What’s Going on in Your Head?

by | Jun 18, 2015 | TMJ / Pain

man with headacheHeadaches are never any fun – especially when they’re chronic (ongoing, recurring). That’s the case for about a quarter of the 12 million Americans who seek medical help for their headaches each year.

And according to a new study in the Journal of General Internal Medicine, more patients are asking for more and more tests, from CAT scans to MRIs, to try to pinpoint the issue.

Are these helpful? Necessary? Not always. Sometimes a lifestyle change can be enough.

Examining trends in headache management, the authors found that clinics are often rushing to perform unneeded tests at the patient’s request instead offering lifestyle counseling first – “contrary to numerous guidelines.” Indeed, there are numerous triggers for migraines and other head pain, including poor diet, too much sugar, alcohol, sleep problems, stress and a sedentary lifestyle. Often, multiple triggers can be in play.

As lead author Dr. John Mafi told NPR,

“Patients are more assertive than ever before….They do research online, are more informed and sometimes go to the doctor demanding, ‘I think I need an MRI.’ ”

And while an informed patient is a good thing, Mafi says sometimes the patient gets it wrong. “I think there’s a subconscious perception that more is better, and that fancier, more expensive tests are better and that equals better care.”

And it’s not just the waste of money, time and resources that’s of concern here. There are medical risks, as well. For instance, excessive exposure to radiation via things like CT scans may raise your risk of certain cancers. And just recently, radiology experts voiced concerns about the safety of some of the drugs used to improve MRI imaging.

Those are pretty considerable risks when simple changes in eating, sleeping or other habits may be enough.

They also may overlook one very common source of head, face, jaw and neck pain: dental conditions. Things like TMJ disorders, bruxing and malocclusion (teeth not coming together properly) are all common headache triggers, as well. According to the American Academy of Craniofacial Pain, even minor problems can lead to a cascade of ill effects:

Your head weighs approximately 15 pounds – the weight of an average bowling ball! Imagine your head as a baseball balanced on top of a pencil by a number of rubber bands. When muscles are tense, they shorten. Now imagine shortening just one of those rubber bands. Some rubber bands would stretch, some would shorten, and the baseball would be thrown off kilter! Similarly, when even a single jaw, neck, or shoulder muscle becomes shortened, all of the other muscles are forced to overwork to keep the head balanced on top of the spinal column. We see then that dental headaches originate from an unstable bite which cause the muscles of the jaw, head, and neck to overwork and become painful. Once the muscles become painful, a vicious cycle begins.

In addition, temporomandibular disorders may also cause pain in your neck and shoulders and cause ringing in your ears, as well as clicking in or locking of your jaw.

Another condition, trigeminal neuralgia, results in piercing, sudden pain that may occur without warning and mimics the symptoms of a migraine. Traditional treatment often involves heavy medications – and their negative side effects. Sometimes surgery is ordered, which carries its own risks. Fortunately, these aren’t your only options.

When a patient comes to us complaining of headaches or TN-like pain, we start by looking beyond their pain pattern and history. We consider diet, sleep patterns and how the chewing muscles are working. Has trauma triggered inflammation of the nerve? Has the nerve become compressed? Has it been stripped of its myelin sheath?

The fundamental question: What can we do to help alleviate your pain safely and effectively, without drugs or other short-term solutions that do little more than suppress symptoms? The least invasive, long-term solution is what we desire for our patients.

If you are experiencing chronic headaches and suspect your dental conditions may have something to do with it, give us a call to discuss your options. We’re always happy to answer any questions you may have. If you’re outside the Dallas area and need to find a biological dentist closer to home, all three of the main professional associations have online directories available:

Image by Lisa Brewster

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