Micaela Weinberg Physiotherapy

What makes us so special?

We are a team of physiotherapists dedicated to the TMJ. We are so dedicated that I can’t help assessing people’s TMJs when talking to them. I watch how that jaw is moving more on one side and how that person must have tinnitus or headaches stemming from their TMJ. It’s not always ideal meeting someone for the first time with an ice breaker or do you suffer from headaches on the right side of your eye? Yeah shame, I can see that it’s a chronic issue stemming from that jaw hyper mobility on the right and that poor left side is so locked, it needs some of our Physio Q20.

And even when I try not to look at the person’s mouth move lopsidedly or that one side of the jaw jutting more forwards, I notice it in their eyes too. See that nose that has deviated to the left and that eye that is slightly droopier, yeah that’s from TMJ issues too. It leaves me in a helpless situation so next time you meet me at the shops or at a restaurant, rest assured your jaw function is being assessed. Some may think it’s cool to get a free assessment, others may think it’s super creepy and leave my jaw alone 🤷‍♀️

On a serious note, I often get asked what is my favourite thing to treat with the TMJ. And that’s an easy one for me, migraines. I recently gave a talk at the Headache Symposium about the link between migraines and TMJ disorders and the results are mind-blowing! There is a bidirectional relationship between the two in English terms meaning having TMJ dysfunction makes you more likely to get migraines and having migraines makes you more likely to get TMJ issues.

The link between the two is HUGE! If you still reading this, I’ve got your back- how are these two linked? I’ve had migraines for years but didn’t know my jaw could be a part of such a thing. You need to give me more detail.

Here it goes…a hormone called CGRP (calcitonin gene-related peptide for those wanting to get the full scoop) is found to be elevated in those with migraines. Okay cool, you are still with me, but let’s get to the juicy stuff… this hormone is also found to be elevated in people with jaw issues. An injury or dysfunction of the jaw leads to CGRP being released at the jaw level by the trigeminal nerve. And this trigeminal nerve has a division that goes to the meninges (coverings of the brain) and this CGRP released by the trigeminal nerve because of jaw issues travels along that branch to the meninges (the ophthalmic branch for our medics). This causes CGRP levels to be raised at the meningeal sites and causes the blood vessels to dilate (become wider) giving you migraines.

Here you can see the three branches of the trigeminal nerve and the top branch going to those meninges of the brain. The top right shows the trigeminal nerve releasing the CGRP at the CGRP receptor which is found to be elevated in migraines.

There you have it my fellow TMJ friends, the link between migraines and TMJ. I’ll let you take a guess why it’s my favourite issue to treat? Because it’s treatable! I have patients suffering from migraines for tens of years and have seen mind-blowing (excuse the pun) changes in their migraines from treating the TMJ and trigeminal nerve 🤯

Yours truly,

In TMJ, TMDs and everything in between

Micaela Weinberg ✌️