PREVALENCE OF TEMPOROMANDIBULAR JOINT DISORDERS IN PATIENTS WITH CHRONIC MIGRAINE
DOI:
https://doi.org/10.71000/jv5a3y29Keywords:
Chronic migraine, Comorbidity, , Cross-sectional studies, Headache disorders, Myofascial pain, Temporomandibular joint disorders, Tertiary care.Abstract
Background: Chronic migraine is a debilitating neurological disorder frequently accompanied by comorbid conditions, including temporomandibular joint disorders (TMDs). Due to overlapping symptomatology and shared pathophysiological mechanisms such as central sensitization, TMD may influence the severity and management of chronic migraine. However, limited data exist regarding the prevalence and clinical profile of TMD in chronic migraine populations, particularly in South Asian contexts.
Objective: To determine the prevalence and clinical characteristics of temporomandibular joint disorders in individuals diagnosed with chronic migraine.
Methods: A cross-sectional study was conducted at a tertiary care medical and dental hospital in Lahore over an eight-month period (October 2024 to June 2025). A total of 210 patients aged 18–55 years with chronic migraine, diagnosed per ICHD-3 criteria, were evaluated for TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Data on TMD subtypes and pain-related disability were also collected using the Graded Chronic Pain Scale (GCPS). Statistical analysis was performed using SPSS v28.0 with a significance level of p<0.05.
Results: TMD was present in 94 of 210 chronic migraine patients (44.8%). Myofascial pain was the most common subtype (40.4%), followed by disc displacement (23.4%) and arthralgia (14.9%). Mixed-type TMD was observed in 21.3% of cases. Among TMD-positive patients, 33.0% exhibited Grade 3 disability and 18.1% were categorized in Grade 4 by GCPS.
Conclusion: TMDs, particularly pain-related subtypes, are highly prevalent in patients with chronic migraine. Early identification and multidisciplinary management of TMD may improve clinical outcomes and quality of life in this population.
References
Réus JC, Polmann H, Souza BDM, Flores-Mir C, Gonçalves DAG, de Queiroz LP, et al. Association between primary headaches and temporomandibular disorders: A systematic review and meta-analysis. J Am Dent Assoc. 2022;153(2):120-31.e6.
Calixtre LB, van der Meer HA, Visscher CM, de Oliveira AB, de Godoi Gonçalves DA. The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross-Sectional Telehealth Study. J Oral Rehabil. 2024;51(12):2577-87.
Sangalli L, Eli B, Mehrotra S, Sabagh S, Fricton J. Calcitonin Gene-Related Peptide-Mediated Trigeminal Ganglionitis: The Biomolecular Link between Temporomandibular Disorders and Chronic Headaches. Int J Mol Sci. 2023;24(15).
Fall EA, Chen Y, Lin JS, Issa A, Brimmer DJ, Bateman L, et al. Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study. BMC Neurol. 2024;24(1):399.
Shustorovich A, Bova M, Delavaux LV. Common Pain Disorders in Women: Diagnosis, Treatment, and Rehabilitation Management. Phys Med Rehabil Clin N Am. 2025;36(2):297-310.
Gross AJ, Hudson JW, Matias C, Jones BJ. Effects of onabotulinumtoxin A in patients concurrently diagnosed with chronic migraine encephalalgia and temporomandibular disorders: A retrospective case series. Cranio. 2024;42(6):688-98.
Memmedova F, Emre U, Yalın O, Doğan OC. Evaluation of temporomandibular joint disorder in headache patients. Neurol Sci. 2021;42(11):4503-9.
Rosales Leal JI, Sánchez Vaca C, Ryaboshapka A, de Carlos Villafranca F, Rubio Escudero M. How Confinement and Back to Normal Affected the Well-Being and Thus Sleep, Headaches and Temporomandibular Disorders. Int J Environ Res Public Health. 2023;20(3).
Yakkaphan P, Lambru G, Renton T. Impact of migraine and fibromyalgia on temporomandibular disorder: A retrospective study on pain, psychological factors and quality of life. J Oral Rehabil. 2024;51(10):2029-42.
Yakkaphan P, Elias LA, Ravindranath PT, Renton T. Is painful temporomandibular disorder a real headache for many patients? Br Dent J. 2024;236(6):475-82.
Kang JH. Neck associated factors related to migraine in adolescents with painful temporomandibular disorders. Acta Odontol Scand. 2021;79(1):43-51.
Spisila T, Fontana LC, Hamerschmidt R, de Cássia Cassou Guimarães R, Hilgenberg-Sydney PB. Phenotyping of somatosensory tinnitus and its associations: An observational cross-sectional study. J Oral Rehabil. 2024;51(10):2008-18.
Akerman S, Romero-Reyes M. Preclinical studies investigating the neural mechanisms involved in the co-morbidity of migraine and temporomandibular disorders: the role of CGRP. Br J Pharmacol. 2020;177(24):5555-68.
Mnguni N, Olivier B, Mosselson J, Mudzi W. Prevalence of concurrent headache and temporomandibular disorders: a systematic review protocol. JBI Evid Synth. 2021;19(1):263-9.
Rauch A, Angrik C, Zenthöfer A, Weber S, Hahnel S, Nitschke I, et al. [Prevalence of temporomandibular disorders in seniors-Symptom-related analyses in younger and older seniors]. Z Gerontol Geriatr. 2022;55(6):482-8.
Viñals Narváez AC, Sánchez-Sánchez T, García-González M, Ardizone García I, Cid-Verdejo R, Sánchez Romero EA, et al. Psychological and Behavioral Factors Involved in Temporomandibular Myalgia and Migraine: Common but Differentiated Profiles. Int J Environ Res Public Health. 2023;20(2).
van der Meer HA, Tol CHM, Speksnijder CM, van Selms MKA, Lobbezoo F, Visscher CM. Psychosocial factors associated with pain outcomes in patients with painful temporomandibular disorders and headaches. Eur J Oral Sci. 2023;131(2):e12919.
Ferrillo M, Migliario M, Marotta N, Fortunato F, Bindi M, Pezzotti F, et al. Temporomandibular disorders and neck pain in primary headache patients: a retrospective machine learning study. Acta Odontol Scand. 2023;81(2):151-7.
Dibello V, Lozupone M, Sardone R, Ballini A, Lafornara D, Dibello A, et al. Temporomandibular Disorders as Contributors to Primary Headaches: A Systematic Review. J Oral Facial Pain Headache. 2023;37(2):91-100.
Bizzarri P, Manfredini D, Koutris M, Bartolini M, Buzzatti L, Bagnoli C, et al. Temporomandibular disorders in migraine and tension-type headache patients: a systematic review with meta-analysis. J Oral Facial Pain Headache. 2024;38(2):11-24.
Lee SH, Jo JH, Park JW. Temporomandibular disorders patients with migraine symptoms have increased disease burden due to psychological conditions. J Oral Facial Pain Headache. 2025;39(1):70-80.
Ashraf J, Närhi M, Suominen AL, Zaproudina N, Saxlin T. Temporomandibular-disorder-related pain as a predictor of severe headaches. Community Dent Oral Epidemiol. 2022;50(3):206-15.
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Copyright (c) 2025 Saiyyadah Tahzeeb, Almeera Ashfaq, Haifa Saquib Baqai, Muhammad Adnan Aslam, Syeda Batool Zehra Naqvi, Naila Abdul Waheed (Author)
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