TMJ in Fibromyalgia and Chronic Fatigue Syndrome

How These Conditions Are Related

Temporomandibular joint disorder (TMJ) causes jaw pain, and people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) tend to struggle with TMJ more than those without these conditions.

A woman holding her head in pain
Frederic Cirou PhotoAlto Agency RF Collections / Getty Image

More than 10 million people in the United States are believed to be affected by the jaw pain of TMJ, and the disorder is more prevalent in people assigned female at birth compared to people assigned male at birth.

Overview

The temporomandibular joints connect your jaw to your skull. They're stabilized by muscles and ligaments that open and close your mouth. Pain or tenderness in or around the joints is referred to as a TMJ disorder.

The causes of TMJ still aren't well-known, but most experts agree that trauma to the jaw or temporomandibular joint can lead to it. Other associated conditions include anxiety, stress, and rheumatoid arthritis. The pain can range from mild to severe and treatment generally depends on the severity.

TMJ, Fibromyalgia, and Chronic Fatigue

We don't know yet why people with fibromyalgia and chronic fatigue are more prone to TMJ disorders. When TMJ occurs before CFS or FMS, it's possible that TMJ pain contributes to the development of central sensitization. Hypersensitivity of the central nervous system is believed to be a key component of both fibromyalgia and chronic fatigue (also known as myalgic encephalomyelitis).

When the other conditions are diagnosed first, TMJ may be related to lax connective tissues believed to be associated with them. An emerging theory is that all of these conditions may fall under the umbrella term central sensitivity syndromes.

Since people with FMS and ME/CFS feel pain more acutely than others, they may suffer more from numerous painful conditions.

Diagnosis

TMJ disorders are most often diagnosed and treated by dentists. There's no single widely accepted test. A dentist may check the jaw for tenderness, popping, clicking and difficulty opening and closing your mouth. A dentist may also see how your teeth fit together by taking an X-ray and a mold of your mouth.

It's a good idea to ask a regular healthcare provider to rule out other causes of facial pain, such as sinus headaches or earaches. Also, if you have myofascial pain syndrome (which is common in people with FMS), trigger points on the sternocleidomastoid muscles in the front of the neck can cause jaw pain. It's unknown whether these kinds of trigger points actually cause TMJ or just cause similar symptoms.

TMJ Symptoms

Other than headaches, TMJ symptoms are quite distinct from symptoms of fibromyalgia and chronic fatigue. They include:

  • Jaw pain
  • Discomfort or difficulty chewing
  • Painful clicking in the jaw
  • Difficulty opening or closing the mouth
  • Headaches
  • Locking jaw
  • Teeth that don't come together properly

You should bring up any jaw pain with a healthcare provider and dentist right away. TMJ treatment is likely to be more effective if you catch it early.

Treatments

In some cases, TMJ symptoms go away on their own. If you have persistent symptoms, your healthcare provider may recommend either conservative treatments or a more aggressive approach.

Conservative treatments include:

  • Stress reduction
  • No gum chewing
  • Avoiding wide yawning
  • Ice packs
  • Mouth guards
  • Anti-inflammatory drugs, such as Aleve (naproxen) and Motrin/Advil (ibuprofen)

More aggressive treatments include orthodontics or surgery. These aggressive treatments are controversial, so you may want to get a second opinion before considering them.

Treatments for TMJ vs. FMS/ME/CFS

TMJ treatments don't generally interfere with fibromyalgia or chronic fatigue treatments. However, those people with temperature sensitivity may have a hard time tolerating ice packs or recovering from surgery because of their other conditions. Also, some experts believe that many people with ME/CFS are sensitive to certain types of anesthesia, although this has not been proven in clinical studies.

Any time you're taking medication for more than one condition, you should talk with a healthcare provider and pharmacist about possible drug interactions.

If you're considering surgery, be sure you speak to a surgeon about any accommodations you may have because of your other conditions.

Even routine dental appointments can be hard on people with these conditions. Make sure you're prepared for the appointment and know the options for helping you get through it.

A Word From Verywell

The pain of TMJ can make your fibromyalgia or chronic fatigue more difficult to manage, making treatment especially important.

We're constantly learning more about the facial pain of TMJ and what it has in common with disorders involving widespread muscle pain. This research could help us better understand TMJ and its relationship to chronic fatigue and fibromyalgia, leading to better treatment for all of them.

Frequently Asked Questions

  • Can TMJ cause all over body pain?

    Not usually. However, TMJ can cause pain throughout the head, neck, and face. The temporomandibular joint sits behind the trigeminal nerve, a major nerve that branches across the face and can spread pain throughout the eyes, ears, mouth, forehead, cheeks, tongue, teeth, and throat. 

    TMJ does not cause all-over body pain, however. Conditions that cause widespread body pain and are associated with TMJ include fibromyalgia and chronic fatigue syndrome (also known as myalgic encephalomyelitis.  

  • Is TMJ a neurological disorder?

    While TMJ is typically diagnosed and treated by a dentist, research shows temporomandibular joint disorders have a neurological aspect. TMJ is associated with abnormal pain perception in neural pathways in the trigemino-thalamo-cortical system.

  • Is TMJ a lifelong condition?

    TMJ can be an acute or chronic condition. Left untreated, TMJ can worsen over time and become a prolonged pain condition. With treatment and lifestyle adjustments, TMJ can often be managed.

  • Does TMJ affect your memory?

    It may, but the evidence isn't very strong. A 2011 study found that temporomandibular disorders can affect memory retrieval, although the exact mechanisms are not fully understood.

    It is suspected that pain from TMJ causes an increase in cortisol, which may have an impact on glucocorticoid receptors in the hippocampus. This can cause memory impairments. 

  • Can a brain MRI show TMJ?

    Possibly. Research shows that brain MRIs of people with TMJ show changes to areas of the brain responsible for pain perceptions. These abnormal brain responses occurred in response to both non-painful and painful stimuli.



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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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