Read through our Migraine Frequently Asked Questions below to see if your concerns and symptoms are addressed. If you have a unique question, please use our Ask The Doctor form to send an email question directly to Dr. Halmaghi.
Too many different doctors:
“I’m an 18 year old female, and in good health other than I’ve had a headache non-stop, 24/7, for the past 2 years. I’ve been to multiple neurologists, headache specialists, had MRIs taken, acupuncture, self-hypnosis, and been on almost 30 different medications. Nothing helps. No one can tell me what’s wrong…they say it’s one thing, and then when they can’t fix me they ship me off to another doctor. The general consensus is that I have “tension headaches that don’t respond to treatment.” I’ve gone to a local TMJ specialist a couple times in the past few months, but…it’s not any better. He gave me naproxen, and some anesthetic injections. It’s difficult for me to find a single place on my head that doesn’t hurt. I also hear a quiet buzzing sound in that ear. Can you tell me anything that makes sense out of any of this?”
You make sense, unfortunately your doctors do not. You are no different than the other 20+ million sufferers in our country who continue to suffer needlessly from a condition that can be easily cured. Your doctors cannot provide a diagnosis or a cure for you because they have not studied the latest treatments that work. Don’t blame them…most medical schools have not even heard of cranial decompression treatments. Most dental schools are still trying to figure out how to start teaching these concepts. Too many dentists are attempting to treat these conditions, unfortunately they fall way short! Head pain treatment requires an immense amount of knowledge and experience, however your problem is most likely quite simple to fix once you get the right diagnosis and treatment. Many people and doctors are very skeptical about the relationship between jaw dysfunction and head pain (i.e. migraines, headaches, ear pain, tinnitus, etc.) How can the jaws cause migraines? How can jaw dysfunction cause neck pain, ear aches, headaches, ringing in the ears, and so many other facial and head pain issues? There is one thing that is clear and certain: jaw dysfunction/misalignment is usually the one and only reason behind your pain! So, even if you have been suffering with migraines for over 20 years, you will be happy to know that the future of headache treatment is here now and we can cure your problem…with guaranteed results! No ands, ifs, or buts about it. The future is here now!
Jaw Popping Noise?
“I have severe migraines. Whenever I open my jaw there is a popping noise on both sides, just below my ear lobes. I read somewhere that this has something to do with the jaw not being aligned properly. Is this critical to be corrected? What will happen if left untreated? What is the treatment? Is it common? What causes it? Does it have anything to do with having teeth pulled?”
You have a dislocation of your joints most likely caused by a poor alignment of your jaws and teeth. There are numerous causes, everything from genetics to trauma or grinding of your teeth. Missing teeth is another big reason for this imbalance. You need to have transcranial x-rays or tomogram x-rays, followed by a MRI (performed in the open and closed positions with heavy biting pressure on your back teeth). Most likely your lower jaw is biting too far back with poor support of your back teeth. Compression of the joint happens due to lack of good posterior tooth support. That’s why you have migraines!!! Once you find out the extent of damage it is easy to come up with a treatment. You’re lucky to actually hear the noises in your joints. Most chronic sufferers usually have no joint noises, but always exhibit a damaged jaw joint. That is why so many doctors fail to diagnose TMJ problems. They think that if the joint makes no sounds, there is no problem. Unfortunately, the truth is the opposite…the less noises (accompanied with head pain), the more the damage to the joint that is normally apparent. The jaw joint is a very complex part of your body. With proper treatment we can actually help to regrow connective tissue inside the joint area and provide normal healing. This type of treatment is one of the marvels of modern dentistry. We have had orthopedic surgeons inquire about how we are able to physically repair the joint. The answer is simple: we have the advantage of being able to use the teeth as soldiers in the repair process. The are no other joints in the human body that have this advantage!
Neck and Back Pain?
“I have been experiencing a stiff neck and some back pain for some time now. I went to the Dr. for back pain and he did a x-ray and ended up doing a MRI. It all came back okay. My pain is worse and the neck is getting more stiff and spreading into my shoulder. Most recently I have had pulses of pain on my lower jaw from an apparent tooth problem. I’m wondering if this can be an abscessed tooth that is causing me to feel bad and to have the stiff neck and back pain.”
Doubtful that an abscess can cause such problems. If it was an infection, your face and throat would be quite swollen and the diagnosis could be made easily by any dentist. Most likely, you have the side effects of CMD (Craniomandibular) problems related to TMJ. One of the biggest misdiagnoses that we see today happens with patients who present with “ghost” pains. Many patients complain of tooth aches that have nothing to do with their teeth. It feels like a tooth is hurting, yet nothing shows on the x-ray or examination. Unfortunately, these patients end up receiving numerous procedures that are unnecessary. We have seen some patients get over 20 root canals and multiple extractions for no obvious reasons other than the fact that the dentist could not properly diagnose a CMD/TMJ problem. If you cannot receive an accurate and concise diagnosis for your problem, don’t get any dental procedure performed until you are certain that the diagnosis is correct. Instead, consider that the problem is more neurologic or muscular in nature.
Orthodontics causing pain?
“I have been diagnosed with TMJ. I am wondering if having braces put back on will help. I wore braces for almost three years when I was a freshman in high-school, but my orthodontist took them off early because (he was trying to be nice) he figured it was good. I only wore rubberbands for a month and I needed to have worn them for at least 4. What should I do? I would really like to have my braces put back on not only to fix the TMJ but to also make my teeth a little straighter and my bite look better.”
A lot of TMJ problems are actually caused by braces, due to the fact that the wires can cause your teeth tend to shift backwards thereby straining the TMJoint. Some studies indicate that over 50% of patients who undergo orthodontic treatment end up with headaches, migraines, and jaw problems. Before you begin any new Orthodontic treatment you must get Transcranial or Tomographic X-rays to properly evaluate the position of your joints. These x-rays will also help as a blueprint towards establishing harmony between teeth, muscles, nerves, and joints. Do not undertake any treatment that plans on shifting your front teeth backwards without paying attention to the position of the jaw joint. If you have “bucky beaver teeth” slow down and make sure you are on the correct treatment path. Your bite will most likely need to be “raised” and your front teeth will need some “freedom” for chewing. Sit down with your orthodontist and discuss these things carefully. A Sassouni Plus drawing and evaluation is always a starting point for such treatment. If your dentist or orthodontist cannot perform this x-ray computerized analysis, run!
Bad Jaw Alignment but no Bite problems?
“I am only 22. I had braces for three years (3rd through 6th grade) and I was in a few very bad car accidents. During my sophomore year of college I noticed my jaw hurt began hurting considerably….popping, locking (open and closed, etc.) Local dentist told me I had TMJ, and made me a stint to sit on my lower teeth. I wore it for two years, didn’t help, visited a chiropractor for a year, helped some, not much. Another dentist told me that the only teeth that were hitting were my back two molars and they were very cracked. My jaw was very much out of alignment, so he filed my back two teeth down. The only teeth that don’t touch now are the eight teeth up front. My concern is that since I have no normal overbite or underbite (my front teeth practically sit on top of one another) well, how do I fix this, or is it unfixable, and is that what makes my TMJ symptoms worse? How can I set my teeth to where they are supposed to be?”
You have just about every possible problem that a head pain sufferer has experienced – jaw misalignment, congenital problems, and trauma. I would venture to say that your orthodontics was improperly performed. Your treatment solution will most likely include braces, root canals, crowns, gum treatment, etc. You may not be able to solve your situation with braces, alone. An orthodontic evaluation must be done by using Transcranial or Tomographic X-rays to properly evaluate the position of your joints as well as a Sassouni Plus Computer Tracings of a Lateral Cephalogram X-ray. These tests are necessary in order to tell why your jaws do not align properly. It may be a lack of proper growth of your top jaw (maxilla) or improper development of your lower jaw (mandible) or a combination of both. If you do not properly diagnose your condition, you cannot receive adequate treatment. It does not matter whether you have an overbite, underbite, crossbite, or not bite at all. What matters is how your teeth and jaws work together and where your jaw joints ends up when you function. You also need to check your neck for possible damage from your car accident. An MRI is critical to find out if you have any slipped discs or verterbral damage. Neck dysfunction can exacerbate your problem and make treatment much harder to accomplish. The neck and the jaws work closely together to accomplish the basic functions of your head. One cannot function properly without the other.
“I suffered tmj from whiplash for about four months. When I put my finger next to my ear and I open and close my mouth I feel a bump coming and going. It feels dislocated. I open my mouth and I have a bump that is hard sticking out of my skin next to my ear. Its been 4 months. It constantly gets worse. What should I have done and what is the bump? Is it dislocated? What treatment is best?”
My first concern with any bumps is to have them evaluated and make sure that your jaws are not broken. Only x-rays can show this. An oral surgeon should evaluate you for this problem. On a lighter note, the bump you feel may just be the top part of your jaw bone (head of the condyle.) You feel this part because it moves freely. The jaw functions in different angles. It rotates, it slides, it moves side to side, and front to back. It is the most complex joint in the human body. It also is responsible for being intimately associated with over 25% of the nerves of your body and over 40% of the nerves of your head. Any problems with the joint itself can have far reaching effects on your total health. If you were diagnosed with whiplash, which normally occurs in accidents even as low impact as 9 mph, you must be careful to protect your joint from future damage. Sometimes a small tear shows no signs of pain or problems for many months, even years. We see many car accident victims years after the trauma. At first, nothing is found. However, as time progresses the joint can wear down as a result of even minor damage.
My Oral Surgeon says TMJ doesn’t cause headaches:
“A year ago I was diagnosed with TMJ after being treated for everything from a sinus infection to an ear infection. With the TMJ I have horrible headaches that sometimes will not allow me to perform my job. I have been to an oral surgeon, and he removed all of my wisdom teeth and we waited to see if the problem got better, it didn’t, actually it feels as if it got worse. This particular doctor told me that TMJ does not cause headaches and that I should see someone about braces to solve my problem. It seems like I am running around in circles trying to get the proper care. I have been suffering from this for at least a year now.”
Your surgeon is 100% WRONG! He doesn’t know what he’s talking about and it makes me terribly upset to see this. 99% of all headaches, including undiagnosed migraines, are caused by the TMJ. Taking out wisdom teeth is a common practice performed by many dentists who think it will solve TMJ problems. Unfortunately, unless the wisdom teeth are causing serious bite problems, this type of treatment is just simply being performed due to a lack of knowledge! You may need braces, once you get the right diagnosis. Once you get the correct treatment, your problems will be solved.
Ear – Sinus Problems and Head – Arm pain:
“For the past two months I have been to the doctor 5 times. I thought I had ear and sinus infections. But none of the medicine seems to help. I recently started to notice that my jaw is extremely sore. Someone told me it is possibly TMJ, because I clench my teeth very bad at night. I also noticed that my neck and arms were very sore too. I felt like I couldn’t extend my arms all the way out. Would this be a result of TMJ? Before I knew about TMJ I scheduled an appointment to go see an ENT because I thought I had bad ear problems. But I have come to the conclusion that I probably have TMJ (because all the symptoms I have fall into TMJ).”
You do need to see the ENT. You must be certain that nothing more serious is going on (i.e. cancer, cysts, etc.). I have seen problems like this that are indeed related to an infection in the ear. Most of your symptoms DO point to an advance neuromuscular problem, most likely associated with your neck and jaw muscles. You must treat both areas in order to improve. You will need a TMJ expert as well as a physical medicine specialist to guide your treatment. A good ENT specialist should coordinate these doctors for you!
Eye Pain Concerns?
“About four months ago I happened to be reading and all of a sudden I developed this pain in my left eye, like a dull ache. The same goes for my left ear. For a few days it felt sore. I had my sinuses x-rayed and a series of blood work, had my eyes examined by the eye doctor. All the results came back negative. Also I felt this pain on left side on top of my head a numbness. It feels like something is pushing into my eye. Could it be my wisdom teeth? I know I have still two I haven’t had removed. Also the pain is felt more when I move my jaw.”
Your wisdom teeth and your eyes are two counties away from each other. Only serious cysts or infections in the wisdom tooth area could cause such visual disturbances. I doubt it’s your wisdom teeth, but have them evaluated by an oral surgeon nevertheless. What you are describing are typical symptoms of jaw joint compression problems. The same nerve that feeds sensation to your eyes goes to your sinuses, teeth, jaws, tongue, gums, etc. Read more about the trigeminal nerve and its huge effects on head pain! New studies are currently showing that the trigeminal nerve controls not only the function of the jaws, teeth, gums, tongue, sinuses, eyes, etc. but also directly controls the blood flow of the arteries within the brain itself. Furthermore, studies show that your brain spends over 50% of its energy trying to process input from this nerve alone. Now you know why a phantom tooth ache and your fifth pair of glasses remain undiagnosed by your doctor.
TMJ causing Nausea?
“I am 22 years old. I just recently went to the ER for severe headaches, pain in the jaw area and for being nauseous. My doctor told me that I have TMJ and gave me medicine for it that is not helping. What I was wondering was if my being nauseous all of the time and literally getting sick could be caused by this TMJ??? I have been this way ever since I visited the emergency room 2 weeks ago!! Please help me with any information that you can. It would be greatly appreciated!”
Hurray for your doctor! Stop by and buy him some lunch for being intelligent and ahead of his time! Your headaches are causing your vagus nerve to go into dysfunction. Many of the nerves from your jaws, tongue, throat, neck , ears, etc. meet together at an area called the medullary dorsal horn (in the brain stem). Such powerful nerves as the trigeminal, facial, hypoglossal, accessory, and vagus are interconnected in this area of the brain stem. That is why so many unexplained symptoms happen with patients suffering from headaches and facial/head pain: burning tongue, fired-up throat, “ghost” tooth pain, vomiting, rushing heart rates, flushing of the face/neck, congested sinuses, dizzinness, ringing in the ears, etc. Even if one of these nerves are compressed all of the above nerves can be thrown off track and start producing irrational changes in your head and neck areas.
Hissing Ear Noises?
“I had suffered from extreme ear aches, pressure and jaw clicking for over a year until my doctor had diagnosed me with TMJ. I went to an orthodontist and decided to have braces put on. During this time I would have jaw pain and “noises”. I described it to my dentist as if my jaw was making a sliding noise. He listened to my jaw with some device and told me that if it continued that we may have to take the braces off. Anyway I continue to wear braces for 3 years. Everything seemed to be fine until March 1st. I woke up feeling a little “brain fog” and had this pulsating or hissing noise in my right ear only. It was not a constant noise just if I bent over or moved my neck in a certain direction. I went to the doctors and he said he said that my ear was retracted and that was caused by TMJ. Anyway, I have been dealing with this for the past 10 months and was wondering if you have any suggestions. I have tried Zyrtec and Allegra D which did help a little.”
My suggestion is probably that your orthodontics was done incorrectly. TMJ problems must be solved with functional orthodontics and careful monitoring through Transcranial or Tomogram X-rays. If your orthodontist did not do this for you, it may be necessary to get into a new treatment program with someone that understands these difficult problems. Your TMJ pain and symptoms should have been cured long ago if the orthodontics was done properly.
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