New CH.com Forum
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl
Cluster Headache Help and Support >> Cluster Headache Specific >> TMJ and clusters
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1247153671

Message started by Bob Greenwood on Jul 9th, 2009 at 11:34am

Title: TMJ and clusters
Post by Bob Greenwood on Jul 9th, 2009 at 11:34am
I was told this morning by my ear nose and throat doctor I have TMJ. It's on the same side I get my CH's on.
Does anyone else have this? Or does anyone see a connection?

Title: Re: TMJ and clusters
Post by Todd D on Jul 9th, 2009 at 11:42am
Hi Bob,

I also have TMJ.  I also grind my teeth at night and have a night gaurd to help with that.

I can tell when a CH is coming because I feel it in my teeth and jaw.  It's a burning, pressure sensation.  For a while I thought the CH was do to the TMJ, then thought it was my eye's getting weak (needed glasses).

I now think that the CH is the cause, and TMJ is a symptom.  I believe the nerve that gives us the CH pain is the one that relates to the jaw etc.

It'll be interesting to see what others report.

Todd

Title: Re: TMJ and clusters
Post by triprover on Jul 9th, 2009 at 1:23pm
I had TMJ well prior to the CH's.  I agree with Todd on the fact that when I'm about to get hit I can feel it in my jaw.  It's almost like I have a 20 second head start to the O2.  

Title: Re: TMJ and clusters
Post by Bob_Johnson on Jul 9th, 2009 at 1:26pm
A great deal of time & $ has been expended exploring this link and the results are almost zero. I did a search in the medical literature and found only this one report; all others were 10 or more years old. Which says, virtually no attention being given to this relationship by medical pros which suggests they don't see a relationship to explore.
======
Cephalalgia. 2009 Apr 30.
Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic.

Kang JK, Ryu JW, Choi JH, Merrill RL, Kim ST.

Department of Oral Medicine and Orofacial Pain, College of Dentistry, Wonkwang University, Iksan, Korea.

Kang J-K, Ryu J-W, Choi J-H, Merrill RL & Kim ST. Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic. Cephalalgia 2009. London. ISSN 0333-1024The aim of this study was to identify and diagnose headache in a temporomandibular joint and orofacial pain clinic population using the second edition of The International Classification of Headache Disorder criteria. IN 502 TEMPOROMANDIBULAR DISORDER AND OROFACIAL PAIN PATIENTS, 246 PATIENTS (49%) WERE DIAGNOSED WITH TENSION-TYPE HEADACHE (TTH), FOLLOWED BY MIGRAINE WITHOUT AURA (14.5%), PROBABLE MIGRAINE (12.9%), MIGRAINE WITH AURA (7%), PROBABLE TTH (4.8%) AND CLUSTER HEADACHE (0.2%).

(edited for length)
PMID: 19438924

Title: Re: TMJ and clusters
Post by monty on Jul 9th, 2009 at 4:20pm

Bob Johnson wrote on Jul 9th, 2009 at 1:26pm:
A great deal of time & $ has been expended exploring this link and the results are almost zero. I did a search in the medical literature and found only this one report; all others were 10 or more years old. Which says, virtually no attention being given to this relationship by medical pros which suggests they don't see a relationship to explore.


I disagree with those conclusions. The trigeminal nerve sends signals out to the jaw, and gets them back for processing. Anything that keeps the trigeminal chronically activated could feed into clusters ... TMJ, sinus infections, injury to the nose or areas around the trigeminal ... it can all cause 'peripheral sensitization' that makes the trigeminal nerve frazzled and more likely to scream or spasm.

How do nerve blocks work? They dampen down peripheral activity. The most effective nerve block is probably the sphenopalatine ganglion, which transmits impulses between the jaw/sinuses and the trigeminal.  

Also, there was recent work on myofascial trigger points, which found that clusterheads tend to have more active trigger points, and that deactivating these can reduce the pain. Most commonly, TMJ involves trigger points, which lock up muscles (and which can refer pain to areas outside of the actual affected muscles, and cause hypersensitivity of nearby nerves).


Quote:
Head Face Med. 2008 Dec 30;4:32.

   Myofascial trigger points in cluster headache patients: a case series.
   Calandre EP, Hidalgo J, Garcia-Leiva JM, Rico-Villademoros F, Delgado-Rodriguez A.

   Institute of Neuroscience, University of Granada, Granada, Spain.

   Active myofascial trigger points (MTrPs) have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs) provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3%) and in 6 (85.7%) of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

   PMID: 19116034 [PubMed - indexed for MEDLINE]


In this case, they used injections of lidocaine or similar to deactivate the trigger points, but it can be a Do-It-Yourself project with various massage techniques that are specific, but not difficult to learn.

New CH.com Forum » Powered by YaBB 2.4!
YaBB © 2000-2009. All Rights Reserved.