In the 1980's my colleagues and I found an association between parafunctional oral habits and a diagnosis of common migraines. The last clinical paper I wrote on the subject is attached. I am considering initiating additional research in this regard, but wanted to first find out if this had been investigated further by others. I have found more recent studies on oral habits related to facial pain, but not directly related to those diagnosed with common migraine.
Article New Approaches in the Assessment and · Treatment of Chronic Headaches
Dear Dr. Moss,
I study trigger point dry needling under ultrasound guidance for many applicatiosn. Please find on my papers regarding this technique. http://www.epmajournal.com/content/3/1/13
I found it very useful for craniomandibular pain, that is feasible under precise visual control only.
This method is effective for migraine patients in approx. 60-70 %. I suppose others, those uneffective, were related to either non-myofascial cause of migraine either to non-recognized trigger points. Oral habits is very interesting issue.
I am ready to collaborate in this direction. Best wishes, R. Bubnov.
I just looked over the article. I was vaguely familiar with this approach back in the 1980's when I was involved in reviewing the literature. It appears you and others are making progress in improving the efficiency. In relation to my own interests, have you or others looked specifically at a uniform common migraine group versus classic migraines in your treatment since I suspect these represent two distinct populations. Additonally, have you done this directly with the temporalis muscle on the affected side or have you used other sites? What kind of long term effects do you get or does this mainly provide immediate symptomatic relief only? I think two interesting aspects. One would be to look at common migraine patients versus classic migraine versus no pain controls and to have the patients clench their teeth for several minutes (maximum of 5 probably) or until the pain was judged unbearable. With no pain controls this is known to create pain that resolves fairly quickly. The question would be whether this leads to the characteristic headache pain in the common migraine versus the classic migraine patients. If so, a second study could be whether the treatment you discussed would differentially affect common versus classic migraine patients. Additionally, if the common migraine patients were to develop pain following clenching, could your technique alleviate the pain? Just some initial thoughts. I am unsure as to whether any of these studies may have already been done. Bob
This is very good points for study design. I utilize the method for headache, but still did not perform clear study for migraine. I think MTPs DN is effective for common migraine. Doppler and fMRI will be necessary to assess.
I work on all chewing and related neck muscles.
Technique works for a long time, has long term effect for some localizations up to 95%, but relapses occur, mostly in craniomandibular area, for pelvic pain, it depends on anatomy - e.g. hernias in cervical spine or habits as you suggested. It's another point to study. The method works on bruxism as well.
Such sudies were not performed as this technique is possible under US guidance only, and since I reported in 2009-2010 very few publication emerged and no one for TMJ, migraine with DN and US, as I know. Rost
Here is another underlying factor which is stress . Reasons precipitating stress should be handled first . If these reasons are treated TMJ disorders will be decreased and alleviated .
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