Doctors' Choice Physical Medicine

Schuylkill County: Neck and Jaw Dysfunction Can Cause Headaches

Pottsville PA: If you are a headache sufferer, you know that they can be very disabling.  They can alter your normal pattern of living, sometimes from days to weeks at a time.  Simple things like reading the newspaper, cooking, driving a car, and/or looking down, can become almost intolerable.  Canceling plans for the day or saying “no” to activities that you enjoy can be very frustrating.

Headaches From Your Neck

There can be many “triggers” of headaches.  However, recent studies have headache researchers claiming that all headaches are the similar and stem from the neck.  In other words, tension headaches and migraines are the same disease or at least very closely related.  They are different mainly in severity and location.  Almost all headaches have tight neck muscles.  Sometimes the tight neck muscles can be the cause of headaches.  Other times the tight neck muscles are the result of the headache.  Neck pain affects approximately two thirds of the population at some point during their lifetime.  Headaches, in the absence of neck pain, are quite uncommon.

Headaches From Your Jaw

Another interesting and lesser-known relationship to neck pain and headaches is the jaw (frequently referred to as the TMJ).  There is a strong association with upper neck dysfunction as well as headaches.  The muscles that move the jaw are largely innervated by the Trigeminal Nerve.  Several studies have found that when structures innervated by the Trigeminal Nerve were irritated neck and/or jaw pain was produced and vise versa.  Similarly, patients with jaw problems (called temporomandibular dysfunction or, TMD) often report neck pain.

When we open our mouth wide, head-neck extension always occurs followed by head-flexion when we close the jaw.  Hence, the neck is always moving when we chew, yawn, talk, and clench our teeth.  In fact, all of these every day activities result in jaw, head, and neck motion extending from the base of the skull down through the entire cervical spine.

Manipulation Eases Pain, Improves Jaw Function

In one study, 37 female patients with neck pain were randomly assigned to a control or experimental group.  Mouth opening and pressure pain levels were recorded to a region innervated by the Trigeminal Nerve.  The experimental group received a spinal manipulation to the upper neck region the other a fake manipulation.  After the manipulation, the mouth opening measurements and pressure pain levels were repeated.  The group receiving the upper neck manipulation showed a significant increase in active mouth opening motion as well as improved pressure pain tolerance compared to the control/non-manipulation group.

Three Knuckle Jaw Test

Three Knuckle Jaw Test

One simple screening test we use is the three-knuckle test.  You should be able to insert the middle knuckles of your middle three fingers vertically between your front teeth.  We have found very few headaches suffers can do this.  It is an indication of jaw dysfunction. This study is very important as many people suffer from neck pain, headaches, and jaw joint dysfunction.  It has been demonstrated when we bite down, there is a corresponding tightening of two important muscles in the neck and upper back region.  Similarly, studies show relaxation of muscles in the neck, upper back, and TMJ after spinal manipulation to the neck is applied.  Injuries to the jaw joint are common but often not pursued by headache patients as often they will say, “My jaw clicks and snaps but I don’t think about it much.”

What To Do

Proper examination and treatment of headache patients must focus on multiple regions, not just the neck area.

If you, a friend, or a loved one is struggling with neck pain, headaches, or jaw pain, we will properly assess your condition and administer the appropriate care that is required.  We also coordinate services with other health care providers when necessary.  Sometimes the service of a dentist or orthodontist is required.

Want To Know More?

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA