Headaches come in many types. Some of them are very common, such as tension headaches. Others are rare. Some of these rare types can be mysterious, such as new daily persistent headaches (NDPH). Although recent research has revealed some insights into NDPH, there is still much we don’t understand about it. However, some evidence suggests that some cases of NDPH might be linked to temporomandibular joint disorders (called TMJ or TMD). For those cases, TMJ treatment might provide relief from what might otherwise be an untreatable condition.
At the Michigan Head & Neck Institute, our Detroit TMJ dentists have helped many people get relief from what seemed to be mysterious headaches. We may be able to help you.
What Is New Daily Persistent Headache?
NDPH is usually considered a primary headache disorder. This means that it’s a headache that happens on its own rather than being a symptom of another condition. However, this doesn’t mean that it isn’t related to another condition, especially in individual cases, just that it isn’t known to be a symptom.
NDPH typically starts on a day you can remember. It begins, then becomes very intense for a few seconds to a few minutes. Then the pain likely diminishes but remains moderate to severe, and it doesn’t go away.
Not all people experience the same type of pain with NDPH. Some have tension-type headache pain, while others experience migraine-like symptoms. Tension-type headache symptoms are more dull and throbbing and usually occur on both sides of the head. Migraine pain is more likely to be on one side of the head. Pain can be pulsing, pounding, or throbbing. People may have additional migraine-like symptoms, such as:
- Light sensitivity
- Sound sensitivity
- Nausea
- Vertigo
- Auras
These are all consistent with NDPH.
How Is NDPH Diagnosed?
NDPH is a descriptive diagnosis. This means that there is no specific test to determine that you have the condition. Your doctor will ask you about your headache. To be considered NDPH, your headache should meet specific criteria, including:
- You remember when the pain started
- Pain is constant and moderate to severe in intensity
- Pain lasts at least three months
The official NDPH guidelines state that you should remember precisely when your headache started. Because the pain is marked by a sudden and intense onset but never goes away, this is very common. It’s often easy for people to remember when NDPH started because about half of all sufferers have no history of headaches.
Next, your doctor will likely recommend tests to eliminate other potential causes of your headache. Your doctor will likely ask pointed questions, such as whether your headache intensity changes if you’re standing or lying down. They may perform a complete head and neck examination. Your doctor may also recommend an MRI and/or CT scans. In addition, your doctor may recommend bloodwork and even a spinal tap. Some doctors are concerned about conditions related to cerebrospinal fluid that can masquerade as NDPH.
Often, doctors forget to recommend tests for TMJ as part of the process. Doctors often don’t understand TMJ, its symptoms, and its relationship to headaches. If you’ve been diagnosed with NDPH but haven’t been tested for TMJ, you should see a Detroit TMJ dentist to get a TMJ evaluation.
What Causes NDPH?
Most patients that report NDPH have no history of headaches in the past. In addition, about half of people with the condition experience no triggering event. For those that do identify a triggering event, an infection and/or flu-like illness seems to be the most common. Stressful life events and intubation during surgery each account for about 9% of cases, while 7% of people can point to a specific trigger, but it’s not common and may include:
- Cranial hypertension
- High altitude climbing
- Onset of menstruation
- Antidepressant withdrawal
- HPV vaccination
- Postpartum
- Medication overuse
- Cervical massage
- Fainting
With this wide variety of triggering events, it’s no surprise that doctors still haven’t isolated a single cause for NDPH.
However, we know that two of the everyday triggering events are linked to TMJ. Stressful life events and intubation can both trigger TMJ. Stress can lead to clenching and grinding of the teeth. This puts stress on the temporomandibular joint, leading to TMJ. Similarly, intubation can cause dislocation of the joint. The dislocated joint can lead to dysfunction that triggers TMJ symptoms. Note that if TMJ is the underlying cause of your NDPH, your onset of headaches may be weeks or even months after stress or surgery. If either of these preceded your headaches, we recommend seeing a Detroit TMJ dentist for evaluation.
Treatment for NDPH
Because we don’t know the cause of NDPH, doctors recommend treating the headache according to your symptoms. If you have symptoms like a tension-type headache, then you should get tension-type headache treatment. If you have migraine symptoms, you should get migraine treatment.
TMJ treatment is consistent with these recommendations. Our Detroit TMJ dentists help people with both types of headaches get long-term relief from symptoms, often without medications or surgery.
Headache Treatment in Detroit
If you have NDPH, Detroit TMJ dentists can help. TMJ treatment can reduce or eliminate headaches, often without reliance on medications.
To learn whether TMJ treatment is right for your NDPH, please call (586) 573-0438 or use our online contact form to request an appointment at the Michigan Head and Neck Institute, serving the Detroit area from Warren, MI.
