Have you ever experienced a migraine? Migraines, headaches and other types of head or facial pain can make it impossible to focus on anything else or sometimes even to function.

But why exactly is that? Researchers at Duke University in Durham, North Carolina, may know why.

In a study published in December 2017, researchers from the university found that there is a specific medical reason why head pain feels worse than pain anywhere else in the body.

The findings of the study, published in the journal Nature Neuroscience, show that the nerve pathways that detect pain in the head have a direct route to the cells in the brain that trigger fear and anxiety.

The direct route is called the trigeminal nerve ganglion, a cluster of nerves in the head. The trigeminal nerve is one of three primary nerves in the head, and not only plays a role in signaling the brain that pain is coming, but also controls autonomic functions such as sneezing, blinking and tear production.

Why does this matter for patients who live with chronic head or facial pain?

“It means that they have higher levels of anxiety, depression and stress about their condition,” said Dr. Ettienne van Zyl, a Rogers, Arkansas, dentist.

This is also often the case for individuals living with other chronic pain, such as the pain of temporomandibular joint disorder (TMD).

“In many cases, patients with TMD or other jaw disorders experience intense pain and life-altering side effects,” van Zyle said.

TMD occurs when the temporomandibular joints (TMJs) become damaged or displaced. These joints, located in front of the ears on either side of the skull, attach the lower jaw to the head and allow the jaw to move up and down, back and forth, and side to side.

When these joints become damaged through trauma, age, or wear and tear, they become inflamed. This inflammation can affect the muscles that surround the TMJs, causing stiffness and pain.

Additional side effects of TMD include difficulty eating; loss of use of the jaw; clicking, popping and snapping when the jaw is moved; and the possibility of the jaw locking open or shut.

TMD can also cause – you guessed it – migraines, headaches and facial pain.

“In many cases, the development of TMD is gradual. Small signs show up over time and are frequently ignored until the pain becomes so intense that it is debilitating,” van Zyl said.

The Duke researchers hope their work can lead to different ways to either prevent or lessen head pain and, subsequently, reduce emotional upset.

In the meantime, there is a range of treatments for TMD to help get patients out of pain right now.

“Treatments such as the use of oral appliances, neuromuscular orthodontics and myofunctioncal therapy can help put the jaw into an ideal position, which reduces muscle tension and stress on the joint,” van Zyl said.

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