TMJ and “The Prevalence of Neck Pain in Migraine.” Neck Pain More Frequent Than Nauseau in Migraine

A new article from Headache Jan 20, 2010 from the Carolina Headache Institute (see Pub Med abstract below) on the presence of neck pain in migraine showed that neck pain was more common than naseau. This is consistent with migraines being a trigeminal nerve disorder and/or a TMJ disorder. While nauseau is not related to muscle pain , neck pain is almost always muscular in orgin and related to myalgia and/or myosits . Neck pain is highly affected by TMJ disorders (often called the Great Imposter) and patients with both neck pain and headache are usually easier to treat than patients with just head pain.

The study reported that the “Prevalence of neck pain correlated with chronicity of headache as attacks moved from episodic to chronic daily headache.” This is also evidence that these “mograones” are actually headaches of musculoskeletal and trigeminal orgin. Therefore neuromuscular treatment (as described in Cranio by Dr Barry Cooper) has an excellent chance of being “overwhelmingly successful” at relieving these headaches. See

It is also reported that when neck pain was present they were more likely to become Chronic Daily Headaches.

Dentists treating TMJ disorders with Neuromuscular Dentistry have always used low frequency TENS to pulse the Trigeminally innervated muscles. The new protocol being taught at LVI and frequently discussed at ICCMO meetings involves adding additional electrodes to pulse the Accessory ( Cranial nerve XI) Nerve to relax neck muscles that are intimately related to jaw function, head and jaw posture.

It is well known that many if not all headaches have a muscular component and are frequently referred from neck and jaw muscles.

The article discusses neck pain as an aspect of migraine which is another step of convergence of migraine and TMJ disorders. Neck pain has not traditionally been considered a diagnostic feature of Migraine though it has always been considered consistent with TMJ disorders (TMD) and Tension Headaches. Patients looking for an alternative treatment for chronic daily headaches, ETTH and migraines should be evaluated by a Neuromuscular Dentist and fitted with a diagnostic orthotic. The success rate of intra-oral neuromuscular orthotics is extremely high in reducing and eliminating headaches without excessive use of drugs.

Dr Shapira practices Dental Sleep Medicine and Neuromuscular Dentistry as part of a comprehensive general dental practice in Gurnee, Chicago, Skokie, Vernon Hills and treats patients with difficult Sleep, Headache, Migraine and TMJ disorders that have not responded to other treatment He sees patients from Illinois and Wisconsin as well as long distance patients. Patients traveling from distances can make arrangements for discounted hotels thru Delany Dental Care LTD. 1-800-TM-Joint

PubMed abstract
Headache. 2010 Jan 20. [Epub ahead of print]
The Prevalence of Neck Pain in Migraine.
Calhoun AH, Ford S, Millen C, Finkel AG, Truong Y, Nie Y.

From the Carolina Headache Institute, Chapel Hill, NC, USA (A.H. Calhoun, S. Ford, and A.G. Finkel); University of North Carolina, Department of Psychiatry, Chapel Hill, NC, USA (A.H. Calhoun, S. Ford, and A.G. Finkel); University of North Carolina, Department of Physical Medicine and Rehabilitation, Chapel Hill, NC, USA (S. Ford); Blue Sky Neurology, Denver, CO, USA (C. Millen); University of North Carolina, Department of Biostatistics, Chapel Hill, NC, USA (Y. Truong and Y. Nie).
(Headache 2010;**:**-**) Objective.- To determine the prevalence of neck pain at the time of migraine treatment relative to the prevalence of nausea, a defining associated symptom of migraine. Methods.- This is a prospective, observational cross-sectional study of 113 migraineurs, ranging in attack frequency from episodic to chronic migraine. Subjects were examined by headache medicine specialists to confirm the diagnosis of migraine and exclude both cervicogenic headache and fibromyalgia. Details of all migraines were recorded over the course of at least 1 month and until 6 qualifying migraines had been treated. For each attack, subjects recorded the presence or absence of nausea as well as the intensity of headache and neck pain (graded as none, mild, moderate, or severe). Results.- Subjects recorded 2411 headache days, 786 of which were migraines. The majority of migraines were treated in the moderate pain stage. Regardless of the intensity of headache pain at time of treatment, neck pain was a more frequent accompaniment of migraine than was nausea (P < .0001). Prevalence of neck pain correlated with chronicity of headache as attacks moved from episodic to chronic daily headache. Conclusions.- In this representative cross-section of migraineurs, neck pain was more commonly associated with migraine than was nausea, a defining characteristic of the disorder. Awareness of neck pain as a common associated feature of migraine may improve diagnostic accuracy and have a beneficial impact on time to treatment. PMID: 20100298 [PubMed - as supplied by publisher]