Our experience with headache patients is typified by our patient Beth (the facts of this case are true, only the names have been changed to protect the innocent.) Beth was referred to me by a neighbor for evaluation of chronic jaw dysfunction including clicking and popping jaw joints, jaw-locking open and closed, and jaw muscle pain. Other significant complaints included chronic severe migraine headaches, frontal headache, occipital headache, and neck pain. She was under the care of her physician for migraine headache treatment with daily medication and 1-2 visits weekly to the hospital emergency room for injections. She was also receiving chiropractic treatment 2-3 times weekly for neck pain.
A complete craniofacial pain diagnostic workup was performed in my office. The results of these evaluations revealed Beth suffered severe jaw muscle dysfunction, chronic jaw muscle spasm, and moderate destructive bone changes in her jaw joints. Careful analysis of jaw muscle and temporomandibular joint function using electromyography and computerized jaw motion analysis indicated a removable oral appliance could correct many of the jaw movement problems. The removable orthotic was delivered and Beth was instructed to wear the orthotic at all times.
Within the first week of wear, she had a dramatic reduction in her headache intensity and frequency. From the first week, Beth never again needed to go to the emergency room for headache treatment. Over the following months, her chiropractic adjustments were reduced and she no longer required prescription headache medication. At approximately 14 months, the orthotic wear was gradually reduced to nighttime wear only. At her 5-year follow-up evaluation, Beth continued to be virtually headache free. Her current dominated complaint is continued neck pain, which is controlled by chiropractic treatments 2-3 times monthly. Beth continues to wear her oral orthotic every night and there has been no further destruction of the jaw joint bone.
Unfortunately, Beth suffered for many years inspite of regular medical, dental, and chiropractic care by good caring doctors doing the best they could to help her. The problem was they simply were not trained to recognize the signs of jaw dysfunction, which had been present for years. It was Beth’s neighborhood friend, a chiropractor, who made the connection and as a result changed Beth’s life for the better.
