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.
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TMJ and clusters (Read 757 times)
