For years, Sarah believed she was suffering from TMJ disorder. Like many others, she thought her persistent jaw pain was due to a problem with her jaw. After all, she had been diagnosed multiple times by multiple providers. She had been given several mouth guards and told to avoid crunchy and chewy foods—but nothing seemed to work. Then, she discovered the surprising truth: her jaw pain wasn’t TMJ at all. It was something else entirely. Here’s Sarah’s story and why many people may be misdiagnosed.
(This story is based on a true patient case, but we’ve changed the name and some details to protect the patient’s identity.)
Meet Sarah: The Frustration of Constant Jaw Pain
Sarah had been battling jaw pain for over five years. At first, it seemed manageable, but over time, her symptoms became more unpredictable and debilitating. She noticed her pain was always worse with certain triggers—especially when the weather changed.
“Every time it rains or the seasons change, my jaw pain flares up,” Sarah explained. “I especially notice it in the fall and spring, when the weather can’t seem to make up its mind.”
But it wasn’t just the weather. Sarah began to see a pattern with her diet as well.
“When I eat foods like soy, dairy, or gluten, my jaw tightens up and the pain becomes unbearable. Sometimes it's so bad, I even vomit from the pain. When it comes on, I know I'm done for the day and I need to go lay down.”
The (Mis)Diagnosis: TMJ Disorder
With her worsening symptoms, Sarah visited multiple doctors and specialists over the years. She got multiple diagnoses with one that kept resurfacing—Temporomandibular Joint (TMJ) disorder. She was told that her jaws and supporting musculature were the source of her pain, and she was given mouth guards, or what some call occlusal orthotics, to alleviate her symptoms.
“I went through at least three different mouth guards, but none of them helped,” Sarah recalled. “In fact, sometimes the pain got worse after wearing them.”
Despite her best efforts, Sarah’s pain persisted, especially during the rainy season or after indulging in foods she loved. She was stuck in a cycle of frustration, with no lasting relief in sight.
The Surprising Truth
After years of struggling, Sarah was referred to me. After taking a detailed history, I began to suspect that her pain may not be stemming from her TMJ. Her triggers were not consistent with classic TMD triggers but rather she had migraine without aura. Her pain spiked with weather changes and specific foods (foods that do not require significant jaw function - milk and soy sauce). She also had classic migranous features including photophobia (sensitivity to light) and phonophobia (sensitivity to sound) along with vomiting.
Migraine does not always present as a classic "headache," but they can manifest as facial or jaw pain.
Sarah’s reaction was one of shock.
Why Migraine Can Be Mistaken for TMJ Disorder
Facial pain associated with migraine is often misdiagnosed as TMJ disorder, because both conditions share overlapping symptoms, like jaw discomfort and muscle tension. Additionally, many patients may present with both, and many times TMD may trigger migraine or vice versa. However, certain clues—like sensitivity to weather changes and certain foods—are classic indicators of migraine, not TMJ disorder. Sometimes food triggers may seem tricky as crunchy and chewy foods can exacerbate TMJ disorder; however, milk and soy sauce do not require jaw function to consume them.
For Sarah, her pain flared up when barometric pressure changed, such as before a rainstorm or during shifts in seasons. These environmental triggers are common migraine triggers. Additionally, certain foods including soy, dairy, and gluten, which often accompany migraine, were a clear sign that her pain wasn’t purely TMJ related.
What Sarah Learned: The Right Diagnosis Made All the Difference
Once Sarah received the correct diagnosis of migraine, her treatment plan shifted. Instead of focusing solely on her TMJ, we began treating her for migraine. She started a preventive migraine regimen and changed her diet to avoid triggers which helped reduce her pain significantly.
“For the first time in years, I finally feel like I’m in control of my pain,” Sarah shared.
Could You Be Misdiagnosed, Too?
If you’re experiencing jaw pain that doesn’t respond to typical TMJ treatments, or if you’ve noticed patterns with weather changes or food triggers, it’s worth considering whether your pain is truly TMJ disorder. Like Sarah, many people are misdiagnosed, spending years treating the wrong condition.
By seeking out an orofacial pain specialist and discussing your full range of symptoms, including potential migraine triggers, you could be on your way to finding the right treatment—and real relief.
Disclaimer: This blog post is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional for diagnosis and treatment of any medical condition.
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