TMJ and Migraines: New article supports concept of migraine developing from Musculoskeletal causes

Dr. Shapira Blog, Chicago 0 Comments

A recent article in Cephalgia (PubMed abstract below) clearly explains how there is a reciprical (two way) relationship between TMJ disorders, Musculoskeetal Disorders and Migraine.

In the conclusions the article states: “These dysfunctions support a reciprocal interaction between the trigeminal and the cervical systems as a trait symptom in migraine.”

While TMJ disorders (TMD) are not specifically listed the musculoskeletal disorders would specifically include those structures related to the Trigeminal Nervous System especially the TrigeminoCervical Complex.

The Trigeminal Nerve is known to be involved in all headaches and migraines. The Trigeminal Nerve is also known as the Dentist’s Nerve. It innervates the Teeth (pulp) the periodontal ligaments, the upper and lower jaws, the Temoromandibular Joints, the jaw muscles, the Tensor Tympani that tenses the ear drum, the Tensor Veli Palatini that open and closes the eustacian tubes, the lining of the sinuses and the nose, the innervation to the anterior two thirds of the tongue, the lower eyelid and tear glands via Sphenopalatine Ganglion. After amolification in the Reticular Activating System it accounts for over 50% of all input to the brain including the majority of proprioceptive input. There are major connections to the Autonomic Nervous System, Sympathetic and Parasympathetic syystem.

 

Cephalalgia. 2017 Jan 1:333102417716934. doi: 10.1177/0333102417716934.
[Epub ahead of print] Musculoskeletal dysfunction in migraine patients.

Luedtke K1, Starke W1, May A1.

Objective The aim of this project was to evaluate the prevalence and pattern of musculoskeletal dysfunctions in migraine patients using a rigorous methodological approach and validating an international consensus cluster of headache assessment tests. Methods A physiotherapist, blinded towards the diagnosis, examined 138 migraine patients (frequent episodic and chronic), recruited at a specialised headache clinic, and 73 age and gender matched healthy controls following a standardised protocol. Eleven tests, previously identified in an international consensus procedure, were used to evaluate cervical and thoracic musculoskeletal dysfunctions. Results Primary analyses indicated statistically significant differences across groups for the total number of trigger points, flexion-rotation test, thoracic screening, manual joint testing of the upper cervical spine, cranio-cervical flexion test, and reproduction and resolution. Ninety three percent of the assessed patients had at least three musculoskeletal dysfunctions. Post-hoc tests showed significant differences between episodic or chronic migraine patients and healthy controls, but not between migraine groups.

Conclusions A standardized set of six physical examination tests showed a high prevalence of musculoskeletal dysfunctions in migraine patients. These dysfunctions support a reciprocal interaction between the trigeminal and the cervical systems as a trait symptom in migraine.

Migraine; cervical; joint dysfunction; musculoskeletal; trigger points
PMID: 28641450 DOI: 10.1177/0333102417716934

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