint therapy
There are 2 types that I use:
-Tanner splint-this covers all of the teeth (usually lowers)
-NTI-this usually just covers the front teeth

Other causes of headache
One must always be aware of other causes of headaches, such as stress related or very rarely tumours, so sometimes CT or MRI scans need to be done. Other causes include diet, hormonal changes, physical exertion and sleeping patterns.

TMJ refers to the temporomandibular joint which is right in front of your ears. One can have problems with the joint itself or with structures around the joint. The National Institutes of Health currently refer to these problems as “Temporomandibular Disorders” (TMD). It is a general term which describes a wide variety of signs and symptoms such as; headaches, jaw pain, jaw fatigue, limitation of movement, clicks and pops, grating, locking open and/or closed, muscle pain, TMJ pain. Before any treatment is rendered, a 21-point examination should be done and a specific diagnosis made for your individual condition(s). Only then can the correct treatment be planned.

The causes of TMDs (and other ailments) can be many. As a general rule, the causes fall into one or more of these four categories of stress which can exceeds one’s adaptive ability and cause these signs and symptoms:

ENVIRONMENTAL STRESS
In other words, LIFE! We are all subjected to a variety of environmental stressors which can take a toll on us. Common examples are job or school difficulties, relationship problems, financial matters, family stresses, etc. These all can lower our resistance to the point that we begin to feel badly. Many people find relaxation, meditation, yoga etc as good ways to help deal with these issues. Become aware of these life situations that seem to take a toll on your general well-being and find ways to address them. Medications are sometimes prescribed for short durations to help.

STRUCTURAL STRESS
In particular this refers to general body alignment such as posture etc. People who work in front of the computer, type a lot, keep a phone on their shoulder for extended periods, get tense behind the wheel of their cars can subject their bodies to structural stress. Sleeping on your side with your arm under one side of your jaw can subject your TMJs to structural stress. Many find “body awareness” helpful to improve posture and body positions. Exercise, especially stretching, can reduce structural stress to our body. Often physical therapy and massage can help a lot along with ultrasound, infrared, TENS. Snoring and other sleep disorders add to structural stress and pain. Medications such as anti-inflammatories and muscle relaxants are sometimes prescribed for short durations to help. Other general medical conditions that affect muscles and joints such as arthritis or fibromyalgia should be ruled out.

NUTRITIONAL STRESS
What we eat plays a big role in overall health and one’s ability to adapt to stress. Smoking, caffeine and high sugar intake all increase muscle hyperactivity and lower adaptive capacity making us more prone to fatigue and pain. In addition to decreasing their intake, supplements with calcium and magnesium can decrease muscle dysfunction. Also, supplements with chondroiton sulfate and glucosamine can improve the health of the TMJs in particular and other joints in general. If you are unaware of your dietary intake, try keeping a diet diary for a week and see what you learn!

DENTAL STRESS
Teeth and gum problems can often be a source of TMDs. Getting and keeping these healthy are obviously important. Dental stress also refers to bite (occlusion) problems coupled with clenching and grinding. This is where bite splint (nightguard) therapy comes into play, that is, to relieve these stressors. Once the bite splint has relieved the signs and symptoms, your bite needs to be re-evaluated and a plan to improve and harmonize it should be developed.

More than one category of these stressors can come into play at any one time. Or we can “cycle” through these various categories over a period of time. All factors need to be looked at, evaluated and addressed. By following this approach, your particular condition can be resolved or certainly improved significantly.