What Causes Head & Face Pain?
Head and facial pain causes and conditions can include a headache or an underlying infection or problem in the neck, teeth or jaw. Nerve disorders and certain chronic conditions can also cause pain in the head and face. The pain might be dull, throbbing, or sharp, and discomfort might be accompanied by numbness, tingling, or nausea. Common head and facial pain causes and conditions include migraine and tension headaches, myofascial pain syndrome, neuralgia and TMJ.

Migraine, Cluster, Tension and Other Headaches
Migraine headaches cause severe, debilitating pain that can start as a dull ache and progress to a throbbing or pulsing pain that can be located in any portion of the head. Migraine pain is often accompanied by nausea and sensitivity to light and sound. Women are more prone to migraines than men.

Cluster headaches refer to a group of headaches that occur over a relatively short period of time, usually several weeks. These headaches can be quite severe and might occur anywhere from every other day to several times in one day. Men are more likely to suffer from cluster headaches than women.

Tension headaches result from contracted muscles in the neck and scalp. Poor posture is a risk factor for tension headaches, along with stress, depression, and anxiety. The pain from a tension headache is commonly felt in the base of the skull and the back of the neck, along with the front, top, or sides of the head. The neck muscles can also feel tight and tender to the touch.

Sinus infections, which are also called sinusitis, can trigger a sinus headache. These infections occur when the nasal and sinus passages become inflamed due to allergies or viruses. Sinus headaches are typically felt as pressure and discomfort in the forehead and cheeks.

Myofascial Pain Syndrome
Myofascial pain syndrome (MPS) causes knotted muscles with a dull ache that can radiate to the teeth, jaw, or ears, making it difficult to open the mouth widely or chew without pain. MPS has various causes, including grinding the teeth, clenching the jaw, trauma to the jaw, or infection. This condition can also be caused by stress, anxiety, or even a nutritional deficiency.

Peripheral, Occipital and Trigeminal Neuralgia
Peripheral neuralgia, also referred to simply as neuralgia, is a painful condition that occurs when the peripheral nerves become damaged, often resulting in acute pain and other symptoms. Generally caused by an injury or disease, peripheral neuralgia can manifest as a burning, prickling, or stabbing sensation. It can be felt anywhere in the body, but is most commonly felt in the neck or the face. Occipital and trigeminal neuralgia are two specific types of nerve damage affecting the head and face.

Occipital neuralgia occurs when the occipital nerves, which run from the top of the spinal cord upward to the scalp, become injured or inflamed, resulting in a constant aching throb. Occipital neuralgia pain might be felt on one or both sides of the top of the head, in the back of the head or at the base of the skull. The symptoms can be similar to those of a migraine or other headache, including light sensitivity and pain with movement of the head. This type of neuralgia can result from injury, inflammation, or tight muscles that put pressure on the occipital nerves.

Trigeminal neuralgia affects the trigeminal nerves of the face, causing sharp facial pain that some describe as feeling similar to experiencing an electric shock. The two trigeminal nerves run down each side of the head, and each one splits into three branches that control sensations in different parts of the face. Thus, trigeminal neuralgia pain can be felt in any portion of the face, including the lips, jaw, eyelids, cheeks, nostrils, or forehead. The pain might be brief, shooting or stabbing, and it may come and go. It might be triggered by common daily activities like shaving, brushing the teeth, washing the face, or applying makeup.

TMJ
The temporomandibular joint (TMJ), located on both sides of the head right in front of the ears, connects the lower jaw to the skull. It allows you to eat and speak by opening and closing the jaw. The abbreviation “TMJ” refers both to the joint itself and to a group of disorders that can affect this portion of the jaw. More common among women than men, TMJ has many possible causes ranging from teeth grinding to arthritis or congenital structural problems within the jaw. This can make it difficult to diagnose. TMJ causes stiffness and pain in the face, jaw, and neck, along with clicking and locking of the jaw.

Balcones Pain Consultants treat all types of pain located in the face or head with compassionate, individualized treatment plans to get you on the road to being pain-free.

How are Head and Face Pain Treated?
Treatments for head and face pain depend on the specific underlying cause or condition and can range from conservative, less invasive options to more aggressive therapies. The compassionate experts at Balcones Pain Consultants take an individualized approach to each patient’s head or facial pain condition and symptoms to determine the appropriate treatment. Head and face pain treatment options might include oral or topical medications, acupuncture, biofeedback, chiropractic, Botox, nerve blocks, or transcutaneous electrical nerve stimulation.

Treating Head and Face Pain Due to Headaches
Treatment for head pain from migraine, cluster, sinus, or tension headaches depends in part on the frequency and severity of the condition. Many headaches can be treated with various pain medications, including NSAIDs (non-steroidal anti-inflammatory drugs), opioids, and triptans, which block the brain’s pain pathways by forcing blood vessels to constrict. Headache pain can also be treated with allergy medications if the underlying cause of the headaches involves an allergic reaction. Chiropractic adjustments can also reduce or eliminate head pain due to chronic headaches caused by irregularities in the cervical spine.

Migraine-related head pain can also be treated with preventive drugs such as beta-blockers, antidepressants, and anti-seizure medications. In some cases, small doses of ketamine can be delivered in a carefully-controlled setting using intravenous infusion to quickly and significantly reduce the severity of migraine auras and to alleviate migraine pain for up to several weeks. A ketamine nose spray can be prescribed to provide migraine relief for some patients. Botox is also proven to be helpful in treating chronic migraines in adults. Migraines and other types of recurrent or chronic headaches can also be successfully treated with alternative or nontraditional therapies including massage, nutritional supplements, acupuncture, and biofeedback.

Acupuncture and Biofeedback to Treat Head and Face Pain
An ancient healing technique of traditional Chinese medicine, acupuncture is a noninvasive, yet potentially effective method used to treat pain. It involves stimulating specific points on the body with extremely fine, sterile needles to promote the natural healing process. Acupuncture can be a beneficial component of treatment for head and facial pain conditions including chronic migraines and other types of headaches, as well as nerve damage and TMJ.

Biofeedback is another noninvasive technique that involves the use of electrical sensors to provide feedback about bodily functions like temperature, heart rate, sweating, and blood pressure. Patients can use this information to make subtle changes, such as relaxing certain muscles, to reduce pain and improve their overall health. Biofeedback can be an essential component of treating head or face pain related to tension headaches, TMJ, myofascial pain syndrome, and other conditions.

Treating Head and Face Pain Due to Nerve Damage
Peripheral neuralgia (also referred to simply as neuralgia), occipital neuralgia and trigeminal neuralgia can be treated with nerve blocks or transcutaneous electrical nerve stimulation. Some types of neuralgia respond to NSAIDs and other pain medications, but these interventions may be less effective in treating other neuralgic conditions. Muscle relaxants, antidepressants, and anticonvulsants, which block the nerves from firing, can also be effective in head and face pain relief from neuralgia. For some patients, surgical procedures can provide pain relief from neuralgia, while others find nontraditional, complementary therapies like acupuncture, biofeedback, yoga, nutritional changes, or meditation help alleviate discomfort.

Treating Head and Face Pain from Other Conditions
Head and facial pain due to myofascial pain syndrome (MPS) can be treated with biofeedback, which helps the patient learn to relax tension in the jaw and facial muscles. Treatment for head and facial pain due to MPS can also include dietary changes if the condition is related to a nutritional deficiency. Counseling, antidepressants, and anti-anxiety medications can be an effective method of treatment if emotional conditions like chronic stress or anxiety are causing the pain.

Head and face pain caused by TMJ can be treated with NSAIDs and other pain medications, as well as antidepressants and muscle relaxants. Alternative therapies like acupuncture and biofeedback can also be quite effective in treating pain associated with TMJ. Physical therapy and counseling can also be an important part of treatment, as can steroid injections into the jaw joint or, for some TMJ patients, surgery.

Advanced Treatments for Head and Face Pain Management
Severe or chronic pain which does not respond to other treatments, or which significantly impacts your life or activity level, may be treated with more advanced methods. It’s important to let your healthcare provider at Balcones Pain Consultants know about all your symptoms, so that we can help you to return to living life as smoothly and quickly as possible.