Headache & Migraine Pain – Self Diagnostic Check list
We encourage you to read through the information on our Migraines Explained page before reviewing this checklist:
Head pain and more serious migraines are not hard to diagnose. Once you find out where your imbalance is, the cure is often quite simple. Although this website cannot cover every possible diagnosis, there are some generalized 'issues' that are common in most head pain sufferers. If you may have one or more of any of the below problems you may be predisposed to head imbalance patterns that are causing your headaches, migraines, jaw pain, neck, and ear pain.
Normal function of the jaws and the head depend on a stable occlusion (how the jaws and teeth bite together and align with your skull) and the posture of your neck. If this balance is destroyed or genetically deficient, you can develop many symptoms. All treatment is geared toward relieving the pressure caused by the instability/imbalance and providing a proper functional relationship for the jaws, head, and neck.
Sometimes it’s possible to perform self-diagnosis in order to explain why you have headache or migraine pain and find ways to alleviate symptoms or even cure them all together. The following information will provide some identifying characteristics for people who suffer from migraine pain.
Do You Have…
1. No signs of any neck, TMJ damage, or jaw imbalance problems?
Let’s start with a scenario where a patient is having absolutely no jaw, muscular, TMJ, or neck pain whatsoever. These patients visit their dentist, physician, and many other specialists who cannot detect any abnormality with their alignment, jaws, or TMJs. The problem is often due to the fact that the jaw joint exhibits no noises or signs of pain. This is very common with chronic pain patients, especially migraine sufferers. These patients are often found to have joints that have slowly 'plasticized' over time due to long-term damage. The protective disk slowly resorbed, over time, with no apparent signs of pain or problems. The joint itself adapted to the dysfunction by smoothing out the skull bone and the head of the lower jaw (the condyle). The 'hyalinized' bone (smoothed bone) makes no noise or causes no pain within the joint itself because it has polished itself in an effort to protect the area. The problem, however, comes with time as the surrounding tissues, muscles, nerves, blood vessels, and brain sense the dysfunction and start to cause head pain. This is the most commonly misdiagnosed and missed problem in today’s headache war.
2. Do you grind or clench your teeth?
This is one of the most common and widespread problems affecting a large segment of the population. Tension headaches are often the result of this problem and migraines may not begin for a long time. As the teeth wear down from continuous grinding and/or clenching, so do the joints. Worn teeth lose their ability to support the proper jaw to jaw balance and the jaw joints (TMJs) become the primary braking mechanism of the jaws. Keep in mind that your teeth act like the front brakes on your car while the jaw joint acts as the rear brakes. If you wear down the front brakes then the rear brakes will quickly wear out also. The cartilage inside the TMJs can wear away and the condyle (head of the lower jaw) will start to cause pressure to the brain, ears, nerves, and arteries…because there is no brake pad to protect the joint. Migraines begin when there is over 60% damage of the cartilage in the jaw joints. Only CT scans or MRIs can determine whether you have damage to the jaw joints.
3. Undiagnosed tooth pain or unpleasant dental experience?
We see a large number of patients who experience toothaches that are in fact not tooth related. This is called 'ghost toothaches.' Often, these patients receive root canals or extractions in vain. The problem persists or gets worse. The underlying issue is neurologic and not tooth borne. Proper diagnosis requires skill and experience.
4. Chronic neck and shoulder pain?
The jaws and your neck/shoulder work in tandem. If one is out of alignment, the other cannot be balanced. Proper treatment can only be accomplished by taking into consideration all working parts. Physical therapy and chiropractic may work temporarily to relieve neck pain, but they will not provide any long term healing without functional jaw treatment. You must find specialists that can help with your jaw function and your neck dysfunction.
5. History of accidents or trauma?
Whiplash or trauma can cause neck and jaw dysfunction (particularly sprain or strain of the TMJ.) Often, the symptoms are not felt for months or years. Proper diagnostic tests must be performed in order to determine the extent of any injury. Treatment must be done with close cooperation with physical medicine specialists. CT Scans and MRIs are required post-trauma and many months after the incident as well. Damage to cartilage can take time to develop. Trauma can cause Traumatic Brain Injury (TBI) which exacerbates clenching and bruxism and can lead to migraines, headaches, facial pain, jaw pain, dizziness, vertigo, ear pain, and tinnitus. Effective treatment must be implemented immediately after the trauma.
6. An overbite?
The most common of all problems is an overbite. The probability and severity of migraines, headaches, jaw pain, and ear pain in patients that have overbites is over 70%! The teeth simply cannot hold the jaws in the proper position and pain sets in slowly since early childhood. An overbite is easy to diagnose by noticing that your lower teeth fit too far underneath your top teeth. This may be only slightly discernible, while in some patients it is so obvious that the lower teeth disappear behind the upper teeth when they bite down all the way. The problem with this relationship is that the muscles that connect the lower jaw to the skull bone overpower the lower jaw, causing it to compress the joint, skull bone, and brain tissue.
A small lower jaw can also be a sign that the sutures (growth plates of your skull) have not developed properly and may be calcified, thereby causing a generalized 'tightening' of all of the bony plates of your head. This leads to a skull bone that is non-resilient and very rigid. Healthy skull bones have flexible suture lines that allow for an overall elastic function of the skull, just the way springs and shock absorbers allow your car to go over bumps. Calcified plates indicate a struggle of the skull to maintain proper function. Think about your car working without coil springs and shock absorbers! This is what happens with many overbite patients and chronic pain sufferers. They become wheelbarrows.
Correcting overbites can be effectively done using Functional Orthodontics, including Invisalign, to correct the imbalance and provide more support to the TMJs. Complete and permanent reduction of all migraine symptoms is achieved with such treatment.
7. Normal looking bite?
A normal looking bite is NOT always so normal. Your front teeth may look perfect, but a shrinking effect is noted as you look towards the back teeth. This is coupled with a cross bite that leads to loss of support and compression to the arteries of the face, head, and brain. How your back teeth stabilize the position of the jaws is one of the most important determining factors. Worn and unstable bites can often look normal. Only a trained eye and full diagnostics can help to determine where the pain comes from.
8. An uneven bite or underbite?
An uneven bite can be a nightmare. Such bites can cause the brain to think that it needs to send signals to the muscles to clench and grind the teeth down in order to get the back teeth to touch together. This is a very pathologic problem that leads to pain.
Class II Underbite (big lower jaw) also causes jaw muscle irregularities. The lower jaw becomes too powerful for the joint. The upper jaw is not strong enough to 'house' and support the lower jaw. Many underbites can be corrected with conservative orthodontic treatment including Invisalign.
9. Serious tooth misalignment?
An underbite with one sided crossbite is a serious misalignment. Most of the pain will be on the left side, resulting in left sided migraines and ocular (eye) pain! There are no such things as hemiplegic or ocular migraines. It is the compression and damage done to this side of the jaw joints that causes the migraine and eye problems to be experienced on this side.
10. Slanted bite?
Slanted teeth coupled with ocular migraines, pain, and inability to open the mouth.
This is an easy one! Dentures cannot support your jaws. They are plastic, inefficient excuses for the loss of your teeth. Most denture wearers eventually reach a stage of dysfunction that is hard to repair. Your jaws may no longer have any support left since you lost your natural teeth and your dentures are no more than a set of band-aids. Denture wearers are predisposed to wearing down their joints because it is practically impossible to support the jaws in the right position. Dentures are not stable enough to provide adequate jaw to jaw relationships. This leads to dysfunction within the jaw joint, over time. Furthermore, the jaw bones shrink with age and continuous pressure from the dentures. As the jaws shrink, the dentures become 'looser' and more unstable. Many denture wearers reach the point where they can no longer wear their artificial teeth due to the bone loss factor. The only solution for your problem is to place implants in your jaws and find proper stabilization of your dentures, thereby improving the stability and function of your jaw joints. You will need a team of skilled dentists and oral surgeons!
12. Missing teeth?
Loss of teeth causes loss of jaw support. This eventually puts unusual stress on the jaw joint, nerves, and blood vessels of the brain. Reconstructive methods, including implants, must be used to bring back balance to the jaws and head.
13. History of reconstructive dental work?
Changing the size and shape of teeth can make them pretty, but can also cause unusual bite circumstances. When cosmetic dental work on multiple teeth is performed there could be consequences of bite problems or changes. This can lead to headache and migraine pain problems!
14. History of braces?
Braces are used to correct a genetic defect. Although most treatments can have successful cosmetic results such treatment can also make major changes to your bite and the position of your jaws. Functional orthodontics is often used to treat head pain problems. At the same time, orthodontics can cause head pain problems.
Orthodontic care straightens teeth, but the majority of orthodontic care does not address the jaw to jaw relationship or the jaw joint function. If your teeth are straight but the jaw to jaw relationship is not corrected properly, then you can develop slow lingering problems with the jaw joints.
Some studies show that 50% of patients that complete orthodontic treatment end up having jaw dysfunction and eventual head pain problems.
This is especially true for patients who have received premolar extractions. Taking out these teeth causes the jaws to shrink, consequently constricting the jaw function and compressing the jaw joints. Many migraine sufferers have received this type of care. Even if your teeth look perfectly straight, it does not mean that your jaws align properly. Many of the patients that we see look like they have Hollywood teeth. Unfortunately, what the orthodontics accomplished and what genetics gave you may not be in harmony. Don’t let a perfect smile or a perfect bite fool you!
Additional Factors to Consider for Headache & Migraine Pain
15. Do you get frequent sinus infections and sore throats?
If you have exhausted the medications prescribed by your ENT doctor then maybe the true cause is a jaw problem. Even if you don’t have headaches or other symptoms, jaw imbalance problems can lead to sinus issues. The muscles of the jaws attach directly to the sinuses.
16. Do you have a hard time getting numb for dental procedures?
Whether for dental procedures or experiencing unusual complications after dental work, the problem may not be your dentist, but pinched nerves either in the jaw joint or between tight muscles. Forget about being comfortable and numb during dental procedures, until you treat the underlying muscle and nerve problems!
17. Do you feel tired during the day?
Sleep Apnea may be a cause of your headache or migraine pain. Many pain patients require a sleep study. If you’re having fatigue problems you need to get to the root of the problem and find out if you have a constricted airway (snoring, breathing difficulty, asthma, sleep apnea, etc.) or a pain induced narcolepsy. Sleep apnea can be a major contributing factor behind many pain issues discussed here. Additionally, many health issues can be directly attributed to Sleep Apnea.
18. Have you been diagnosed with depression?
It does not take a long time for chronic pain patients to develop psychological or even psychiatric problems. Learning to deal with the pain may be more than the human body can tolerate. Remember: the trigeminal nerve accounts for over 50% of your brain’s processing. The jaw joint houses over 25% of all of your body’s nerve impulses and over 40% of the nervous impulses of your head. The trigeminal nerve is fully responsible for the regulation of blood flow of your brain’s own blood vessels. Compress this nerve alone and you have some serious repercussions. Include a few more of the nerves associated with the jaws and you can have some debilitating effects. It’s not in your head! It is in your jaws! Again, many people have no joint noises or pain within the TMJ. Why are there so many unexplainable symptoms, ranging from depression to chronic pain if nobody can find anything wrong? The answer is quite simple: the skull bone has only 1/16th of an inch of protective bone covering the jaw joint. Yes, there is very little bone keeping the condyle (head of the lower jaw) from entering the brain tissue. As the joint becomes dysfunctional (with or without pain), the brain starts to sense the frequent pounding/beating in this area, since there is inadequate bone protection. As the joint loses most of its protective barrier and the brain becomes exposed to the constant beating of the lower jaw, pain worsens! Unfortunately, nobody can get to the root of the problem because the symptoms and signs of the dysfunction are not readily apparent and observable.
If you need further assistance diagnosing your facial, neck, or migraine pain please set up an appointment with our clinic. Solve your pain in 6-8 months or we’ll give you your money back.