Why Migraine and Jaw Pain Go Together: New Research (2025) Explains the Link

Posted on December 26 2025, By: Cerebral Torque

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Migraine and TMD: The Two-Way Connection

Why these conditions so often occur together and what it means for your treatment

Introduction: Two Conditions, One Patient

If you have migraine, there's a good chance you've also experienced jaw pain, clicking, or difficulty opening your mouth. If you have temporomandibular disorder (TMD), you've probably noticed that headaches seem to come with the territory. This isn't coincidence.

A 2025 systematic review and meta-analysis published in the Journal of Oral Rehabilitation has provided the strongest evidence yet that migraine and TMD share a powerful bidirectional relationship. The research team, led by Marlon Ferreira Dias and colleagues at São Paulo State University, analyzed 17 studies involving over 10,000 patients to quantify just how strongly these conditions are linked.

Key Finding

The meta-analysis revealed that people with migraine are over 6 times more likely to have TMD compared to people without migraine. Meanwhile, people with TMD are nearly 3 times more likely to have migraine. This bidirectional relationship has major implications for how both conditions should be diagnosed and treated.

Understanding TMD

Temporomandibular disorder (TMD) is an umbrella term covering conditions that cause pain and dysfunction in the jaw muscles, temporomandibular joint (TMJ), and related facial structures. It's the most common cause of non-dental pain in the face, affecting roughly 10-15% of the population.

TMD Subtypes

TMD can present as myofascial pain (involving the jaw muscles), articular disorders (involving the joint itself, including disc displacement), or a combination of both. The cause is multifactorial, potentially involving parafunctional habits like teeth grinding, psychosocial factors, and anatomical or genetic features.

TMD and migraine share several characteristics. They both involve heightened pain sensitivity, both are associated with psychiatric and psychosocial conditions, and both are significantly more common in women than men. These overlapping features hint at shared underlying mechanisms.

10-15%

Population Prevalence

TMD affects a significant portion of the general population

Women

Higher Prevalence

Both TMD and migraine are more common in women

Multiple

Subtypes

Myofascial, articular, and mixed presentations

The Bidirectional Link

Previous research had established that primary headaches, especially migraine, are among the most common conditions occurring alongside TMD. What hadn't been clearly established was the specific relationship between migraine and TMD, and whether this relationship works in both directions.

The 2025 systematic review set out to answer this question definitively. The researchers searched five major databases and three grey literature sources, ultimately analyzing 17 studies that used standardized diagnostic criteria for both conditions: the Research Diagnostic Criteria for TMD (RDC/TMD) or Diagnostic Criteria for TMD (DC/TMD) for jaw disorders, and the International Classification of Headache Disorders (ICHD) for migraine.

What "Bidirectional" Means

A bidirectional relationship means the connection works both ways. Having migraine increases your risk of TMD. Having TMD increases your risk of migraine. This isn't simply correlation - each condition appears to genuinely increase the likelihood of developing the other.

This has practical implications. For example, if you're being treated for one condition, your healthcare provider should be screening for the other. Treating just one while ignoring the other may lead to incomplete symptom relief.

What the Research Shows

The meta-analysis included six studies with sufficient data for quantitative analysis, involving over 2,000 patients total.

6.08x

TMD Risk with Migraine

Patients with migraine are 6.08 times more likely to have TMD (95% CI: 4.80-7.68)

2.64x

Migraine Risk with TMD

Patients with TMD are 2.64 times more likely to have migraine (95% CI: 2.19-3.18)

To put this in context, an odds ratio above 2 is generally considered a "large effect" in medical research. An odds ratio of 6.08 is substantial. The certainty of evidence was rated high using the GRADE methodology.

Study Quality

Of the 17 studies included in the qualitative assessment, seven were classified as low risk of bias, nine as moderate risk, and one as high risk. The studies came from nine different countries: Brazil, Sweden, USA, Canada, Turkey, Italy, Poland, the Netherlands, and Germany, with sample sizes ranging from 45 to over 4,200 patients.

Why Do These Conditions Overlap?

While the exact mechanisms linking TMD and migraine haven't been fully worked out, researchers have identified several potential explanations.

Peripheral Sensitization

TMD involves sensitization of nerve endings in the jaw muscles and joint. This can lower the threshold for pain and maintain local discomfort. The sensitized nerves may then trigger or worsen migraine attacks through connections in the trigeminal pain pathway, which serves both the face and the head.

Central Sensitization

Both conditions involve the release of neurotransmitters like substance P and calcitonin gene-related peptide (CGRP) - the same molecule targeted by many newer migraine medications. This can lead to central sensitization, where the brain and spinal cord become hypersensitive to pain signals.

Shared Neural Pathways

The trigeminal nerve system is central to both conditions. Pain signals from the jaw travel through the same pathways as migraine pain, creating opportunities for cross-talk and mutual amplification.

The Pain Amplification Cycle

When TMD causes chronic jaw pain, it can interfere with the trigeminal system in ways that aggravate, perpetuate, or even trigger migraine attacks. Similarly, the neural changes associated with chronic migraine may lower the threshold for developing TMD symptoms. This creates a potential feedback loop where each condition can worsen the other.

Clinical Evidence: Key Study Findings

The systematic review synthesized findings from multiple research teams. Several patterns emerged.

Summary of Research Findings

Key studies examining the relationship between migraine and TMD, showing consistent associations across different populations and study designs.

Finding	Evidence	Clinical Significance
TMD Prevalence in Migraine	86.8% of women with migraine had TMD Compared to 33.3% of women without headache	Migraine patients should be routinely screened for TMD
Chronic Migraine Risk	OR = 30.1 for chronic migraine with painful TMD 95% CI: 3.58-252.81	Painful TMD dramatically increases chronic migraine risk
Episodic Migraine Risk	OR = 3.7 for episodic migraine with painful TMD 95% CI: 1.46-9.16	Even episodic migraine shows significant TMD association
Headache Frequency	48.3% with TMD had headaches vs 25.3% without TMD Nearly double the headache frequency	TMD is a significant risk factor for headache disorders
TMD Subtype Matters	Severe myofascial TMD shows strongest association Stronger than articular TMD or lower severity grades	Muscle-related TMD appears most linked to migraine
Quality of Life Impact	Comorbidity causes greater disability Higher social impairment than either condition alone	Treating both conditions improves outcomes

One particularly notable finding is that women with chronic migraine showed a TMD prevalence of 91.3%, while women without headache had a prevalence of just 33.3%. This dramatic difference underscores just how tightly linked these conditions are.

What This Means for Treatment

The bidirectional relationship between migraine and TMD has direct implications for clinical care. The research team emphasized that the existence of one condition increases the likelihood of the other, and the best approach is to address both simultaneously.

Treatment Principle

Studies have shown that treating both migraine and TMD together can lead to better outcomes than treating either condition in isolation. This integrated approach may significantly improve both conditions and enhance overall quality of life.

Practical Treatment Considerations

Screen for Both Conditions Essential

Address Jaw Muscle Pain Important for Migraine Control

Migraine Prevention May Reduce TMD Severity

Multidisciplinary Care Recommended

Address Central Sensitization Benefits Both Conditions

For patients, this research validates what many have experienced intuitively...jaw problems and headaches often go hand in hand, and getting relief from one without addressing the other can be frustrating and incomplete.

Screening and Diagnosis

Healthcare professionals working with either orofacial pain or headache should be prepared to identify symptoms of both migraine and TMD, particularly when a patient presents with one condition.

When to Screen for TMD in Migraine Patients

Consider TMD evaluation when migraine patients report jaw pain, difficulty opening the mouth, clicking or popping sounds in the jaw joint, pain when chewing, or facial pain that doesn't quite fit the migraine pattern. Remember that over 85% of women with migraine in some studies had concurrent TMD.

When to Screen for Migraine in TMD Patients

TMD patients should be asked about headache frequency, characteristics (throbbing, one-sided, with light or sound sensitivity), and associated symptoms like nausea. Patients with painful TMD have dramatically elevated odds of having migraine.

Diagnostic Criteria Used in Research

The systematic review included only studies using validated diagnostic criteria. For TMD, this means the Research Diagnostic Criteria for TMD (RDC/TMD) or the newer Diagnostic Criteria for TMD (DC/TMD). For migraine, studies used the International Classification of Headache Disorders (ICHD). Using standardized criteria helps ensure accurate diagnosis and allows comparison across studies.

Conclusions

This systematic review and meta-analysis provides high-quality evidence for a strong bidirectional association between migraine and temporomandibular disorders. The relationship is not subtle. Migraine patients are over 6 times more likely to have TMD, while TMD patients are nearly 3 times more likely to have migraine.

Key Takeaways

Association Strength Strong Bidirectional Link

Evidence Quality High Certainty (GRADE)

Clinical Action Screen for Both Conditions

Treatment Approach Address Both Simultaneously

Future Research Mechanisms & Longitudinal Studies Needed

The practical message is clear. Clinicians should systematically screen for both conditions, especially when one is present. Treating both together may lead to better outcomes than addressing either in isolation.

Important Medical Disclaimer

This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. If you experience jaw pain, headaches, or symptoms of either condition, consult with qualified healthcare providers who can properly evaluate your specific situation and develop an appropriate treatment plan.

References

Dias MF, Ferro AC, Spavieri JHP, Ferrisse TM, Gonçalves DAG. Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis. Journal of Oral Rehabilitation. 2025;0:1-13. doi:10.1111/joor.70110
Klasser GD, Romero RM. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 7th ed. Quintessence Publishing; 2023.
Slade GD, Fillingim RB, Sanders AE, et al. Summary of Findings From the OPPERA Prospective Cohort Study of Incidence of First-Onset Temporomandibular Disorder: Implications and Future Directions. Journal of Pain. 2013;14(12 Suppl):T116-T124.
Gonçalves MC, Florencio LL, Chaves TC, Speciali JG, Bigal ME, Bevilaqua-Grossi D. Do Women With Migraine Have Higher Prevalence of Temporomandibular Disorders? Brazilian Journal of Physical Therapy. 2013;17(1):64-68.
Fernandes G, Franco AL, Gonçalves DA, Speciali JG, Bigal ME, Camparis CM. Temporomandibular Disorders, Sleep Bruxism, and Primary Headaches Are Mutually Associated. Journal of Orofacial Pain. 2013;27(1):14-20.
Gonçalves DA, Camparis CM, Speciali JG, Franco AL, Castanharo SM, Bigal ME. Temporomandibular Disorders Are Differentially Associated With Headache Diagnoses: A Controlled Study. Clinical Journal of Pain. 2011;27(7):611-615.
Wieckiewicz M, Grychowska N, Nahajowski M, et al. Prevalence and Overlaps of Headaches and Pain-Related Temporomandibular Disorders Among the Polish Urban Population. Journal of Oral & Facial Pain and Headache. 2020;34(1):31-39.
Conti PC, Costa YM, Gonçalves DA, Svensson P. Headaches and Myofascial Temporomandibular Disorders: Overlapping Entities, Separate Managements? Journal of Oral Rehabilitation. 2016;43(9):702-715.
Gonçalves DA, Camparis CM, Speciali JG, et al. Treatment of Comorbid Migraine and Temporomandibular Disorders: A Factorial, Double-Blind, Randomized, Placebo-Controlled Study. Journal of Orofacial Pain. 2013;27(4):325-335.

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