Headaches caused by temporomandibular joint disorders

The temporomandibular joint is where the lower jaw meets the skull, right in front of the ears. The cause of disorders of the temporomandibular joint is not clear, but the symptoms are thought to arise from either stress or problems with the muscles of the jaw or with the parts of the joint itself.

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Possible causes include:

• Injury
• Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth
• Grinding the teeth, which puts pressure on the TMJ
• Presence of osteoarthritis or rheumatoid arthritis in the TMJ

The pain from TMJ disorders is usually dull and aching, occurring just below the ear on one or both sides of the face. The pain is usually localized but may expand to the temple, toward the middle of the face, or across the top and front of the skull. The pain is often aggravated by chewing. Patients frequently describe a clicking and locking of their jaw, and an examination may indicate tenderness over the jaw and joint slipping upon opening and closing the mouth. In addition, patients often cannot open their mouths widely.

Treatment for TMJ disorder usually begins with some combination of anti-inflammatory drugs, muscle relaxants, mouth splints, biofeedback, and counseling.