Category: Headaches

Does Teeth Clenching Cause Your Morning Headaches?

Post author By John E. Dinan, DMD MS
Post date April 8, 2024
No Comments on Does Teeth Clenching Cause Your Morning Headaches?

Or Is It Something Else….

Is this you?

Every day, you wake up with a pounding headache in your temples. It’s been going on for months. In an attempt to identify what’s causing your headaches, you jump online and come across more than a few web pages that suggest they could be caused by nighttime teeth clenching, also called Night Bruxism.

I’m John Dinan, an Orofacial Pain specialist practicing in the New York City metropolitan area. Orofacial pain is a dental specialty that helps people suffering from unexplained pain in their head, face, or neck.

Identifying the Cause: Teeth Clenching or More?

Morning headaches can indeed be related to nighttime teeth clenching, particularly if your pain is felt in the sides of your head. Here’s why: Your temporalis muscles, which cover the sides of your head up to the edges of your eye sockets, allow your jaw to open and close. When you clench your teeth for hours every night, your temporalis muscles can become very sore, resulting in pain in your temples when you wake up.

Other Contributors to Morning Headaches

Not every morning headache is caused by teeth clenching. There are dozens of conditions that can result in morning headaches. So, it’s essential to rule out other possible causes before scheduling an appointment with an Orofacial Pain specialist.

Poor Sleep : Sleep is essential to health, and according to the American Academy of Sleep Medicine, adults should get at least 7 hours of sleep per night. Sadly, most people simply do not allow themselves enough time for sleep, and this lack of sleep over time can lead to health problems such as cardiovascular disease, depression, diabetes, and pain.
Sleep hygiene best practices include going to sleep at the same time every night, making sure your bedroom is quiet, dark, relaxing, and a comfortable temperature, removing electronic devices from the bedroom such as TVs, computers, and smartphones, avoiding large meals, and drinking caffeine or alcohol before bedtime.

Migraine : Migraines are characterized by recurrent, often disabling, headache attacks and affect about 12% of Americans. Many people who get migraines go to bed feeling fine but wake up with a throbbing headache, sensitivity to light and sound, and nausea.If your morning headaches sound like this, you may have a migraine condition. Happily, migraines can be successfully treated by your primary care provider or a neurologist.

Alcohol & Caffeine : A typical alcohol hangover is characterized by a wicked headache the next morning. However, caffeine withdrawal symptoms can cause morning headaches, too. Within 24 hours of having your last cup of coffee, your body may start to experience withdrawal symptoms, including headaches upon awakening, as the effects of yesterday morning’s coffee wear off. And, of course, many illicit drugs have withdrawal side effects, including morning headaches.
If you suspect alcohol, caffeine, or other drugs may be causing your headaches, it’s time to reduce or stop and see if they subside.

The ‘Headache Bucket’ Theory : Envision a metaphorical bucket representing your capacity for headaches. Various elements contribute to this ‘headache bucket’ — including poor sleep, migraines, and sleep bruxism — each adding to the overall burden. When your bucket overflows, you experience a headache. It’s important to realize that even if sleep bruxism isn’t the primary issue, it could still play a significant role in amassing the volume that leads to your pain.

Moving Forward: Steps to Alleviate Your Pain :

Let’s confront these causes together. When other potential reasons have been excluded or are being managed, yet the headaches persist upon waking, it’s time to consult an Orofacial Pain specialist. If teeth grinding emerges as a contributory factor, rest assured, there is a suite of effective treatments on hand, ranging from conservative self-care approaches to sophisticated therapeutic interventions.

Taking Action: Don’t Let Headaches Hold Your Mornings Hostage :

The pathway to alleviating your morning headache lies in a proactive approach—explore each cause, seek professional advice, and embrace the treatments that resonate with your needs. Reflect on your sleep habits and substance intake, and consult a specialist for personalized guidance.

Dr. John Dinan, DMD MS is a board-certified Orofacial Pain specialist at New York TMJ & Orofacial Pain.

If you live in the NYC metropolitan area and are suffering from TMJ symptoms, feel free to contact us and make an appointment to see one of our Orofacial Pain specialists.

Which Type Of Dental Night Guard Is Right For You?

As an orofacial pain specialist, patients come to me when they’re suffering from the painful symptoms of a temporomandibular disorder, which you may know as TMJ. TMJ refers to the temporomandibular joint, the joint that enables you to open and close your mouth. Many new patients who come to my office have been wearing a standard dental night guard (sometimes called an oral appliance, occlusal splint, or mouth guard) while they sleep, but their symptoms are not improving or even getting worse. Before I explain which type of dental night guard is right for you, I want to make sure you understand TMJ and its causes.

First, What Causes TMJ?

Symptoms of jaw (TMJ) problems often arise due to sleep bruxism, a condition characterized by constantly grinding or clenching your teeth during sleep. Sleep bruxism affects about 10% of adults and up to 15% of children.

The American Dental Association has been surveying dentists about TMJ since the beginning of the pandemic. More than 70% report a significant increase of patients who are grinding and clenching their teeth both during sleep and while awake (called awake bruxism) – many of whom never had the issue before. Some patients even have cracked or broken teeth as a result of bruxing. Bruxism is thought to be related to several risk factors, including high-stress levels – so it comes as no surprise that this increase coincides with the pandemic.

How To Determine Which Type of Dental Night Guard Is Right For You

If you’re like many people, your dentist may have informed you that your teeth are becoming flat and worn-down because of grinding and clenching while you’re asleep. Your dentist may have recommended you start wearing a dental night guard while you sleep, or you may have already purchased one over-the-counter at your pharmacy.

If this sounds familiar, the standard type of night guard made by your dentist is probably adequate. However, over-the-counter night guards must be used with caution and for a limited amount of time because they can cause your teeth to shift.

However, if you’re one of those people who have a sense that something’s wrong because your teeth are sore, or your jaw muscles feel tight when you wake up in the morning, or if you have any of the symptoms listed below, a standard guard made by your dentist or an over-the-counter night guard you buy at a pharmacy is probably not the dental night guard that’s right for you.

All Dental Night Guards Are Not The Same

TMJ problems often involve the structures of your temporomandibular joints and usually require more evaluation and different types of dental night guards for your specific problem. If you suffer from any of the TMJ symptoms below, a standard dental night guard will likely not address your specific problem and could even make your problems worse.

Symptoms of TMJ:

Difficulty opening your mouth
Pain (beyond soreness or discomfort) when opening/closing your mouth
Jaw pain when you eat
Clicking or popping in your jaw during movement
A sense that your jaw is locked
A feeling that your bite is “off”
Daily pain and tension in your face
Headaches when you wake up
Tension or pain in your neck

Like other joint systems in your body, TM joint problems are orthopedic problems. There are ligaments that support your jaw joints and shock-absorbing discs that cushion them. And, there’s also a lubrication system that keeps your TMJs moist and nourished. These all can become compromised due to teeth grinding and clenching, whether it happens while you’re asleep, during the day, or both.

The result is often injury to your TMJs resulting in sprains, instability and painful inflammation. Sometimes, the pressure of grinding and clenching can even cause one of your shock-absorbing discs to change and cause joint noises, lockjaw and pain.

What To Do Next

Your next step is to make an appointment with an orofacial pain specialist. An orofacial pain specialist will likely provide you with a clear understanding of your problem (a specific diagnosis beyond “you have TMJ.”). And explain why your jaw muscles and joints are in trouble and what treatments are available in addition to a dental night guard. Many factors can give rise to a TMJ problem, so you will likely be asked questions about your medical health, mental health, sleep, dental history, and about you as a person.

Based on the information gathered and an examination, there’s a good chance your orofacial pain specialist will fabricate a dental night guard that’s right for you – designed to address your specific orthopedic problem – not just to protect your teeth. Factors like the thickness of the night guard, its surface (flat or designed to prevent shifting of the lower jaw), its use on the upper or lower teeth, and where the support is provided are just some of the factors that will be considered.

To find an orofacial pain specialist in your area, ask your dentist for a referral or check the directory at the American Board of Orofacial Pain website.

Your Dental Night Guard Needs To Be Monitored

A diagnosis beyond “You have TMJ” is essential in designing a night guard that will reduce strain and injury to your jaw muscles and tendons, joint ligaments, shock-absorbing discs and lubrication systems. Here’s the most important thing to understand: regardless of whether your dental night guard was designed by your dentist or an orofacial pain specialist, it will not stop your bruxism. When properly designed, your night guard will instead reduce the impact on your teeth, muscles and TMJs caused by your grinding and clenching. In essence, it lets you clench or grind in a “better neighborhood” with the goal of keeping more injury from occurring while you work on reducing the risk factors that caused your jaw to be in trouble in the first place.

And, because a well-constructed dental night guard redistributes force, it must be monitored and adjusted while healing occurs and your symptoms change. It’s essential to go in for regularly scheduled reassessments and modifications to maximize the potential for treatment to be successful.

So, Which Type Of Dental Night Guard Is Right For You?

If you wake up with any of the TMJ symptoms above – even if you’ve been wearing a dental night guard, do not give up hope! A more specific diagnosis, a better understanding of why you have the problem, and a night guard designed to address your individual symptoms may well be the answer. Based upon the nature of your problem, more comprehensive care is usually part of the plan, which may include exercises, stress-reducing activities such as mediation or yoga, medication, dry needling and trigger point injections, BOTOX® injections or joint injections. These decisions are best made by an orofacial pain specialist.

Feel better!

Learn more about TMJ and bruxism here

Tags Bruxism, Headaches, Jaw Problems, Oral Appliances, Orofacial Pain, TMJ

Headaches Jaw Problems TMJ

Can A Dentist Cure Your Headaches?

Most people who suffer from severe headaches don’t think about going to their dentist to get help. But a dentist may be the right professional to turn to if your physician has not been able to determine the root cause of your pain. But first, it’s important to determine whether the headaches you are experiencing fit into a primary or secondary category.

Primary headaches are migraines, tension headaches, and cluster headaches. Many dentists do see patients with primary headache problems, but it’s for the secondary type of headache that they can be particularly effective.

Secondary headaches can be caused by many things, but in particular, trauma to the temporomandibular joint. The temporomandibular joint is your jaw joint and problems in this area are commonly referred to as TMJ. A traumatized jaw joint can be the result of injury, a structural deficiency, a malocclusion (bad bite), newly placed or worn dental work, oral disease, or sleep bruxism (teeth grinding and clenching at night).

Today, many dentists are trained in assessing and treating these kinds of orofacial pain problems. In fact, in 2020, the American Dental Association approved orofacial pain as a dental specialty. Orofacial pain specialists are now board-certified dental specialists who limit their care to patients with orofacial pain disorders. Dentists trained in this special field are increasingly important as health team members in the diagnosis and treatment of severe and persistent headaches that are TMJ-related.

The Negative Effects Of Sleep Bruxism

If you clench or grind your teeth at night, you are not alone. Millions of Americans do it. Why does bruxism often cause severe headaches? The constant pressure is being exerted by the act of clenching and grinding your teeth can cause trauma to your TMJs. Next, the nerves become agitated, and here comes pain. But what’s tricky is that pain from TMJ can show up in other places on your body, such as your neck, your face, or even your head. This is called referred pain. Your TM joints are positioned very close to your cranial nerves, and severe headaches are often the result.

So, Can A Dentist Cure Your Headaches?

If you feel your headaches could be caused by teeth grinding and clenching (at night or during the day, or both), now’s the time to seek the help of an orofacial pain specialist. They will not only be able to determine the source of your pain, but will put a treatment plan in place that may include massage, relaxation techniques, a nightguard to protect your teeth, or even BOTOX®. I’ve been treating patients with these problems for over 3 years, and in most cases, a change in lifestyle to reduce bruxism combined with treatment, the outcomes are very positive.

Start by asking your physician or dentist for a referral to an orofacial pain specialist or check out the American Board of Orofacial Pain’s physician directory here, and search for a member with “Diplomate” status.

Good luck!

If you live or work in the NYC or Long Island metro area, feel free to call my office to make an appointment for a consultation. I see patients in person or by telemedicine on Zoom. NYC 212-265-0110 Hauppauge 631-265-3136

Tags Bruxism, Jaw Problems, Referred Pain, TMJ

Headaches Jaw Problems Nightguards & Oral Appliances Orofacial Pain Sleep Apnea TMJ

How To Evaluate Yourself For TMJ

Post author By Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Post date April 12, 2021
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Note: This article explains how to evaluate yourself for TMJ, what you can do about it, and how to determine when you need to get some professional help.

This past year’s pandemic challenges have led more people to seek care for TMJ problems than ever before. In fact, you may be reading this article because you’ve had your first experience of TMJ during the past year.

If you suffer from these kinds of problems, there are some steps you can take to relieve your symptoms. But before you try to evaluate yourself for TMJ, you must first understand the risk factors that led to your jaw being in trouble in the first place.

As an orofacial pain specialist for the past 35 years, I have treated thousands of patients who came to me suffering from jaw problems. They usually arrive at my office with complaints of jaw pain or stiffness, headaches in their temples, or facial pain that, in some cases, is taking over their lives. Many have limited jaw opening, joint popping and/or cracking. Some even experience locked jaws upon waking up in the morning.

While a traumatic event such as a car accident or an underlying medical disorder or treatment can be the culprit, for most people a wide variety of risk factors can cause TMJ pain problems. It is my job to properly diagnose, identify the causes, help my patients cope with TMJ – and eventually, get better.

Before You Evaluate Yourself For TMJ, You Must Understand What TMJ Is

The most important thing to understand about TMJ problems is that they are orthopedic in nature. Just like any other muscle and joint structure in your body – knees and shoulders, for example – if they become overworked, sprained, fatigued or injured, pain and instability will arise. Your jaw muscles and jaw joints (TMJs) are no different. An orthopedic problem can’t be treated until what is causing the pain is identified. It’s the same for TMJ problems.

How To Evaluate Yourself For TMJ – Identify The Cause & Make Changes

TMJ problems can involve your muscles, joints or both. To evaluate yourself for TMJ joint problems, pay attention to whether the pain is in front of your ear when you move your jaw or touch the area and if your jaw joints click, pop and/or lock. If you can answer yes to both questions, you should not try to cure yourself. See a dentist with experience in TMJ care or a TMJ specialist in your area right away. (There’s a link at the bottom of this page to the American Academy of Orofacial Pain, where you can find a specialist in your area.)

To evaluate yourself for TMJ muscle problems, you would probably describe your symptoms as soreness, stiffness, spasms or achiness. If you push your fingers firmly along your jawline or into your temples, you will experience more pain than you expected. Your jaw motion may be limited but it’s not accompanied by joint clicking or popping sounds.

If you’ve determined your TMJ problem is of the muscle variety, your next step is to figure out why and how your muscles became so irritable in the first place. To do so, you’ll need to do a little investigating to find out what is happening in your life during the day and at night.

6 Daytime Behaviors & Postures That Could Be Causing Your TMJ Problems

Starting today, pay careful attention to your daytime behaviors and postures, particularly while you’re working. Working behaviors and postures are some of the leading causes of TMJ problems. And, working at home is a big reason for the considerable increase of people seeking care during the past year.

When you evaluate yourself for TMJ of the muscle variety, look for these six common daytime behaviors that could be causing your jaw or neck muscles to fatigued:

Your head leans forward while you work at your computer.
You consistently look down at your phone.
You hold your breath or take shallow quick breaths with your mouth open.
You brace your jaw muscles (but your teeth are not clenched).
You often keep your teeth clenched.
You bite your nails and/or cuticles, cheeks, lips or tongue.

Did you identify any of the six behaviors or postures above during your workday? If you said yes, believe it or not, that is good news! Because if you can start eliminating them right away. And there’s a pretty good chance you can start feeling better right away, too.

Start by paying attention to your breathing patterns. If you discover that you hold your breath or breathe shallowly, go online and search for “restful breathing techniques.” You’ll see a lot of results and almost any you choose will help. Also, take more breaks. And make some adjustments to your workstation to improve your head posture. (Here’s a helpful guide). Also, download a reminder app such as Time Out for Mac that will help you remember to take breaks.

5 Nighttime Factors That Could Be Causing Your TMJ Problems

An essential step in evaluating yourself for TMJ is identifying what is happening to your jaw muscles, jaw joints or neck muscles while you’re asleep. This, understandably, is not easy – but it’s definitely doable. If you consistently wake up with jaw or neck pain, tightness in your jaw, or headaches – you can assume one or more of the following four factors are present:

Insomnia – You have trouble falling asleep or staying asleep.
Fragmented Sleep – Your sleep is full of lots of small arousals. Your brain wakes you up numerous times during the night.
Inadequate Sleep – You routinely get less than the recommended hours of sleep. (See the link at the bottom of this page to determine what is recommended for your age group).
Bruxism – You clench and/or grind your teeth while you sleep.
Breathing Problems – You struggle with breathing due to nasal or other airway restrictions while you sleep.

If you suspect factors 1, 2 or 3, try one or more of the following:

Take melatonin at bedtime.
Don’t drink coffee after noon.
Don’t use your electronic devices late into the evening.
Stop all work-related activities one hour before going to bed.
Read a good book.
Exercise in the morning instead of after work.
Eat dinner earlier.
Practice some breathing exercises before you get into bed.
Try some gentle stretching or yoga before bed.

If you suspect factor 3 – Bruxism – this is for you:

If you wake up occasionally with sore teeth but nothing more severe than that, consider purchasing an over-the-counter oral appliance at your local pharmacy. (Note: there are many terms for oral appliances such as mouthguards, bite plates, and teeth protectors – they all mean pretty much the same thing.)

If your symptoms get better after wearing your over-the-counter oral appliance at night for several weeks, your next step is to visit your dentist to be fitted for a custom oral appliance. This is very important because wearing an oral appliance over a long period of time that is not custom-fitted can lead to complications such as shifting teeth, bite changes and even airway obstruction.

If your symptoms do not get better after wearing your over-the-counter oral appliance it’s time for you to get some professional help. Make an appointment with your dentist or an orofacial pain specialist. (See the link at the bottom of this page to the American Academy of Orofacial Pain to find an orofacial pain specialist).

If you suspect Factor 4 – Breathing Problems – here’s what to do:

If your self-evaluation for TMJ leads you to suspect you have a nighttime breathing problem – it may be sleep apnea and you must see a sleep professional right away. Your struggle to breathe at night is likely reducing airflow and causing your blood oxygen to lower. That places excess stress on your body.

You should opt for an overnight sleep evaluation monitored by a professional. (Link here to find a sleep center near you.) If the sleep evaluation indicates you do have a sleep breathing disorder such as apnea, there are many options for you after the sleep study. You may be told to sleep on your side, wear nasal strips, use a custom-made oral appliance, or lose weight. Many people find that a continuous positive airway pressure (CPAP) machine is a lifesaver. (Read: What Is CPAP?) In severe cases, nasal surgery, orthodontics, jaw advancement or another correction surgery may be the solution.

How To Evaluate Yourself For TMJ – In Conclusion

Let’s say you have been able to get your TMJ problems under control by changing one or more of the six daytime behaviors above. That is great. And even if your nighttime behaviors are of the Factors 1, 2, or 3 variety and you tried some of the simple solutions I recommend, there’s a chance you’re already feeling better.

TMJ problems, however, are often caused by several risk factors. For you, relief may only be achieved with a professional approach. Take a little bit of time to find a trained orofacial pain practitioner in your area and you should be able to get on the road to feeling better very soon.

Helpful Links:

American Academy Of Orofacial Pain (Look for a provider with Diplomate status)

How Many Hours Of Sleep Are Enough For Good Health?

Tags Bruxism, CPAP, Headaches, Jaw Problems, Locked Jaw, Lockjaw, Oral Appliances, Orofacial Pain, Sleep Apnea, Teeth Grinding, TMJ

Headaches TMJ

Transcendental Meditation Can Ease TMJ Symptoms and Headaches

In my practice I work with patients who suffer from facial pain, tight jaws, headaches (of a muscle or migraine variety), neck pain, or a combination of two or three symptoms. Some of my patients are poor sleepers and many of them grind and clench their teeth at night, resulting in problems with the TMJ (temporomandibular joint). But what most of these patients have in common is an extraordinarily high level of stress due to tension at work, overwhelming financial burdens, caring for aging parents, and more.

Sound familiar to you? Read on:

The logical way to reduce stress would be to make some big changes in your life, right? But that’s no simple task, if it’s possible at all. Unfortunately, when you live with stress over a long period of time your brain can become either fatigued, upset, or both. In this state you are more likely to develop physical ailments associated with the muscles of the head, neck and jaw. This perpetual state of mind-body imbalance can result in unhappy muscles resulting in facial pain, stiffness, spasms, limited head or jaw motion, and/or frequent muscle or migraine headaches.

The question then becomes “Are there treatment strategies that deal with the source of unhappy muscles instead of merely dealing with the end result?” This is where Transcendental Meditation (TM) comes in. Though it is far from being the only technique that addresses brain fatigue and upset, there is increasing scientific evidence that suggests that TM can help achieve mind-body balance.

How does TM work to ease TMJ symptoms and headaches?

The practice of TM promotes restful alertness of the mind. When you are in a restful alertness state there is improvement in the coordinated functioning of all parts of your brain (called EEG Coherence). EEG Coherence means that brain is operating in its most efficient way. In this state there is synchronization of the many types of brain waves communicating with your organ systems, and your organs are communicating in synchronization with your brain. When these communication pathways work well, muscles and joints are under a lower level of strain, they fatigue less, and they function more smoothly and easily.

Over time, people who practice TM report less pain, decreased strain, and more comfort in their face, jaw, neck and head.

As a doctor whose specialty is treating pain I will always have patients who need prescriptions, muscle or joint injections, oral appliances, exercises, rehabilitation and other relaxation strategies. But I now strongly advise all my patients to consider making Transcendental Meditation a part of their daily routine. So far, the feedback from my patients who practice TM is very encouraging.

After a consultation in my office I can refer you to one of the TM centers that I work with; sometimes even enabling you to receive a lowered fee to be trained.

Do you practice TM? Please feel free to share your experience here:

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ, and headaches.

Tags Headaches, TMJ

Headaches TMJ

Migraine Headaches & TMJ: The Connection

For years, patients have come to my office with acute and longstanding TMJ problems and report that they have suffered with migraine headaches as well. These problems have in fact been labeled with the term “comorbid,” representing two or more medical conditions existing simultaneously regardless of their causal relationship.

As a result of these patients’ jaw symptoms, treatments such as oral appliances, jaw exercises, muscle trigger point injections and massage/physical therapy have been routinely used. As a result of varied and unpredictable treatment results particularly among my female patients, several things have become clear:

The patients’ TMJ symptoms often did not respond sufficiently to treatment if the migraine headaches were not under control.
Migraine headaches that are under control by the use of medication can become more problematic when an acute TMJ problem is present.
Patients whose migraine headaches are under control actually reported a further decrease in the frequency, duration and intensity of their migraines once TMJ treatment is started.

Though these are anecdotal observations, a recent article in the Journal of Orofacial Pain provides some insight into these observations. Some important factors to keep in mind are:

Patients who have both TMD and migraines have an increased likelihood that the nerves in their face and jaw will fire excessively even when prompted by normal stimuli, such as talking, opening or closing the jaw, eating food of normal consistency, or when the face is placed on a pillow. As a result, the likely emergence of pain and muscle tension increases.
In women with migraines, inflammation in the TM Joints and jaw muscles can produce higher levels of suffering due to the way pain signals from these structures are interpreted in the brain.
TMD pain could reduce the benefit of medications being used to treat migraine headaches.

As a result of these findings, it is now even more important to merge the evaluation and treatment strategies employed by practitioners that focus their practices on these two patient groups. A collaborative approach that can integrate TMJ treatments inclusive of oral appliances, trigger point injections, jaw/neck exercise, massage, and physical self regulation techniques with migraine therapies such as medication, diet, cognitive behavioral, and sleep strategies employed by our medical colleagues is clearly the way to go.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problems, TMJ, referred pain, nerve pain, and migraines. Find out more at www.nytmj.com.

Tags Dr. Tanenbaum, Migraine Headaches, migraine headaches and TMJ, migraines and TMJ

Woman with severe Migraine Headache holding hands to head

Case Studies Facial Pain Headaches Women & Pain

Headaches & Facial Pain Caused by Emotional Distress

Caring for the Caregiver

Case Study: Joan

Joan was referred to my office due to her daily headaches and facial pain that had continued to get worse despite taking over-the-counter medication on a daily basis and treating herself to a few massage sessions. She had seen her family doctor who had assured her that there was nothing terribly wrong, that the headaches and facial pain were a result of stress, and that she should start exercising more frequently and try to get more sleep.

Joan came to me when she could no longer tolerate the pain. After careful listening and a full examination, it was clear to me that her pain likely had a muscle origin. For Joan, along with countless other people in America and across the globe, her aching facial, jaw, and neck muscles were undoubtedly the result of an ongoing burden that had begun to dominate her life. Joan’s particular burden was that six months prior, her husband had suffered a debilitating stroke and she had become his sole caregiver.

Joan’s world had changed overnight. She was now a full time, worrier, cook, chauffeur, appointment maker, and sole provider of her husband’s physical and emotional needs. Although she took on these responsibilities with love and commitment, it was clear that she had been unprepared for the enormous challenges she faced. As the weeks and months passed, friends and family retreated to their own worlds, and she was left to fill the voids in her husband’s life, knowing that this job came with an unknown future.

As a result of her daily caregiver obligations, Joan’s sleep suffered, her independence all but disappeared and her ability to exercise and stay healthy dwindled to almost nothing. Suddenly her neck ached, headaches emerged, and she found herself gritting her teeth during the day as she tried to maintain patience and deal with the physical effort it required to get her husband showered, dressed, and fed.

Joan’s headaches and facial pain were clearly the result of muscles that were in crisis as a result of a ‘brain under siege’ and muscle fatiguing behaviors (clenching/raised shoulders…) that were prompted by the realization that she was alone and unprepared for an unknown future. The more Joan and I talked, the more I realized that not only was she suffering with pain, but she was lonely and depressed as well.

To help address Joan’s sore and painful jaw, face and neck muscles, I set her up with number of common therapies. These included “physical self regulation techniques” which help patients identify and change the behaviors that they have developed as a result of ongoing life challenges and stressors.

Just becoming aware of when the brows are furrowed, the lips are tense, the shoulders are raised, the jaw muscles are braced, or the teeth are clenched is the first step. I then taught her a number of exercises and breathing techniques that reduce muscle tension and can lead to significant pain relief over time. To complement these self-care efforts, we added medications, muscle injections, oral appliances, and physical therapy.

Though as a result of these efforts Joan felt somewhat better (in spite of the fact that nothing had actually changed in her life), there clearly was more that had to be done to help Joan not fall back into her acute pain state once formal treatment in my office stopped. That is when I introduced her to the Caregivers Survival Network, founded by Adrienne Gruberg.

By joining The Caregiver Survival Network (CSN), she became part of a community of other caregivers eager to interact, share stories and be a source of support. She found a lot of free services geared exclusively to a caregiver’s needs and links to other organizations and websites for caregivers, as well. As a result of taking advantages of the ideas and services shared on the CSN, her feelings of being alone started to dissipate and I feel that Joan is on the mend both physically and emotionally.

If you are in a similar situation, or know someone who is, please direct him or her to http://www.caregiversurvivalnetwork.com/

Tags Caregiver Survival Network, Dr. Tanenbaum, Facial Pain, Headaches, Referred Pain, TMJ Case Study, Women & Pain

Headaches TMJ

Causes of Migraine Headaches: TMJ?

Could TMJ be the Cause of a Migraine Headache?

The answer is: No!

People who suffer from chronic debilitating headaches are often misdiagnosed because doctors sometimes mistake tension headaches (which can be cause by TMJ disorders), for migraine headaches. The reason is that it’s not unusual for people who have TMJ to experience headaches that are as intensely painful as migraines. But TMJ does cause of migraines.

How Does TMJ Cause Tension Headaches?

Tension headaches are the most common form of headaches and can be caused by the constant tension held in the muscles in your face, head, and neck when they remain contracted over a long period of time. The tension that can build in your jaw muscles from a TMJ problem can lead to such powerful headaches that they’re often mistaken for a migraine. In addition, when the muscles in your jaw, face, or neck constrict, they reduce blood flow. As a result, less oxygen and nutrients are delivered to the muscles, which predispose them to fatigue and pain. Also, as the nerves running through the muscles become irritated, lactic acid and other irritating chemicals accumulate. The end result is more intense headache pain symptoms, that can be as intense as a migraine.

A dentist with experience in TMJ and neuromuscular disorders of the jaw can properly diagnose the difference between TMJ and migraines. Some symptoms of TMJ headaches include:

Tightness around the head
Band-like pressure around the temples
Persistent aching in the jaw muscles
Discomfort in the facial muscles
Increased pain with jaw use

Once diagnosed, there are a number of relief options for TMJ-related tension headaches. Treatments include:

Jaw and Neck Exercises
Muscular Injections
Physiotherapy
Medications
Oral Appliances
Simple Relaxation and Sleep Strategies

Before you dismiss the possibility of a disorder in the TMJ (Temporomandibular Joint), be aware of the symptomatic similarities between TMJ and migraines. The difference could mean a lifetime of relief from the pain of tension headaches.

Dr. Donald Tanenbaum has been practicing in New York City and Long Island for over 20 years. He is uniquely qualified to diagnose and treat bruxism, TMJ and TMD problems, Sleep Apnea, facial pain, muscle pain disorders, nerve pain disorders, tension headaches, and snoring. Learn more about Dr. Tanenbaum here.

Tags Causes of Migraine Headaches, Donald Tanenbaum, Migraine Headaches, Migraines, Tension Headaches