The most important point first: acute medication such as triptans or painkillers has a firm place in migraine treatment – it acts on the pain. Anyone who also looks for the triggers cannot avoid one question: where does the tension come from? One possibility that is rarely checked in the usual work-up is craniomandibular dysfunction (CMD) – a reflex, nerve-driven misregulation in the jaw system.
Why painkillers do not explain the cause
With frequent use of acute medication, a medication-overuse headache can also develop – the headache then partly sustains itself. A causal work-up therefore starts one level deeper: with the tension in the chewing and neck muscles and with irritation of the trigeminal nerve, which is central to head and facial pain.
The rarely checked cause: the jaw system
If the bite position is unfavourable, the chewing muscles constantly work against resistance. This overload can carry on via muscle and fascial chains into the temples, forehead and neck and irritate the trigeminal nerve. This is how tension headache arises, which can turn into migraine-like headaches. In our clinical experience, the muscle activity settles when the bite position is relieved; how strongly and how quickly this affects the attacks differs from person to person.
This is no criticism of those who have treated you so far. Neurology and general practice work carefully and examine their own area thoroughly; there, quite simply, nobody measures the bite. Why this is so →
Five starting points without medication
- Relieving the bite position. An individually made positioning splint brings the lower jaw into a relieving position, without any intervention on healthy teeth.
- Releasing the muscles. Physiotherapy, manual therapy and osteopathy relax the chewing, head and neck muscles.
- Treating trigger points. Targeted treatment of tense muscle points can dampen the transmission of pain.
- Regulating stress and sleep. Stress increases clenching and grinding. Relaxation techniques, sleep hygiene and breaks lower the baseline muscle tension.
- Posture and ergonomics. An upright head posture relieves the neck. We regularly observe in practice that the spine further down also interacts with the jaw system – a causal connection, however, has not been scientifically proven.
What you can expect: a cure cannot be promised. How quickly something changes differs from person to person – and depends on how much of the complaint actually comes from the jaw system.
What you can do yourself today
Gentle immediate help without tablets: consciously keep your teeth apart during the day (lips closed, teeth loose), cooling on the neck, a quiet, darkened room, drink regularly, and a short jaw and neck stretch. Also keep a headache diary – it helps to recognise patterns and triggers. You will find further instructions under CMD exercises at home.
When an assessment makes sense
If your complaints persist despite neurological treatment, are worst in the morning and go together with jaw clicking, teeth grinding or neck tension, a look at the jaw system is worthwhile. The CMD System Check records, among other things, muscle activity by EMG and chewing forces tooth by tooth – measured instead of assumed. The first step takes two minutes: the CMD self-test.
Please do not change anything on your own: a CMD assessment does not replace neurological treatment, it complements it. Please always discuss changes to your migraine medication with your doctor. With a sudden, very severe headache, with fever and a stiff neck, with visual, speech or paralysis symptoms, or after a fall, you need an immediate medical assessment – not CMD diagnostics.
Frequently asked questions
Can migraine-like headaches be treated without medication?
Acute medication relieves the pain but does not explain where it comes from. If a trigger lies in the jaw system (CMD), it can be addressed there without medication – in addition to medical treatment, not instead of it.
What helps immediately against a headache without tablets?
A darkened, quiet room, cold on the neck or forehead, consciously relaxing the jaw muscles, gentle stretching and drinking enough. This relieves – it does not find the cause.
How quickly does a causal treatment work?
No serious time frame can be given for this. How quickly something changes differs from person to person and depends on how much of the complaint actually comes from the jaw system.
Does this replace the neurologist?
No. It complements neurological treatment. Changes to medication must always be discussed with a doctor.
Do your headaches come from the jaw system?
Without obligation – with an initial assessment straight away.