Migraines, Cluster Headaches and Tension-Type Headaches: What is Fastest and Most Effective Treatment? What is the Safest Treatment?

The pain, agony and suffering associated with headaches of all types can rapidly destroy your quality of life.   The suffering while waiting for medication to take effect can be maddening.  This is even more true when an individual has chronic severe headaches.

The most common approach of patients is to try over the counter medications that all have similar issues with slow onset and negative side effects.  Effectiveness varies and often only minimal or partial relief is obtained.

Non-steroidal anti-inflamatories  (NSAID) are probably the most common headache medication used.  This includes aspirin (Bayer), ibuprofen (Advil or Motrin), naproxen  (Allieve) and etedolac.  All of these drugs are excellent anti-inflamatories and all of them have serious side effects including GI disturbances including gastric reflux, burning, ulcers, esophageal burns, and increased bleeding times. 

 The biggest issue is not the negative and often dangerous side effects but the  lack of effectiveness and slow onset.

Tylenol or Acetaminophen is even less effective but usually does not cause GI distress but can cause permanent liver damage especially if taken with alcohol.  Again the biggest issue is poor pain relief and  the  considerable time it takes  to reach effective blood levels to treat the pain.

Pain is felt in the Limbic System where we feel emotion.  When patients are suffering severe pain their emotional level plummets. 

The National Headache Foundation recommends a Triple-Combination Medication  of acetylsalicylic acid, (aspirin), acetaminophen, and caffeine for tension-type headaches.  Unfortunately, this still requires absorption in thee GI tract and carries the same risks as the individual drugs.  Excedrin is a combination medication with these ingredients.  Excedrin and Excedrin Migraine are actually the same medication.

Compare these OTC Drugs and response time to Self-Administered Sphenopalatine Ganglion (SPG) Blocks which typically utilize 2% lidocaine, a natural anti-inflammatory that is often given to stabilize a patients heart beat but is best known  as dental anesthetic.  

Patient's can self-administer an SPG lidocaine block in minutes and relief for Migraine and Cluster Headaches can be almost immediate.  SPG Blocks are especially effective for Tension-Type Headaches and other Trigeminal Nerve associated headaches.

Sphenopalatine Ganglion Blocks can be administered in physicians offices and in Emergency Departments utilizing a nasal catheter such as a Sphenocath, Allevio or TX360.  These are all specialized catheters designed to "squirt" lidocaine to the mucosa covering the Sphenopalatine Ganglion where it sits in the pterygopalatine fossa.  The Sphenopalatine is also known as the Pteerygopalatine Ganglion, named for where it is found.

 While these "squirt gun technique" blocks are effective and can also give almost immediate relief they are also expensive and the patients life is disrupted by the headache and the need to travel for the  headache treatment.

The use of cotton-tipped nasal catheters allows the patient to self-administer SPG Blocks.  This  can be used prophylactiically to prevent headache occurrence as well as to alleviate headaches at initial onset before their increasing severity disrupt patient's lives.

Most physicians do not train patients to self-administer these blocks but it is an easily learned procedure utilized for  over 100 years.

The Sphenopalatine Ganglion is the largest Parasympathetic Ganglion of the head and is part of the Autonomic Nervous System.  The Sympathetic nerves are also part of the autonomic nervous system and are involved in the "fight or flight" reflex which is also known as the stress reflex. 

 The Sphenopalatine Ganglion is also known as the SPG, the Pterygopalatine Ganglion, the Nasal Ganglion, Meckel's Ganglion and Sluder's Ganglion after the physician who first described it's role in treating headaches in 1908.

While many medications can be utilized with SPG Blocks there is no study that has shown anything to be more effective than lidocaine.  Lidocaine is a natural anti-inflamatory with positive cardiac effects in the presence of irregular heart rhythm.  It is commonly utilized as dental anesthetic.

Drugs.com list 66 drugs to treat migraines, including triptans but none have been shown to be more effective than SPG Blocks though there is a massive amount of drug side effects associated with these medications.  All of these medications can be helpful and  SPG Blocks are safe to be used in combination with any headache or migraine medication.

Most importantly,  SPG Blocks can give the fastest relief possible with the lowest risk of medication side effects.  Patient may find that if they self-administer SPG Blocks they require far lower doses of medication if they need it at all.

There are side effects to Sphenopalatine Ganglion Blocks but in general they are positive.  About 1/3 of essential hypertension can be cured with SPG Blocks.  SPG Blocks can relieve anxiety, depression and stress.  The blocks can relieve a wide range of eye, ear, nose , sinus and jaw pains.  A 1930 article "Sphenopalatine Phenomena"  by Hiram Byrd in Annals of Internal Medicine (JAMA) showed almost 100% success in 10,000 blocks in 2000 patients with virtually no negative side effects.

This amazing technique almost became lost as part of forgotten medicine when Big Pharma and pharmaceuticals changed medicine starting in the 1940's.  This technique may have been lost forever but returned after the publication of a popular book "Miracles on Park Avenue" which detailed the practice of Dr Milton Reder an octogenerian  New York City Otolaryngologist whose entire practice focused on treating patients utilizing only Sphenopalatine Ganglion Blocks.

Injection of the Sphenopalatine Ganglion may be a way to increase effectiveness of the block in an acute severe headache.  Dentists are the experts at the intraoral injection through the greater palatine canal.  Extra-oral injections may be done via the Suprazygomatic Approach without fluoroscopy, usually by a Neuromuscular dentist trained in treating TMJ /TMD and orofacial pain or ENT's with extensive experience in treating chronic pain patients.

Sphenopalatine Ganglion Blocks are also very effective for treating TMJ disorders and associated Myofascial Pain and Dysfunction.  TMD and MPD are the primary underlying cause of all tension headaches and muscle contraction headaches.  

Neuromuscular Dentistry utilizes the Myomonitor that has a fifty year safety record as a neuromodulation unit for the trigeminal and facial nerves as well as the sympathetic and parasympatheetic fibers of the autonomic system that pass thru the SPG.

The use of a Diagnostic Neuromuscular Orthotic is often the first step in permanently eliminating Tension-Type Headaches.

Learn more at www.SphenopalatineGanglionBlocks.com

Myofascial Pain Syndrome: MPS. A New Nomenclature for Myofascial Pain and Dysfunction: MPD

Myofascial Pain Syndrome: MPS

Relief of chronic Myofascial Pain and Dysfunction at www.ThinkBetterLife.com

Myofascial Pain Syndrome is a ewer term than Myofascial Pain and Dysfunction. It specifically takes Dysfunction out of the disorder which is a major mistake. Myofascial Pain is a disuse / misuse syndrome and is always a type of repetitive strain disorder.

TMJ Disorders, TMD,, Craniofacial Pain, Tension Headaches, Migraines,Cervicalgia and almost all chronic head and neck pain is directly related to Myofascial Pain and Dysfunction, MPD, MPS, Myofascial Pain Syndrome.  

Amazing Videos of Pain Relief from Migraines, TMJ, TMD, MPD, MPS, Fibromyalgia, Myofascial Pain Syndrome and Myofacial Pain and Dydfunction.

https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg

Visit Dr Shapira's website to learn more and schedule an appointment.
www.ThinkBetterLife.com

 This type of change is designed to allow drug therapy instead of addressing underlying issues. It is part of an unfortunate swing in medicine to avoid cause and effect, corrrective actions, physical therapy, exercise, manual therapy and instead look at treatment with pharmaceuticals

90-95% of all pain is Myofascial Pain or pain coming from muscles and fascia. Dr Janet Travell wrote the book Myofascial Pain and Dysfunction: A Trigger Point Manual.

This youtube video is of a Fibromyalgia patient condemned by medicine to a life of constant pain. This diagnosis is faulty to say the least.
https://www.youtube.com/watch?v=A5xUFtuZe_Y
This patient has "Recovered" from fibromyalgia or never had fibromyalgia or the definition and signs and symptoms of fibromyalgia are a faulty system of diagnosis leading to faulty treatment.

Myofascial pain results from injury and chronic misuse of muscles. Repetiitive strain injury is the primary cause of SPG. Dysfunction or improper function is an essential issue in understanding these problems.

Myofascial pain is often mispronounced as Myofacial pain.

Fibromyalgia is a questionable diagnosis. How chronic MPD and Fibromyalgia are related is hotly contested. MPD patients recover and Fibromyalgia patients do not. Fibromyalgia can best be treated as systemic MPD but treating with the medical model leads to the medication model. This is a model that says recovery is not possible. I suggest treating all patients with a goal of complete remission initially. Treatment designed to promote healthy physiology is always better than treatment with medication to cover up symptoms.

Myofascial pain and Dysfunction (MPD) is a common, painful disorder that is responsible for many, if not the majority of pain clinic visits. MPD can affect any skeletal muscles in the body. Skeletal muscle accounts for approximately 50% of body weight, and there are approximately 400 muscles in the body. MP is responsible for many cases of chronic musculoskeletal pain and the diagnosis is commonly missed.

Mayo Clinic says about MPD "Myofascial pain syndrome is a chronic pain disorder. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain from muscle trigger points.."

Mayo clinic's description is actually and over-simplification. It is a result of distorted function that leads to formation of taut bands within the muscles. These are mediated through muscle spindles. The trigger points are areas of low EMG located in the taut band capable of causing pain referral to distant sites.

The term "Myofascial pain syndrome" leaves out the idea of Dysfunction. It is easy to move to medical management of functional problems when the dysfunction is discounted. MPD Typically occurs after a muscle has been contracted repetitively in an awkward manner. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension. Tere is an enormous difference between healthy and unhealthy repetitive motions.

While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial pain and dysfunction syndrome persists or worsens over time if underlying issues are not corrected.. Treatment options for myofascial pain syndrome include physical therapy and trigger point injections. Pain medications and relaxation techniques also can help.

When patients also have TMJ disorders function becomes paramount.

MP can cause local or referred pain, tightness, tenderness, popping and clicking, stiffness and limitation of movement, autonomic phenomena, local twitch response (LTR) in the affected muscle, and muscle weakness without atrophy. Trigger points (TrPs), which cause referred pain in characteristic areas for specific muscles, restricted range of motion (ROM), and a visible or palpable LTR to local stimulation, are classic signs of MP. Over 70% of TrPs correspond to acupuncture points used to treat pain.[1]

An active TrP is an area that refers pain to a remote area in a defined pattern when local stimulation is applied. Satellite TrPs appear in response to a primary, active TrP and usually disappear after the primary TrP has been inactivated. Latent TrPs cause stiffness and limitation of ROM but no pain. Frequently, they are found in asymptomatic individuals.

Although MP and fibromyalgia have some overlapping features, they are separate entities; fibromyalgia is a widespread pain problem, not a regional condition caused by specific TrPs.

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Learn to Change Lives At ICCMO! TMJ, "The Great Imposter" Amazing Patient Testimonials Videos Describe How Neuromuscular Dental Treatment Can Eliminate Headaches, Migraines, Facial Pain and Neck Pain

Improved Quality of Life: These are actual patient testimonial videos of outstanding improvements in quality of life with Neuromuscular Treatment of TMJ and Pain Disorders. Hear about recovery from a patient a Mayo Clinic MD told her was hopeless.

THIS PRESS RELEASE WAS ORIGINALLY RELEASED ON 24/7 PRESS RELEASE

EVERY DENTIST WHO CARES ABOUT THE HEALTH AND WELFARE OF THEIR PATIENTS SHOULD LEARN ABOUT NEUROMUSCULAR DENTISTRY. CREATING HAPPIER HEALTHIER PATIENTS FREE FROM PAIN IS A NOBLE UNDERTAKING!

    Every patient with chronic pain and every physician, dentist and chiropracto truly interested in changing peoples lives should plan on attending the ICCMO Meeting from October 1-October 4, 2015 in San Diego at the Catamaran Resort and Spa.

Integrated TMD Treatments: Solving CranioMandibular Dysfunction Head to Toe
Visit https://www.regonline.com/builder/site/Default.aspx?EventID=1735252 to learn more about the event.

Visit the ICCMO website at: www.ICCMO.org

This year will be of special interest to chiropractors especially NUCCA and Atlas Orthoganol doctors, pain management physicians, physical therapists, sports physicians and more.

Patients who suffer from pain should encourage their doctors and especially dentists to attend.

Headaches and Migraines affect 25% of US households. At least 10% of the population suffers from chronic headaches. Dr Ira Shapira, a long time Highland Park resident founded I Hate Headaches.org to to help patients suffering from chronic migraines, sinus headaches, chronic daily headaches, tension headaches and TMJ headaches. Over 95% of all headache patients have Trigeminal Nerve mediated headaches. His premiere website www.ihateheadaches.org has helped thousands of patients understand how the Trigeminal Nerve and the structures it innervates are responsible for the majority of all headaches.

Many patients think that TMJ (TMD) disorders are only treated with splints. Dr Ira Shapira utilizes a multifaceted approach to giving patients quick and lasting relief from their chronic pain. He utilizes Diagnostic Neuromuscular Orthotics and has over 30 years experience in Neuromuscular Dentistry. He trained with Barney Jankelson the founder of this field and with Bob Jankelson, his son. In addition to utilizing Neuromuscular Dentistry he is one of only a handful of practitioners to utilize SPG Blocks (Sphenopalatine Ganglion Blocks), Trigger Point Injections and Spray and Stretch techniques to treat Myofascial Pain and Muscle pain from Fibromyalgia. He trained with Dr Janet Travell who wrote the book Myofacial Pain and Dysfunction: A Trigger Point Manual.

The ICCMO meeting is a must for doctors wanting to truly help their patients improve their quality of life. Dr Shapira is giving a course on the developmental aspects of TMD, Sleep Apnea and ADD and ADHD. Early pediatric key can allow us to grow healthier future generations.

According to the Migraine Research Foundation
"Children Suffer from Migraine Too

Migraine is very common in children - about 10% of school-age children suffer.
Half of all migraine sufferers have their first attack before the age of 12. Even infants can have migraines. Migraine has been reported in children as young as 18 months. 
Before puberty, boys suffer from migraine more often than girls. The mean age of onset for boys is 7, and for girls it is 11. As adolescence approaches, the incidence increases more rapidly in girls than in boys. This may be explained by changing estrogen levels. 
By the time they turn 17, as many as 8 percent of boys and 23 percent of girls have experienced a migraine.
The prognosis for children with migraine is variable. However, 60% of sufferers who had adolescent-onset migraine report ongoing migraines after age 30. The prognosis for boys tends to be better than for girls.

Many if not most of these problems canbe eliminated or reduced by early intervention according to Dr Shapira.

This link leads to a YouTube Channel of Think Better Life Patient Testimonial videos.
https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg

Everyone with chronic TMJ pain, migraines, neck pain or facial pain should view these videos.

The Website for Dr Shapira's new Highland Park office is www.thinkbetterlife.com.


According to the Migraine Research Foundation website:

"Migraine is an extraordinarily common disease that affects 36 million men, women and children in the United States. Almost everyone either knows someone who has suffered from migraine, or has struggled with migraine themselves. Nearly 1 in 4 U.S. households includes someone with migraine. Amazingly, over 10% of the population - including children - suffers from migraine. That's more than diabetes and asthma combined! About 18% of American women and 6% of men suffer from migraine. Migraine is most common during the peak productive years, between the ages of 25 and 55."

TMJ Disorders have been dubbed "The Great Imposter" because the majority of patients are misdiagnosed or only partially diagnosed by the medical community. The Trigeminal Nerve is frequently called "The Dentists Nerve" because it goes to the teeth, periodontal ligaments,, the sinuses, the tongue, the jaw joints and jaw muscles, as well as the tongue, the tensor of the ear drum, the muscle that opens and closes the eustacian tube and a major contribution to the autonomic nervous system. The Trigeminal Nerve also controls the blood flow to the anterior two thirds of the meninges of the brain, or in simple terms the Trigeminal nerve determines whether you will have migraines. The Trigeminal Nerves or Fifth Cranial Nerves is also the single largest contributor to Chronic Headaches and Migraine. Neuromuscular Dentistry is extremely effective in eliminating and treating migraines specifically because of the trigeminal nerve connection. Neuromuscular Dentistry is specifically directed towards eliminating trigeminal nerve nociception or painful input to the central nervous system.

What the majority of the medical community does not know is that TMJ or TemporoMandibular Disorders can have effects on almost every system in the body. The NHLBI or National Heart Lung and Blood Institute of the NIH published a report entitled CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS that looked at the far reaching effects of TMJ disorders. The report recognizes the importance of "The masticatory apparatus is not only involved in chewing and swallowing but also in other critical tasks, including breathing and talking."

The NIH report also state, "TMD has been used to characterize a wide range of conditions diversely presented as pain in the face or jaw joint area, masticatory muscle pain, headaches, earaches, dizziness, limited mouth opening due to soft or hard tissue obstruction, TMJ clicking or popping sounds, excessive tooth wear and other complaints."

The report shows that 12% of the population suffers from TMD similar to the number suffering chronic headaches and migraines. The report has a major section on "The Craniofacial Complex and its Impact on Control of Upper Airway Resistance and Cardiopulmonary Function" The report covers the pathophysiology of sleep apnea which is implicated in morning headaches, fibromyalgia and Myofascial Pain and Dysfunction. It is now well established that oral appliances are a first line approach to treatment of sleep apnea and snoring for mild to moderate sleep apnea and an alternative to CPAP for severe sleep apnea.

The Autonomic portion of the Trigeminal Nerve is a key cause and cure for migraines and headaches. This is because of its innervation of the meninges of the brain and its control of blood flow to the brain. The SPG Block or Sphenopalatine Ganglion Block is sometimes considered a miracle cure for migranes. The popular book "Miracles on Park Ave" dealt specifically with the high efficacy of SPG Blocks in treating pain. The new MiRx protocol (http://www.mirxprotocol.com/) that has been show effective for preventing and treating migraines is actually just a different method of utilizing the SPG Block. Dr Shapira has been teaching utilization of the SPG Block to dentists and other healthcare professionals for many years.

Learn more about SPG Blocks @ http://chicago-headaches.blogspot.com and at www.thinkbetterlife.com.

The Mayo Clinic has also clearly stated the importance of the Trigeminal Nerve is headaches and Migraines "Although much about headaches still isn't understood, researchers think migraines may be caused by functional changes in the Trigeminal Nerve system, a major pain pathway in your nervous system, and by imbalances in brain chemicals, including serotonin, which plays a regulatory role for pain messages going through this pathway."

Mayo clinic also states, "During a headache, serotonin levels drop. Researchers believe this causes the Trigeminal Nerveto release substances called neuropeptides, which travel to your brain's outer covering (meninges). There they cause blood vessels to become dilated and inflamed. The result is headache pain."

These meninges are the Trigeminally innervated meninges discussed earlier and the serotonin and neuropeptides are the chemicals produced by nerve cells. These same chemicals are involved in TMJ, TMD and Migraines. The Trigeminal Nerve always utilizes these neurotransmitters not just for migraines.

Dr Shapira spent years doing research into sleep apnea and its connection to jaw position. His early research was done as a Visiting Assistant Professor in the 1980's at Rush Medical School in The Sleep Disorder clinic. He worked closely with Dr Rosalind Cartwright the acknowledged Mother of Dental Sleep Medicine. Dr Cartwright recruited Dr Shapira to return to Rush as an Asst Professor in the 1990's till early this century.

The connections between impaired nasopharyngeal breathing and development of ADD and ADHD in children was the topic of a recent lecture Dr Shapira gave in Buenos Aires, Argentina. The development of chronic TMJ disorders, headaches, migraines and postural distortions were all discussed at his lecture to members of ICCMO, The International College of CranioMandibular Orthopedics of which Dr Shapira is a Fellow and Secretary. Dr Shapira is a representative from ICCMO to the American Alliance of TMD Organizations and current Chair of the Alliance of TMD Organizations.

In the 1990's Dr Shapira was a star lecturer for the A4M, The American Academy of Anti-Aging Medicine where he presented his work on the effect of TMJ disorders across ones lifetime. Premature aging and loss of memory and even dementia and Altzheimers disease are part of the same ongoing problem. Sleep Apnea and snoring are types of TMJ disorders according to the National Heart Lung and Blood Institute of the NIH in their report: Cardiovascular and Sleep Related Consequences of Temporomandibular Disorders.

Dr Shapira has been utilizing a multifaceted approach toward relieving chronic pain associated with TMJ disorders for over 30 years and is now bringing his expertise to the North Shore Communities of Chicago. He created www.IHATECPAP.com which addressed Sleep Apnea and snoring and utilizing oral appliances to treat these problems. He also created www.ihateheadaches.org that focuses on many types of headaches and the role of Neuromuscular Dentistry in providing relief of these problems.

The DNA Appliance is offering a possible cure for sleep apnea and TMJ disorders by growing the jaws utilizing Epigenetic Orthodontics. Until recently it was believed these changes could only be accomplished through extensive surgical procedures.

Dr Shapira has also studied Cranial Suture Release techniques and Chirodontics. He inroduced these concepts to a Chiropracter who is his friend and colleague, Dr Mark Freund . Dr Freund has embraced these concepts in totality and has become an expert in these techniques through immersive studying both in the US and Internationally. His primary office is in Lindenhurst but he also sees Cranial patients in Gurnee in Dr Shapira's office www.delanydentalcare.com.

Dr Freund will be treating patients in Dr Shapira's Highland Park office. These techniques treat not only TMJ Dysfunction but also postural distortion such as forward head posture that leads to headaches and neck pain. These postural distortions can have negative effects throughout the entire body.

The NIH just reported over 25 million Americans suffer chronic pain or 11.2% of all Americans. See The Washington Post Story. http://www.washingtonpost.com/news/to-your-health/wp/2015/08/11/nih-m ... onic-pain/

Dr Ira L Shapira created the I HATE CPAP (www.ihatecpap.com) and I HATE HEADACHE (www.ihateheadaches.org) websites to help patients find help with these difficult medical disorders that medicine can frequently not treat adequately without a dental collaboration. Dr Shapira did research in the 1980's as a visiting assistant professor at Rush Medical School where he worked with Rosalind Cartwright PhD who is primarily responsible for the entire field of Dental Sleep Medicine. He also studied with Dr Barney Jankelson who created the initial concepts that neuromuscular dentistry still uses today and created a company Myotronics that is the leading manufacturer of instrumentation used by Neuromuscular Dentistry.

Dr Shapira is the current Chair, Alliance of TMD Organizations
http://www.tmdalliance.org/

Dr Shapira is a Diplomate of The American Board of Dental Sleep Medicine, a Diplomate of the American Academy of Pain Management, and a Fellow of the International College of CranioMandibular Orthopedics (ICCMO). He is a former national and International Regent of ICCMO, its current Secretary and the representative to the Alliance of TMD organizations or the TMD ALLIANCE has a general dental practice (http://www.delanydentalcare.com) in Gurnee, Il and has recently started Chicagoland Dental Sleep Medicine Associates with offices in Vernon Hills and Highland Park. Patients in Northern Illinois or southern Wisconsin can contact Dr Shapira by phone toll free at 1-8-NO-PAP-MASK OR 1-800-TM-JOINT or thru his websites at http://www.ihateheadaches.org or http://www.chicagoland.ihatecpap.com.

  

SEVERE HEADACHE PATIENTS BENEFIT FROM TMJ (TMD) TREATMENT REGARDLESS OF THE TYPE OF HEADACHE, INCLUDING TENSION HEADACHE AND MIGRAINE WITH OR WITHOUT AURA

THIS IS AN OLDER ARTICLE (see abstract below) BUT IS PROBABLY RELEVANT FOR ALL HEADACHE PATIENTS REGARDLESS OF THE TYPE.  The mechanism of TMD therapy is to reduce noxious input into the central nervous system thru the Trigeminal Nerve.  The use of Neuromuscular Dentistry where an ultra-low frequency TENS is used to relax musculature is the most effective method of rapidly correcting the neuromuscular position of the mandible.  Stabilization with a diagnostic orthotic often gives rapid and significant headache relief.   The Trigeminal Nerve plays a central role in nearly all type of headaches and when there is nociceptive input to the brain the the trigeminal it can be widely magnified by the reticular activating system.  In computer lingo GARBAGE IN- GARBAGE OUT in this case garbage being headaches and migraines.

Cranio. 2006 Apr;24(2):104-11.

Headache improvement through TMD stabilization appliance and self-management therapies.

Wright EF, Clark EG, Paunovich ED, Hart RG.

Source

University of Texas Health Science Center, San Antonio, USA. wrighte2@uthscsa.edu

Abstract

The purpose of this study was to assess headache response of unselected neurology clinic chronic headache patients to TMD stabilization appliance and self-management therapies, and to identify features of patients whose headaches are more likely to improve from these therapies. Twenty chronic headache patients in a nontreatment control period were provided appliance and self-management therapies, evaluated five weeks after therapy, and those who chose to continue using their appliances were evaluated three months later. The mean pretreatment Headache Disability Inventory (HDI) score of 64.5 suggested the headaches were severe. After five weeks, the mean HDI score decreased by 17 percent (p<0 .003="" 18="" 19="" 23="" 39="" 46="" a="" and="" appliance="" appliances="" aura="" be="" beneficial="" between="" by="" can="" chose="" comparing="" consumption="" continue="" correlation="" decrease="" decreased="" drop="" dropped="" follow-up="" for="" fourteen="" had="" hdi="" headache="" irrespective="" many="" mean="" medication="" migraine="" months="" no="" of="" p="" participants="" patients="" percent="" pretreatment="" response="" results="" score="" self-management="" severe="" suggest="" symptom="" symptoms="" tension-type="" the="" their="" therapies="" there="" these="" three="" to="" type="" using="" was="" who="" with="" without="">

PMID:

 

16711272

 

[PubMed - indexed for MEDLINE]

MeSH Terms

Migraines, Chronic Daily Headaches, TMJ, TMD and Neuromuscular Dentistry

Tell us about your headaches...: I have suffered from migraines w/and w/o aura since I was 10. I got a brain tear frontal lobe in the third grade. It's only been about the last several years that I got diagnosed with tmj. In the last 6 months it has got unbearable. I've got a permanent mouth guard for night grinding,but I still have pain and migraines help!
First Name: Lorin
Last Name: M.....

DR Shapira's response:

Lorin in Boston,  Your e-mail was rejected, I hope you find this response helpful

Night Guards work great if you only have pain at night or on awakening.  If you have day and night pain it is usually necessary to utilize a 24/7 appliance. TMJ is not a diagnosis but a Joint, the TemporoMandibular Joint.  TMD is a more correct description because it includes the Myofascial and neurogenic aspects of migraine and chronic daily headaches.  I suggest  a neuromuscular diagnostic orthotic as it allows an ongoing healing process as you adjust it for postural changes.  Spenopalatine ganglion blocks can serve to prevent migraines and you can learn to do them easily at home.  Trigger point injections or spray and stretch techniques are useful for eliminating trigger points.

It is a process to correct a lifetime problem and I like the analogy of ealing an onion, you remove one set of problems to get to the next level.

I would like to tell you that everyone who practices Neuromuscular Dentistry (NMD) can help you but NMD is only one part of a larger puzzle.  It is extremely important component of treatment because it addresses nociceptive input to the Trigeminal Nervous system that is primary in all migraine and non-migraine headaches.  Unlike drug treatment that affect the CNS like a shotgun blast NMD particularly is designed to focus on I/O errors or input/output erros into the Trigemininal nervous system.  In computer lingo the expression GARBAGE IN....GARBAGE OUT describes the effect of unfiltered nociceptive input into the central nervous system.  100% of all physicians, neurologists and pain specialists understand that all headaches and migraines are Trigeminally nerve related.  

Neuromuscular Dentistry addresses this input output error of the human computer...ie the brain.

Physicians often consider TMJ and TMD problems a subset of headaches due to their ignorance of the massive input to the CNS (central nervous system) from the Trigeminal Nervous System)

Te use of Botox to treat headaches and Migraines is directly due to effects on the masticatory system of the trigeminal nervous system...  ie a TMD or TMJ problem addressing not the entire scope of the problem but just the myofascial pain aspects.  Botox is a crutch that can be used while correcting the underlying problems.  Unfortunately there is money to be made in injecting dangerous neurotoxins and where there is money there are always willing participants.  The problem is not the use of Botox but the substitution of Botox for correction of the underlying problems.

Read:  http://www.sleepandhealth.com/neuromuscular-dentistry  for more info on neuromuscular dentistry.

I do see up to two long diatance patients  month in my Gurnee office, the first week I see you twice a day on Monday and Tuesday and half a day wednesday.

Ira L Shapira DDS, D,AAPM, D,ABDSM, FICCMO