New daily persistent (NDP) headache is a newly recognized type of primary headache (recognized as not being secondary to another health condition), and it’s one that headache specialists love to hate.
Why do headache specialists dislike this type of headache? Because it’s hard to treat successfully. Maybe part of the reason why these headaches are so hard for them to treat is because some (though probably not all) are actually TMJ headaches. Let’s look at the characteristics of the NDP headache and talk about how TMJ headaches might be misdiagnosed in this class.
What Is NDP Headache?
NDP headaches occur daily, generally from the onset of the disorder or within a few days afterward. It was only added to the International Classification of Headache Disorders in 2004, although it was first described in 1986, and diagnostic criteria were proposed in 1994.
The diagnostic criteria are:
Headache that fulfills criteria B through D within 3 days of onset
Headaches occur daily for at least three months
Pain has at least two of the following characteristics:
Located on both sides of the head
Pressing or tightening without pulsating
Mild or moderate intensity
Not aggravated by mild physical activity
Both of the following:
At most one of the following:
No more than mild nausea or vomiting
Not related to another disorder
Although they’ve established diagnostic criteria, researchers aren’t sure what causes NDP headaches. There are several evocative correlates, such as the predominance of flu-like illness, stressful life event, minor head trauma, or extracranial surgery close to the time that the headaches began. Incidentally, unlike most types of headaches, people with NDP can typically pinpoint when their headaches began, probably because they became chronic within three days of onset.
Possible Links to TMJ
So what makes us think that many cases of NDP might actually be TMJ headaches? There are several good reasons.
First, the mixture of migraine and tension headache characteristics suggests something that can trigger both types of headaches, such as TMJ. What we might be seeing is a partial migraine being triggered by trigeminal nerve stimulation in someone who isn’t otherwise disposed to migraines, accompanied by tension headaches caused by muscle overactivity.
Second, the fact that the headaches can be either unilateral or bilateral, like TMJ headaches.
Finally, the fact that NDP headaches are very difficult to treat suggests that we don’t have a good handle on the diagnosis. Many people with TMJ headaches also found difficulty getting their headaches treated by doctors and even headache specialists before finding relief with neuromuscular dentistry treatment.
This makes us think that it’s likely some cases of NDP are probably TMJ headaches.
If You’ve Been Diagnosed with NDP Headache
It’s part of the diagnostic process for NDP that your doctor should eliminate other potential causes of headache. Among the potential causes of those headaches, your doctor should recommend testing for TMJ. If you weren’t tested for TMJ prior to your NDP headache diagnosis, now is the time you should talk to a neuromuscular dentist about your headaches and see if he can help.