Is It All In the Head?

When you have a headache, the pain may make it difficult – if not impossible – to focus on anything else. Head pain can make doing regular tasks hard, and even just thinking about doing some things can prove challenging. Chances are, you’re not alone if you feel this way about headaches or migraine pain. But, is it all in your head? According to researchers at Duke University in Durham, North Carolina, no; there’s a medical reason why head pain seems worse than pain anywhere else in the body.

Pain Comes to a Head

The study, published in the December 2017 issue of the journal Nature Neuroscience, features research that reveals that the nerve pathways that sense pain in the head are directly linked to the brain through an ‘express route’ to the neurons that cause emotions such as fear and anxiety.

This express route is the trigeminal nerve ganglion, a cluster of nerves in the head.

While nerves in the rest of the body connect to the brain through pathways, they do not have a direct link to emotional centers.

So, what does that mean for patients who live with chronic pain?

‘It means more stress, anxiety and depression,’ said Dr. Sean Endsley, a Waco, Texas, dentist.

Individuals living with chronic pain caused by temporomandibular joint disorder often experience these side effects from their jaw problems.

‘Pain caused by TMD is often described as debilitating or life-altering – and very upsetting for many individuals,’ Endsley said.

TMD is caused when the temporomandibular joints wear down or become displaced, causing stress on the joint.

‘Like any other joint in the body, when the TMJs experience wear and tear, it becomes painful and inflamed,’ Endsley said.

Other uncomfortable side effects of TMD include migraines and headaches, jaw stiffness, difficulty eating and chewing, clicking, and popping.

Those living with TMD also experience the potential for the jaw to lock open – a symptom that can be somewhat unnerving for many people.

‘The thought of your jaw locking open or shut can be disconcerting at best,’ Endsley.

Can the Connection Be Blocked?

Duke researchers on the study hope their research can help find ways to prevent or reduce intense pain in the head from increasing emotional upset.

But, there are treatments for TMD that can help get patients out of pain now.

‘There is a range of treatments for TMD, including neuromuscular orthodontics, that can help move the jaw into a position that is ideal for bite alignment,’ Endsley said. ‘In many cases, TMD develops from a bad bite. Moving the jaw into a more favorable position improves function and reduces pain.’


Duke Today. Why head and face pain cause more suffering. 13 November 2017.