Facial pain, headaches & TMD

Temporomandibular Disorders (TMD) often manifest alongside a range of symptoms, including headaches and facial pain. These symptoms can arise from different underlying mechanisms, most commonly from muscular tension or joint strain associated with TMD, particularly the myalgia (muscle) or arthrogenous (joint) subtypes.

Why facial pain and headaches occur in TMD:

Facial pain related to TMD usually originates from the jaw muscles or the temporomandibular joints themselves. The muscles responsible for chewing, such as the masseter and temporalis muscles are located in the face and scalp. When these muscles are overused, tense, or fatigued (for example, through clenching, grinding, or overactivity), they can become sore and generate referred pain that spreads across the face, temples, or even into the neck and shoulders. This is why many people with TMD report not just jaw pain but headaches, tenderness in their temples, or pain in their cheeks and ears.

Referred pain occurs when discomfort is felt in a region different from the actual source of the problem. For example, tension in the temporalis muscle can feel like a headache. Similarly, irritation of the TMJ itself, especially when inflamed, can cause localised pain around the ear, jaw angle, or lower cheek, and may mimic symptoms of sinus pain or earache.

Jaw stiffness

Jaw stiffness is another common feature of TMD and can significantly influence the development or worsening of pain. When the jaw muscles are overworked or inflamed, they may become slightly less flexible. This makes it harder to open or move the jaw freely, especially after periods of rest (like in the morning). 

Understanding headache types

While TMD can cause headache-like pain, not all headaches are due to TMD. Headaches linked to TMD are typically felt in the temples, sides of the face or jawline. They may worsen after chewing, talking for extended periods, or clenching the jaw. 

However, headaches that include nausea, visual or auditory disturbances, or sharp, stabbing pain may indicate other causes such as migraine, cluster headaches, or neurological conditions. It’s essential to consult your doctor for an accurate diagnosis, especially if the headache is new, severe, or accompanied by other unusual symptoms.

TMD mimicking other conditions

TMD can mimick sinus pain, dental issues, and neurological conditions can also mimic or overlap with TMD symptoms. Sinus pain, for example, often presents in similar regions but is usually accompanied by congestion or other sinus-specific symptoms. Distinguishing between these is key, and your dentist or healthcare provider can help rule out other causes.

Keeping track with JawSpace

Keeping a diary of your symptoms through the JawSpace Check-In can help track when headaches or facial pain occur, what triggers them, and how they evolve over time. This information can be invaluable for both you and your care team in identifying patterns, evaluating treatment strategies, and adjusting your self-care routines.

If your headaches are related to TMD, they may improve as you address jaw function, reduce clenching, manage stress, and use strategies such as heat/ice therapy, jaw exercises, and relaxation. However, if they persist despite these efforts, it’s important to follow up with your healthcare provider for further evaluation.

Quick techniques for facial pain and headache relief

When headaches or facial pain flare up, there are simple strategies you can try to help ease the discomfort and support your jaw:

• Apply warmth or covered ice: A warm compress to your jaw or temples can help reduce muscle tension and soothe discomfort. Covered ice can help reduce inflammation.

• Try the N-stretch: This gentle resting position for your jaw can reduce strain and help your muscles relax.

• Do calming breathing exercises: Diaphragmatic or box breathing can help lower stress, which often contributes to muscle tightness and pain.

• Use self-massage: Massaging your masseter or temples in slow circular motions can help release tight areas and ease jaw stiffness.

• Track patterns in the JawSpace check-in: Logging your symptoms can help you notice what triggers your discomfort, so you can address it earlier next time.

These are not long-term fixes, but they can offer a sense of control and immediate support when symptoms arise.

References:

1. Abouelhuda, A. M., et al., Association Between Headache and Temporomandibular Disorder., Journal of the Korean Association of Oral and Maxillofacial Surgeons 43, 363-367. 2017.

2. Alketbi, N., et al., Prevalence and Characteristics of Referred Pain in Patients Diagnosed with Temporomandibular Disorders According to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Sharjah, United Arab Emirates., F1000Research 11, Article 656. 2022.

3. Bender, S. D., Temporomandibular Disorders, Facial Pain, and Headaches., Headache 52, Suppl. 1, 22-25. 2012.

4. Bizzarri, P., et al., Temporomandibular Disorders in Migraine and Tension-Type Headache Patients: A Systematic Review with Meta-Analysis., Journal of Oral & Facial Pain and Headache 38, 11-24. 2024.

5. Silva, P. F. D., et al., Temporomandibular Disorders and Headache: What's the Relationship?, Journal of Oral Diagnosis 8, Article e20230008. 2023.

6. Yakkaphan, P., et al., Temporomandibular Disorder and Headache Prevalence: A Systematic Review and Meta-Analysis., Cephalalgia Reports 5, n. pag. 2022.