#189 What’s the Difference Between Migraine and TMD Headaches?

This is a profound question.  Is there really any difference between Migraine headaches caused by inflammation of the Temporomandibular Joint, (TMJ), better known as Temporomandibular Joint Disorder, (TMD). 

After successfully treating over 5000 patients with TMD, I am profoundly impressed and disenchanted with the number of people who have been diagnosed by a physician as having Migraine Headaches who present to our office and find out after treating their TMD using a simple oral device and protocol that unloads the TMJ like a set of crutches unloads a damaged knee, their “Migraine Headaches” disappear.  Obviously, they were misdiagnosed by one or more of my medical colleagues.  

 This experience is not occasional.  It is common.  I am not trying to denigrate my physician colleagues.  I am also a physician, and I know my colleagues well.  They don’t think about TMD when they see someone complaining of headaches.  TMD is completely off their differential diagnosis list of possibilities when they hear “I’m having headaches”.  What they do think about is brain tumors, strokes, and “Migraines”.  That’s why one of the first things that will happen if you complain to a physician, PCP, or Neurologist about constant severe headaches, you’ll be sent for an MRI looking for brain tumors of evidence of ischemic or hemorrhagic strokes.  I once lectured to a room full of about 35 family practice physicians and asked “What is the first thing you get for a patient complaining about recurrent or constant severe headaches.  The room was unanimous about ordering a $3,000 MRI.   

That $3,000 expense could have been avoided if the physician had thought about TMD as a possible cause and did a simple examination by pressing his fingers into the joint while the patients close their mouth.  It doesn’t cost anything and if this simple maneuver causes pain in the TMJ, the joint is inflamed and the diagnosis of TMD confirmed. 

The worst part of this common scenario is physicians don’t know what causes Migraine Headaches, but we do know what causes TMD headaches.  Not only do we now know that TMD headaches are directly caused by inflammation within the TMJ, but we can make the inflammation in the TMJ go way by using a simple oral device and protocol. 

Here are the three theories that the medical investigators believe may be involved in creating severe and recurring headaches.  

1. The neurovascular theory proposes that migraine results from abnormal activation of the trigeminovascular system, leading to neurogenic inflammation, vasodilation of intracranial blood vessels, and sensitization of pain pathways within the brainstem and cortex. 

1. The cortical spreading depression theory proposes that migraine, particularly migraine with aura, originates from a slowly propagating wave of neuronal and glial depolarization that spreads across the cerebral cortex. 

1. The brainstem dysfunction theory proposes that migraine originates from abnormal activity within specific brainstem and hypothalamic nuclei that regulate sensory processing, autonomic function, vascular tone, and pain modulation. 

These are the theories.  They admit they don’t know what causes “Migraines”.  We do know what causes TMD headaches.  It’s inflammation within the TMJ.  And inflammation withing the TMJ is easy to eliminate if you use the device and follow the protocol.  It’s that simple. 

There may be no difference between TMD headaches and Migraine Headaches.  Studies need to be done to find out what percentage of patients diagnosed with Migraine Headaches have their headaches resolve when the inflammation within the TMJ is resolved. We are planning on doing that study. 

What do you think would change if 30%, 50%. 70%, 90%, or even 100% of patients diagnosed with Migraine Headaches had their headaches originating from inflammation of the TMJ?  Would that change the headache paradigm?