Do TMJ Disorders Cause Headaches?

Temporomandibular joint (TMJ) disorders are common, and 80% of people with TMJ disorders have headaches. The temporomandibular joints are the jaw joints that allow us to open and close our mouths. They’re located just below the temples and in front of the ears. 

TMJ disorders are problems involving the temporomandibular joints or the surrounding muscles and nerves. There are many different types of TMJ disorders, and all of them can cause headaches. In this article, we explain why TMJ disorders cause headaches, what you can do about it, and when to seek help from a specialist.

What is a TMJ disorder?

TMJ disorders are a diverse group of conditions that cause pain and/or dysfunction in the area of the jaw joint. This area includes the TMJ itself, surrounding jaw muscles, and/or nerves of the face. There are over 30 TMJ disorders. 

Some causes of TMJ disorders include:

• Arthritis (like osteoarthritis or rheumatoid arthritis) causes degeneration or inflammation of the joint itself. 

• Dislocation or subluxation (slipping) affects how the jaw opens and closes.

• Tension or spasm in the jaw muscles can be caused by teeth grinding, jaw clenching, or life stressors.

• Injury to the jaw (like fracture)

Why do TMJ disorders cause headaches?

Simply put, TMJ disorders cause headaches because the TMJs are located on the head. Pain that starts in one area of the body doesn’t always stay in one place. For example, you may have heard that heart attacks don’t only cause chest pain. They can also cause pain in the neck or left arm. 

Similarly, pain that starts in the TMJ area can spread to other parts of the head, causing headache. Pain that starts in one area but causes pain in another is called “referred pain.”

What are the symptoms of TMJ headache?

TMJ headache pain spreads from the TMJ to the jaw, temple, neck, or forehead. You may also have pain in other parts of the head. Pain may only be on one side of the head or both. 

TMJ headaches can feel dull and achy, like tension-type headaches and migraines. They may feel worse in the morning, especially if you grind your teeth. Interestingly, headache may occur before a person knows they have TMJ. 

So how can you tell if you have a TMJ headache or some other type of headache? Symptoms of TMJ disorders are clues the TMJ may be causing your headache. TMJ disorder symptoms include:

• Pain or tenderness of the TMJ or surrounding areas of the face

• Painful locking, clicking, or popping of the jaw 

• Difficulty opening the mouth wide

• Pain, fullness, or ringing in the ears (dizziness and hearing loss occur in rare cases)

• Jaw stiffness

• A change in the way the teeth come together

How do you diagnose TMJ headache?

TMJ headache is a “clinical diagnosis.” That means there’s no single test to diagnose it. Instead, your healthcare provider or dentist will use clues from your history and physical exam to figure out if TMJ headache is the problem. They’ll ask questions to rule out other headache types, too. 

In certain situations, they may order imaging tests (like X-ray, CT, or MRI) to get a better look at the TMJ joint itself. But these tests are normally not necessary.

How do you relieve TMJ headache?

To relieve a TMJ headache, you’ve got to treat the TMJ disorder. But we don’t yet have great scientific data to show which treatments are best. 

The good news? Most TMJ disorders only last weeks and get better without treatment. Only about 5% to 10% of people need specific treatment for TMJ disorders, and first-choice treatments aren’t medications.

This being said, when you’ve got a headache, you want to feel better ASAP. Here are some simple suggestions to improve TMJ disorder pain:

• Work on your posture. Sitting and standing properly can take stress off of the jaw muscles.

• Apply warm compresses (heating packs) to the TMJ for pain relief.

• Reduce your stress levels.

• Stretch and strengthen the jaw with these jaw exercises.

• Rest the jaw by avoiding hard or chewy foods.

• Avoid opening the mouth very wide (yawning, yelling).

• Avoid chewing gum and biting your nails.

Additional options include:

• Physical therapy: Physical therapists can help improve posture or jaw movement via stretching and strengthening exercises.

• Biobehavioral therapies: Certain kinds of therapy (like cognitive behavioral therapy) can help you better process and cope with the pain TMJ disorders cause.

• Oral splints: Wearing custom or over-the-counter mouthguards at night may help people who grind their teeth. The evidence for use isn’t great, and they can be expensive. But they might help when combined with physical therapy. 

If the suggestions above fail, adding medications may help some people. But there’s very limited data to support the use of medications. 

Medications that may help include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, like naproxen (Aleve) and ibuprofen (Advil), may help in the short term. But you shouldn’t use them for longer than 2 to 3 weeks.

• Muscle relaxants: These are also for short-term use. Examples include cyclobenzaprine and metaxalone. 

• Tricyclic antidepressants (TCAs): In people with chronic pain from TMJ disorders, amitriptyline or nortriptyline can be a long-term option. They can also help prevent migraines. Of note, TCAs are used off-label (not FDA approved, but commonly prescribed since they’re generally safe and might help).

Experts do not recommend opiates for the treatment of TMJ disorders.

Many procedures and surgeries may be offered to treat TMJ disorders, but most of them don’t work. There are special circumstances when a procedure may be necessary, like chronic dislocation or cancer of the TMJ. But before considering a procedure, first ask about simpler treatments. Try to understand why the procedure is being recommended as well as the risks. And consider getting a second opinion. 

Can you prevent headaches from TMJ?

We currently don’t have any proven ways to prevent TMJ headaches. But the “simple suggestions” listed above can improve TMJ symptoms.

What kind of provider should I see for TMJ headaches?

If you’re having headaches, schedule an appointment with your primary care provider to talk about your symptoms and confirm that a TMJ disorder is the cause. Some doctors and dentists claim to be “TMJ specialists.” 

But be wary of procedures advertised as cures for TMJ disorders, especially when insurance does not cover them. We just don’t have good data to support most of those treatments. 

For treatment of TMJ disorders, you might seek help from a:

• Primary care provider

• Dentist

• Physical therapist

• Pain medicine specialist

Seek help from an oral and maxillofacial surgeon (jaw surgeon) if you have:

• Injury of the TMJ

• Severe pain and dysfunction of the TMJ due to a joint problem (like arthritis)

• Persistent pain despite conservative treatments (like physical therapy and medications)

Why trust our experts?

Written by:

Samantha C. Shapiro, MD

Samantha Shapiro, MD, is a board-certified rheumatologist and internist with expertise in autoimmune and inflammatory conditions. She founded the division of rheumatology at Dell Medical School at The University of Texas at Austin.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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