Ross Hauser, MD, Danielle Matias, PA-C, Demi Foster, APRN

A March 2025 study in the Journal of oral rehabilitation (1) found that patients suffering from fibromyalgia showed a higher prevalence of TMJ pain, headaches related to TMD (Temporomandibular Disorder), jaw locking, headaches due to bruxism, as well as both sleep and awake bruxism compared to the control group.

Another significant finding was that those with fibromyalgia experienced greater limitations in jaw function and increased anxiety. Furthermore, patients with fibromyalgia reported poorer sleep quality and a lower well-being index.

These problems of TMJ in fibromyalgia patients are not a new understanding.

A November 2023 paper in the Journal of Oral & Facial Pain and Headache (2) evaluated the prevalence of chronic widespread pain and fibromyalgia syndrome in temporomandibular pain disorder patients and the prevalence of temporomandibular pain disorders in patients with fibromyalgia syndrome. The researchers pooled data from 19 previously published studies and found:

• TMDs in fibromyalgia syndrome patients of 76.8%
• Myogenous (pain from masticatory muscles) TMDs were more prevalent in fibromyalgia syndrome patients 63.1% than in disc displacement disorders 24.2%
• 41.8% of fibromyalgia syndrome patients had comorbid inflammatory degenerative temporomandibular pain disorders.

A July 2019 paper published in the journal Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (3) previously found an association between temporomandibular pain disorders and fibromyalgia, with muscle pain, temporomandibular joint pain, and muscle tenderness on palpation as the most common symptoms. Fibromyalgia can be an etiologic or aggravating factor for temporomandibular pain disorders, or it may represent a general vulnerability to pain disorders.

Next, we follow causes.

Altered head postures and the development of active trigger points in the craniocervical musculature in the elderly with myofascial TMD.

A 2019 study from Orthopedic and Oral and Maxillofacial Surgeons in South Korea published in the journal Archives of Gerontology and Geriatrics (4) demonstrated the associations among degenerative changes in the cervical spine, head and neck postures, and myofascial pain in the craniocervical musculature in elderly with myofascial temporomandibular disorders (TMDs).

In this research:

• A total of 120 participants (overage age about 68) were included:
  • 45 participants had no signs of orofacial or cervical pain,
  • 26 participants had myofascial TMD only and
  • 49 participants had both myofascial TMD and cervical pain.
• Myofascial trigger points were evaluated in the temporalis, masseter, trapezius, sternocleidomastoid, sub-occipitalis, and splenius capitis muscles. Relationships among the number of trigger points, head postures, and cervical degeneration were investigated using repeated-measure analysis.

RESULTS:

• The degenerative changes recorded in each level of the cervical spine had complex interactions with head postures. Cervical degeneration, particularly at the level of the second to the third vertebra appeared to be linked to the development of active trigger points in the masticatory and cervical muscles. The results of this study demonstrated that degenerative changes in the cervical spine were related to altered head postures and the development of active trigger points in the craniocervical musculature in the elderly with myofascial TMD.

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TMJ and Fibromyalgia

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Ernest Syndrome | Is this the answer to unresolved TMJ, facial, ear and throat pain?

Prolotherapy for Temporomandibular Joint Pain and Dysfunction

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Our published research

The association between mandibular position to cervical spine and internal jugular vein diameters in upright position. Have we been ignoring critical generators of head and neck pathology? Lockerman LZ, Hauser R. The association between mandibular position to cervical spine and internal jugular vein diameters in upright position. Have we been ignoring critical generators of head and neck pathology? Cranio. 2023 Sep;41(5):403-406. [Google Scholar]

Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction Hauser R., Hauser H, Blakemore KA. Dextrose Prolotherapy and Pain of Chronic TMJ Dysfunction. (2007) [Google Scholar]

References

1 Esteve M, Rosales‐Leal JI. Analysis of Temporomandibular Disorders, Bruxism and Well‐Being in Patients With Fibromyalgia Syndrome: A Case–Control Study. Journal of Oral Rehabilitation. 2025 Mar;52(3):350-6. [Google Scholar]
2 Yakkaphan P, Smith JG, Chana P, Tan HL, Ravindranath PT, Lambru G, Renton T. Temporomandibular Disorders and Fibromyalgia Prevalence: A Systematic Review and Meta-Analysis. JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE. 2023 Sep 30;37(3):177-93. [Google Scholar]
3 Ayouni I, Chebbi R, Hela Z, Dhidah M. Comorbidity between fibromyalgia and temporomandibular disorders: a systematic review. Oral surgery, oral medicine, oral pathology and oral radiology. 2019 Jul 1;128(1):33-42. [Google Scholar]
4 Hong SW, Lee JK, Kang JH. Relationship among cervical spine degeneration, head and neck postures, and myofascial pain in masticatory and cervical muscles in elderly with temporomandibular disorder. Archives of gerontology and geriatrics. 2019 Mar 1;81:119-28. [Google Scholar]