Facial Pain

Last updated on October 18th, 2021 at 03:26 pm

CAN ALLERGIES CAUSE MIGRAINES, SINUS HEADACHES, AND JAW PAIN?

@Neuralgroover

 

Allergies and Sinus Headache

Do you have a bad headache along with sinus pressure, facial pressure, facial pain, sinus pain, nasal congestion, nasal drainage, postnasal drip, or sore throat? It must be a sinus headache, right? Sure, it’s possible if there is a true sinus infection going on. However, the majority of the time it isn’t.

 

Now if these symptoms are associated with fevers, nasty colored drainage, and other infectious symptoms, there could certainly be a sinus infection and sinus related headache. However, without these infectious types of symptoms (fever, nasty colored drainage, signs of infection), the most likely cause is actually migraine.

 

Yes, those several monthly headaches you get with sinus pressure and congestion are probably not recurrent sinus headaches or sinus infections. They are most likely migraine, especially if there is a recurrent pattern such as monthly occurrence. Allergies (and associated sinus symptoms) are not felt to be a common cause of headache, and most of the time those symptoms actually represent migraine. If your sinus headache has features including throbbing, pounding, pulsating pain, nausea, or sensitivity to light and sound, it easily fits criteria for migraine, and should be treated as such. However, a discussion with your doctor is always recommended to ensure there is not an associated sinus infection or other cause of the headache. Your doctor should always be the one making treatment recommendations based on their assessment.

 

With that said, it is still possible that allergies can cause headaches for some patients due to the inflammation involved. The second half of this blog towards the end will address the connection between allergies, headaches, and jaw pain.

 

Sinus Headache and Migraine Misdiagnosis and Mistreatment

The bottom line is that migraine is commonly misdiagnosed as a “sinus headache” by patients, physicians, and other medical professionals when there are sinus symptoms present. Unfortunately, what we end up seeing in the headache clinic are patients with a history of excess unnecessary antibiotics, sinus procedures, and minimal to no relief. By the time patients see us, they have often had sinus surgeries, which surprise, don’t help them. Improvement usually doesn’t begin until the headaches and sinus symptoms are treated as migraine.

 

Sometimes patients report their “sinus headaches” improve with these repeated courses of antibiotics, but this doesn’t confirm a sinus infection. Many antibiotics have anti-inflammatory effects, and it is often this effect on the headache that is being felt rather than an infection being treated. In addition, unnecessary excess antibiotics lead to antibiotic resistance. So, when you actually do need that antibiotic for an infection it may no longer be effective against that bacteria (and remember, most upper respiratory infections are viral, which antibiotics will have no effect on anyway). C-difficile (C-diff) infection (which can be deadly) is another complication of antibiotic use in some patients, so the less unnecessary gamble of antibiotic use the better.

 

There is a rare and controversial type of facial pain called mucosal contact point headache. This type of pain is typically localized to a smaller area in the face, rather than a headache elsewhere. So it is more of a facial pain than a headache. It is suspected to be caused by a severe nasal septal deviation where part of the nasal septum contacts the nasal mucosa across from it. or pressure on the nasal walls and headache. This has also been called rhinogenic headache.

 

How Does Migraine Cause Sinus Symptoms?

The reason for this common misdiagnosis of “sinus headache” is because the trigeminal nerve (cranial nerve 5) is the root cause and central to migraine, and it also innervates the sinuses, teeth, TMJ (temporomandibular joint) area, and the face. So if the migraine is activated and turned on, not only does the pain of the headache turn on, but so does the discomfort in the sinus areas, TMJ, teeth, along with sinus symptoms. The bottom line, if you get recurrent episodic headaches that have any throbby, pulsating or pounding pain, any nausea, or sensitivity to light and sound during a bad “sinus headache”, consider it migraine.

 

How Often is Migraine Misdiagnosed as Sinus Headache?                       

A study of almost 3,000 patients with self-diagnosed or doctor diagnosed sinus headaches showed that 88% of the patients actually had migraine according to ICHD3 criteria, not sinus headaches! The most common sinus symptoms reported in that study were sinus pressure (84%), sinus pain (82%), and nasal congestion (63%).

 

Another study called the American Migraine Study II showed similar results. This was a study involving 30,000 patients. About 50% of patients who were eventually diagnosed with migraine had been previously misdiagnosed, and the most common prior misdiagnosis was sinus headache.

 

Yet another study that looked at 100 patients with self-diagnosed sinus headaches. After a detailed history and exam, patients were given headache diagnoses based on the ICHD3 criteria. Of the 100 patients with self-diagnosed headache, 86% were diagnosed with a migraine related headache disorder, rather than a sinus related headache.

 

Is There a Connection Between Allergies and Jaw Pain?

Occasionally, Virtual Headache Specialist will allow guest bloggers to write an article on a migraine related topic, or collaborate with another website or company to further disperse useful medical knowledge. Sinus headache, allergies, jaw and facial pain are very relevant migraine associated topics. So, the second half of today’s blog topic in the section below was written by a guest author, whereas I wrote the section above. I hope the following article provides additional useful information on allergies, sinuses, and how they may relate to jaw and facial pain. The article below is a collaboration with the Zyrtec website given their allergy expertise on this topic.

 

While many people are aware of the fact that allergies can lead to headaches and sinus pain, they may be surprised to learn that allergies can also cause jaw pain. This can present as tender cheeks, pain radiating to your jaw and teeth, or even discomfort on the top of your head, and often feels worse when you lay down and better when you’re upright.

 

But why?

 

Basically, it’s all about the sinuses. We have four pairs of sinuses (frontal, ethmoid, maxillary, and sphenoid), and sinus pressure and pain in any of them can radiate all over your face — including your jaw. That’s why keeping your sinuses healthy by using a nasal spray, treating your allergies, and rinsing your sinuses with a saline rinse can be so helpful. Eating a healthy diet, exercising, and catching some solid zzz’s each night will also benefit your sinus health. Learn more ways to show your sinuses some love in this infographic.

 

Can Allergies Cause Jaw Pain?**

By Kristen Stewart

 

When you experience jaw pain, your mind may jump to reasons such as teeth grinding or toothaches. By going for the obvious, however, you may overlook something as simple as allergies causing your jaw pain. Keep reading to uncover how allergies can cause jaw pain. First, to help you determine if you may be suffering from allergies, here’s a quick primer on what allergies are, what causes them, and who’s most at risk of getting them.

 

IS IT ALLERGIES OR A COLD?

Allergies affect more than 50 million people in the United States each year, with many individuals suffering from allergic rhinitis. Also known as hay fever, its symptoms are as common as they are annoying — sneezing, runny nose, and itchy, watering eyes to name a few.1

 

While some symptoms overlap between allergies and a cold, you may notice some key differences. Colds are contagious and people often unwittingly infect others for two days before symptoms appear. A low-grade fever and aches and pains may accompany them. This common illness may also develop gradually over a couple days.2

 

On the other hand, viruses don’t cause allergies, so you can’t pass allergies on to anyone else. They occur when the body initially encounters a normally harmless substance and creates antibodies to it. When the body encounters the substance again, the existing antibodies tell the immune system to send chemicals such as histamine into the bloodstream to fight the invader. The immune response causes unpleasant allergy symptoms, and they often come on suddenly rather than gradually.3 Take our allergies versus cold quiz to find out which one you have.

 

ALLERGY CAUSES AND RISK FACTORS

Allergic rhinitis typically comes in two forms:  seasonal and perennial. As its name suggests, seasonal allergies strike at predicted times of the year, most often in the spring, summer, or early fall. The main culprits tend to be pollens from grassestrees, and weeds as well as mold spores transported through the air.

 

People with perennial allergies suffer all year. Triggers tend to be exposures encountered during everyday life such as animal dander, dust mites, cockroaches, or mold spores rather than outdoor greenery or conditions.4

 

While allergies are more likely to strike during childhood, they can develop at any time during a person’s lifetime. Reactions can vary from minor to severe.5

 

Unfortunately, you can’t control most of the risk factors for developing hay fever. People with existing allergies, asthma, or eczema are more likely to have hay fever. And if a parent, sibling or other blood relative has allergies or asthma, your chance of getting hay fever increases. But you can control one risk factor by spending less time exposed to allergens like animal dander or dust mites.

 

ALLERGIES, SINUSES, AND HOW THEY CAN CAUSE JAW PAIN

As any sufferer knows, allergies can wreak havoc on your body. In addition to the well-known sneezing, sniffling, and red watering eyes, you may experience postnasal drip, coughing, and fatigue.6 Allergies can also clog the sinuses. Because of that, they could be the source of your nagging jaw pain.7

 

You probably identify sinus problems with nasal pressure. But allergies can cause lower jaw pain as well as the feeling of general pressure, especially if maxillary sinuses are obstructed. Inflamed and swollen sinuses can affect a number of areas of the face and head and result in issues ranging from headaches and earaches to facial tenderness near the eyes and nose that radiates to the jaw.8

 

It’s possible that seasonal allergies could cause jaw pain in other ways, although more research is needed on the subject. Frequent sneezing and coughing force the mouth open which could lead to muscle tension and overuse strain and create issues with the jaw. Similarly, a stuffy nose may make you breathe through your mouth at night. If your jaw is strained open all night, it makes sense that you could wake up with jaw discomfort.9

 

And for people who have a temporomandibular joint disorder (diagnosed or not), it’s possible that allergies could exacerbate it and cause increased jaw pain. However, the sinuses are the key way allergies cause jaw pain.

 

THE SINUSES EXPLAINED

Many parts of the body get a lot of love. We try to eat right and exercise for our hearts and stay engaged with life mentally and socially to keep our minds sharp as we age. But people often neglect their sinuses. The sinuses may only become your focus of attention if a problem occurs. But it’s worth understanding more about your sinuses, and that’s especially true if you experience jaw pain, because sinus pressure and pain can radiate all over the face.

 

Sinuses are also called paranasal sinuses. They’re air-filled pockets or cavities in the skull and facial bones that connect to the nose through an opening known as an ostium.

Usually when we hear about cavities, it’s when we get bad news at the dentist’s office, but sinus cavities are our allies. Check out our 6 Things to Know About Sinuses page to learn about the remarkable role they play to keep us well and healthy.

 

Like many parts of the body, sinuses aren’t immune from issues. Allergic sinusitis typically comes with the usual allergy symptoms such as sneezing, nasal congestion, and itchy eyes, nose, and throat.10 Allergy headaches can also occur with facial discomfort in the sinus area. Pain can be located throughout the region or sometimes located on just one side.11

 

 

KEEPING SINUSES HEALTHY

The good news is you can take steps to keep your sinuses healthy, which may help alleviate and prevent jaw pain. One action you can take is to manage allergies to keep your symptoms under control. Allergies can cause inflammation of the nose and sinuses which in turn blocks mucus from draining and may lead to an infection.

 

In addition, consider using nasal saline sprays to keep your nose moist. This practice ensures the cilia will work at their optimum level to clear the airways and remove debris. You may also want to irrigate your sinuses with a saline sinus wash to add moisture and flush out dust, pollen, and other intruders. 12 13

 

Beware of irritants such as pollution and smoke. The chlorine found in chlorinated pools may also irritate and inflame your nasal passages and sinuses. If possible, opt to swim in saltwater pools or natural bodies of water to avoid excess exposure to chlorine.14

 

Maintaining good health overall can also help keep sinus issues at bay. Eat a healthy diet, exercise regularly, get enough sleep, and manage stress to boost the immune system and keep colds and flus at bay. Avoid taking antibiotics or steroids if possible as they disrupt the microbiota in the sinuses and may allow pathogens to proliferate.15Finally, it may sound obvious but don’t forget to wash your hands. Handwashing can play a large role in reducing illness and sinus issues.16

FIND THE RIGHT TREATMENT TO EASE YOUR JAW PAIN

If you have severe or long-lasting jaw pain, you may want to talk to a medical professional. But if you suffer from jaw discomfort and allergies, some simple precautions may help you smile — without pain — in no time.

________________________________________________________________________________________________________

Kristen Stewart is a freelance writer specializing in health and lifestyle topics. She lives in New Jersey with her husband, three kids and two very needy cats.

 

**The “Can Allergies Cause Jaw Pain?” section above originated on the Zyrtec website, was written by Kristen Stewart, and is being reshared here for an educational collaboration. The original version can be found here:

https://www.zyrtec.com/allergy-guide/understanding-allergies/symptoms/jaw-pain

 

[1]https://acaai.org/news/facts-statistics/allergies
[2]
https://www.zyrtec.com/allergy-guide/allergy-essentials/allergies-or-cold
[3]https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes…
[4]
https://acaai.org/news/facts-statistics/allergies
[5]
https://www.mayoclinic.org/diseases-conditions/allergies/symptoms-causes…
[6]
https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes…
[7]
https://acaai.org/allergies/symptoms/allergy-headaches
[8]
https://omfs.com.au/patient-information/news-updates/can-allergies-cause…
[9]
https://www.newsmile4u.com/blog/allergy-symptoms-can-hide-tmj/
[10]
https://www.cedars-sinai.edu/Patients/Health-Conditions/Allergic-Sinusit…
[11]
https://acaai.org/allergies/symptoms/allergy-headaches
[12]
https://blogs.bcm.edu/2014/06/25/ten-tips-to-avoid-sinus-infections/
[13]
https://medlineplus.gov/ency/patientinstructions/000801.htm
[14]
https://blogs.bcm.edu/2014/06/25/ten-tips-to-avoid-sinus-infections/
[15]
https://www.nature.com/articles/s41598-019-53975-9
[16]
https://www.cdc.gov/handwashing/why-handwashing.html

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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CLUSTER HEADACHES THROUGH THE CHANGING SEASONS.

@Neuralgroover

Cluster headaches are often considered the most severe type of headaches experienced by headache sufferers. It is often referred to as “suicide headache” because it is so severe, and unfortunately quite a few have committed suicide due to the extreme pain.

 

Cluster headache is 1 of 4 types of trigeminal autonomic cephalalgia syndromes (TACs). The headaches within this headache TACs family share some overlapping features, but have distinct differences, and are all treated much differently. So it is important to first properly confirm the diagnosis of cluster headache and clarify that it is not one of the other TACs.  The ICHD3 criteria classify cluster headache as a strictly one sided headache around the eye, temple, forehead which can last anywhere between 15 minutes up to 3 hours. On the same side of the headache, they must be associated with at least one “autonomic feature” which means a tearing and/or red eye, nasal congestion and/or runny nose, eyelid swelling or puffiness, forehead and/or facial sweating, small pupil and/or drooping eyelid. The patient often has a sense of restlessness or agitation and classically paces around the room, sometimes yelling out in pain (in contrast to migraine where the patient often wants to stay still and quiet in bed).

 

They are called cluster headaches because the headaches come in “clusters”. They may be headache free all year and then all of a sudden develop daily headaches which can occur multiple times per day (sometimes up to 8 times per day). They often occur around the same time every night or during the day, often waking the patient up from sleep around the same time nightly. These cycles of daily frequent attacks can last several weeks to several months. The majority of people who suffer from cluster headaches experience them for about 12 weeks each year, most often when the season changes (Summer to Fall and Spring to Summer). It’s one of the most painful types of headaches and is often more intense than a migraine. Let’s take a look at how cluster headaches happen during seasonal changes and what you can do about them.




Why Do Cluster Headaches Happen During the Fall and Spring?

Many people go months or years in between cluster headache cycles. When the cycles start again, they are often tied to changes in the seasons during Fall and Spring. However, cluster headaches can and do certainly come on outside of season changes as well.

 

Changing influences on the body’s biological clock (hypothalamus) have been a long suspected cause of cluster headache, and still felt to be the most likely culprit. Changes in seasons and daylight savings time changes are often associated with cluster headache flares. Daylight savings time changes impact our sleep patterns. When sleep patterns change, this changes the amount of natural light we are exposed to. For a headache sufferer, this can increase headache patterns. Changes in the amount of natural light that a person is exposed to during sleep-wake cycle changes can influence the body’s normal biological rhythms by influencing the hypothalamus. The result for many patients with cluster headache is that the cluster cycle can then be “turned on”.

 

Decreased natural light exposure during the Fall season due to a shorter duration of daylight may also impact a person’s sleep cycle. Loss of sleep may reduce endorphins (our natural pain-killers) in the body and also play a role in reducing the body’s pain tolerance threshold. A study suggested that a loss of 1 to 3 hours of sleep per night over a period of a few days could result in a headache that lasted from anywhere to 1 hour or a day. Migraine is also often very sensitive to inadequate sleep, which is a common trigger.

 

Why Do Seasonal Changes Cause Cluster Headaches

The change in hypothalamic circadian biological rhythms related to changes in sleep-wake cycles and exposure to natural light remain the most commonly suspected cause for cluster headache. However, the exact, true cause of cluster headaches are still not entirely known. Thus, there have been other theories of what causes cluster headaches as well, including changes in barometric pressure, and histamine release related to seasonal allergy changes.

 

There are a lot of headache triggers that happen during the Fall season including decreases in humidity and temperature which are associated with increases in barometric pressure. When you begin getting into Spring, Summer and warmer months, there tends to be more of a decrease in barometric pressure. These barometric pressure changes are classic migraine triggers for many patients. However, a possible relation to cluster headache has also been suggested. The exact barometric pressure that will lead to cluster headaches will vary depending on the individual. For example, a pressure of 1003 to 1007 hPa was found as a migraine trigger point in an NIH study. A specific pressure change of 6 to 10 hPa (the specific drop in air pressure) was also identified as a range in pressure drop that could cause a cluster headache or migraine.

 

Seasonal allergies have also been suggested to possibly play a role in migraines and cluster headaches. Increased allergies during season changes leads to increased histamine levels and sinus symptoms for some people. Deep within the nasal passageways lies some nervous system structures including the olfactory nerves (which allow you to smell), and important headache and facial pain related nerve ganglia, such as the SPG (sphenopalatine ganglia). For example, the SPG is sometimes blocked (SPG block) by numbing medications to abort various types of headache and facial pain including cluster headache, migraine, and trigeminal neuralgia.

 

Seasonal Affective Disorder also could be linked to various types of headaches that one experiences throughout the year. Certain people may experience a predisposition to anxiety and depression due to seasonal changes, and this may lead to headaches and insomnia.

 

Symptoms of Cluster Headaches

Seasonal cluster headaches can start at any age, however, most people tend to start experiencing these between the ages of 20 to 50. They tend to affect men more than women (in contrast to migraine which is the reverse). To review, some of the symptoms of a cluster headache can include:

  • Redness, swelling, and watering/tearing around the eye on the side of the head where the cluster headache is occurring.
  • A stuffed/congested and runny nose on the same side of the headache.
  • Pale skin and sweating.
  • Drooping of the eyelid and small pupil size on the side of the headache.
  • Sense of restlessness or agitation during the attack.

 

Some of the other headaches that a person might experience include anxiety, and waking up at night. Chronic cluster headache sufferers may notice an intensification of their headaches during the change to fall. If you have cluster headaches occurring for one year or longer without remission, or with remission periods lasting less than 3 months, you fall into the chronic cluster category, which is a small minority of cluster headache patients.




How To Alleviate Cluster Headaches That Are Brought On By Seasonal Changes

There are some very basic things that you can do if you suffer from cluster headaches during seasonal changes. Avoiding alcohol and smoking will help reduce the onset of cluster headaches for some. For example, alcohol is a classic trigger for cluster headache when a patient is in a susceptible cluster headache cycle. Sometimes even the smell of alcohol can trigger an attack. When the same person is outside of their cluster cycle, alcohol does not trigger the attack. So for those that drink alcohol and are unsure if their cluster cycle is done (if they are susceptible to an alcohol trigger), consuming alcohol will often let them know! The hormone melatonin can help regulate your sleep cycle, helping you rest better. Some studies have suggested melatonin levels are lower during a cluster cycle. The dose ranges from 5-15 mg taken about 2 hours before bedtime.

 

Otherwise, the key cluster headache treatments involve having a good abortive (as needed) treatment for when an attack happens, and a good preventive treatment to lessen the frequency and severity of attacks. The following treatments are most commonly used for cluster headaches. However, any treatment should be prescribed and discussed with your doctor because you may have other medical conditions which could make some of these treatments dangerous or life-threatening if being used inappropriately. For example, use of triptans or Dihydroergotamine (DHE) in someone with cardiac disease could cause heart attack or stroke. Use of steroids such as prednisone in someone with an ulcer could cause death by gastrointestinal bleed, or in diabetes could lead to diabetic coma and a visit to the intensive care unit due to excess glucose in the blood. Use of oxygen around smoking could cause an explosion. There are many other examples, which is why any treatment should always be provided and discussed first with your regular medical doctor. Also, you should never use treatments given by a friend if they have a similar headache disorder without first consulting with your doctor.

 

Abortive Treatment For Cluster Headaches

In appropriate patients, as soon as a cluster cycle starts, we often use a course of prednisone. Although this can be adjusted depending on the patient’s medical history, I typically start with 70 mg daily in the morning (since often energizing) with food for 3 days, decreasing by 10 mg every 3 days until off. This often helps to break up and shorten a cycle. Occipital nerve block on the same side of the headache for 1-3 days can also be effective in breaking up and shortening a cycle.

 

100% oxygen consumed by a non-rebreather facemask at cluster attack onset at 12-15 liters per minute for 10 to 15 minutes is very effective for many people.

 

Triptans have been a standard treatment abortively for not only migraine, but also for cluster headache. The difference is that oral triptans are not generally prescribed for cluster headache sufferers because the headache will frequently peak after the medication has had the opportunity to be absorbed by the body. Injectable triptans (Sumatriptan) is the fastest acting, often working within minutes. Nasal spray triptans (Sumatriptan, Zolmitriptan) are the next fastest options.

 

Dihydroergotamine (DHE) is also a good option, especially if not responding to triptans or having multiple attacks daily (DHE can last longer). Injection is the most effective, followed by the nasal spray versions).

 

Neuromodulatory devices can also be effective in aborting a cluster attack. GammaCore is a vagus nerve stimulator device that you can carry with you and it is FDA cleared for the abortive treatment of cluster headache. It is the only device currently with this clearance and indication. SPG (sphenopalatine ganglion) blocks can also be done in a variety of ways between the office or under sedation with pain management. There was a small surgically implantable SPG stimulator (implanted through the roof of the mouth) which could be turned on with the press of a button from a handheld device which seemed very promising and effective, but unfortunately got held up and blocked in regulatory processes and red tape. Hopefully this will be revived in the future.

 

Preventive Treatment For Cluster Headaches

Verapamil is often considered the gold standard of cluster headache prevention to try to stop the frequency of attacks and shorten the cluster cycle duration. It is typically started at the onset of a cluster cycle and titrated up to a higher dose depending on how the cluster attacks are responding, and how the patient is tolerating it. This is a blood pressure class of medication, so needs to be used cautiously in those with normal or low blood pressure, or if taking other blood pressure medications. Clinically, it tends to work better in the immediate release form taken three times daily as opposed to the once daily long acting version. I typically start with 40 mg or 80 mg (depending on baseline blood pressure) three times daily and increase by 40 mg every 3 days (assuming no dizziness, lightheadedness, excess fatigue, etc.) until helping or 120 mg three times daily. Although for some patients, much higher doses are required. Checking an EKG is recommended when making higher dose changes to ensure no heart block. Longer-term use of this prescription drug can be considered for chronic cluster headache or high frequency cycles through the year.

 

Emgality (Galcanezumab) ​​is one of the four available CGRP monoclonal antibodies. These are all made for migraine prevention. However, Emgality is unique in that it is currently the only FDA approved medication for prevention of episodic cluster headache. Notably, Emgality dosing is different for cluster headache prevention (300 mg injection per month) compared to migraine prevention (120 mg injection per month).

 

Other types of preventative treatments for cluster headaches include anti-seizure medications, typically starting with Divalproex (Depakote) or Topiramate (Topamax). For more refractory cases, Lithium is sometimes used as well.

 

For some patients (especially chronic cluster headache), unfortunately even these options do not help them and they turn to alternative treatment options. One option that has gained a lot of exposure is the use of tryptamines at sub-hallucinogenic dosing (“microdosing”) including psilocybin (from mushrooms), lysergic acid amide (LSA), and lysergic acid diethylamide (LSD). In fact, there are also growing published studies suggesting benefits of these types of treatments. There is a group called ClusterBusters where these types of treatments are discussed further. Obviously, there are potential legal ramifications of these treatments since they are all federally illegal substances, but for some patients their cluster headache is so severe and refractory that they will do anything for relief.

 

Getting Help For Your Cluster Headaches

Cluster headaches can impact your ability to complete tasks at work and can require you to take more sick leave, as referenced in one study. Cluster headaches can also have an impact on your relationships with family and friends. If you develop cluster headaches your primary care physician might be able to find a viable treatment option or refer you to a headache specialist or neurologist to help you find a solution for your cluster headaches.




IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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Last updated on October 6th, 2021 at 06:08 pm

TMJ DISORDER AND TMJ ASSOCIATED HEADACHE AND FACIAL PAIN.

@Neuralgroover

The temporomandibular joint (TMJ) is the joint that connects the jawbone and the skull. This is one of the most powerful joints in the human body, as it can apply 162 pounds per square inch when a person bites. It is important to realize that the TMJ is a synovial joint. In other words, it is a joint composed of a capsule filled with synovial fluid. Similar to a knee joint (but on a much smaller scale), the synovial fluid keeps the joint lubricated and healthy. However, this can also be the source of various types of dysfunction. There is a condition called TMJ disorder that can contribute to facial pain and headaches. TMJ disorder is fairly common, impacting about 12% of Americans at any given time. Women get TMJ disorder more often than men; in fact, for every male TMJ sufferer, there are 9 female TMJ sufferers.

TMJ disorder tends to be higher among younger people, while women using estrogen or contraceptives tend to experience TMJ disorder more frequently.




What Is TMJ Disorder and What Causes It?

Loosely put, TMJ disorder is any type of pain and restricted movement that impacts the jaw joint and surrounding muscles. There are several different causes of TMJ, including

  • Injury to the tooth or jaw
  • Grinding or clenching of the teeth
  • Poor posture
  • Stress
  • Other issues

In some instances, even chewing gum can aggravate an outbreak of TMJ. TMJ disorder can lead to headaches and facial pain.

 

TMJ Disorder and Headaches

When TMJ sufferers have a headache, they often report a headache that is like a tension headache in nature. TMJ associated headaches often recur in one or more regions of the head and face and are accompanied by several different symptoms:

  • Tight face and jaw muscles
  • Face or jaw pain
  • Clicking noises in the jaw when chewing
  • Overall restricted movement of the jaw
  • Changes in how the teeth fit together when biting down

It is important to keep in mind that TMJ discomfort can also be a manifestation of migraine headache attacks. Migraines can also cause referred pain to the TMJ areas, neck, shoulders, sinus areas, and face. So if the TMJ discomfort happens primarily when someone has a migraine type headache or symptoms, it could also just be a referred pain syndrome rather than a true TMJ disorder.

 

Is There a Positive Outlook for TMJ Headaches?

TMJ headaches are incredibly uncomfortable, but there is generally a very good outlook for TMJ headaches. Your doctor may suggest a wide variety of treatments to alleviate the pain and often lifestyle changes and other treatments may be required to eliminate and address TMJ disorder. Treatments aimed at alleviating TMJ disorder itself are generally very successful in reducing the frequency of these types of headaches. Let’s take a look at some of the treatments that are available for TMJ headaches.

Very rarely are TMJ disorders serious and long lasting. In these rare situations, diagnosis and treatment must be sought quickly to manage and resolve the condition. Chronic, severe TMJ disorder is very rare, however, tendons, muscles, and cartilage over time can become damaged leading to arthritis. The good news is that most cases of TMJ disorder go away within about two weeks if the jaw is given the necessary time to rest and the root cause, such as stress, is removed.

Occasionally, TMJ disorder will go away on its own. Self-limiting cases are common and being aware of grinding and clenching can help alleviate TMJ over time if it’s not a severe case.

 

Lifestyle Changes to Address TMJ Associated Headaches and Facial Pain

Some behaviors may cause and trigger flare ups of TMJ disorder, as well as associated headaches and facial pain. Some people may experience this disorder from the type of food that they eat, the stress in their life, and certain jaw movements that they have learned as habits over the years. Some small lifestyle changes can help with TMJ disorder and associated headaches and pain, including:

  • Avoiding foods that are hard or require a great deal of chewing
  • Reducing the stress factors in one’s life to prevent jaw clenching and teeth grinding, which are coping behaviors aimed at dealing with stress.
  • Learning jaw exercises to strengthen the jaw muscles themselves and avoiding things like gum chewing and wide yawning, which can irritate the jaw joint.

Over-The-Counter Solutions for TMJ Associated Headaches and Facial Pain

For the short-term, certain medications may help alleviate the headaches and facial pain caused by TMJ disorders. These include NSAIDS, such as aspirin, ibuprofen, and naproxen. These can help eliminate a headache as an abortive treatment. Additionally, icing your jaw can also help relieve the pain associated with a TMJ headache. Jaw exercises can help with muscle relaxation and pain symptoms. Muscle relaxers are often prescribed in conjunction with NSAIDs in an attempt to lessen the muscle spasm and clenching of the muscles surrounding the TMJ.

Long-Term Treatments for TMJ Associated Headaches and Facial Pain

There are a wide variety of different treatments for TMJ disorder, which can help relieve headaches and facial pain. These include physical therapy, Botox, surgery, and other types of treatments.

Sometimes, there are certain exercises that may help address TMJ associated headaches and facial pain. Patients can learn various exercises, like chin tucks, upward tongue, forward jaw, and resisted closing movements. These help with TMJ pain relief. Generally speaking, these exercises provide a very good therapeutic outlook for patients.

Some patients may also benefit from alternative treatments like acupuncture and massage. Consulting with a medical professional is advised to make sure that any exercises are learned correctly.




Splints and Mouthguards For TMJ Disorder

Splints and mouthguards are a treatment that may help alleviate TMJ associated pain and headaches. These do not directly treat the pain itself, but can help prevent clenching and grinding of the teeth. Some dentists may fit these for patients after a consultation with a health professional. Seeing a TMJ specialist for these types of treatments is recommended to ensure precision of the device, because if it is off even slightly, the pain can intensify. The idea behind splints and mouthguards are that they prevent the grinding and biting that typically occurs during sleep, allowing the jaw to rest. Sometimes, a dentist will work on a long-term bite placement solution, which is often a frequently successful treatment for TMJ disorder.

Other Treatments for TMJ Disorder and Associated Headaches and Facial Pain

There are other techniques to help with TMJ disorder that are surgical and alternative in nature. A TMJ arthroscopy is a minimally invasive surgery that allows the surgeon to remove inflamed tissue and align the jaw correctly.

Another treatment that may also work is Transcutaneous Electrical Nerve Stimulation. This provides an electrical pulse that creates muscle contractions so that your jaw muscles will massage themselves. This helps relieve pain and stiffness, simultaneously improving your overall jaw mobility.

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.




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Last updated on October 1st, 2021 at 02:04 pm

ONE-SIDED HEADACHE WITH CONGESTED RUNNY NOSE, OR RED, TEARING AND SWOLLEN EYE. 5 REASONS WHY.

@Neuralgroover

BACKGROUND

Do you have a one-sided headache, left-sided headache, right-sided headache, or one-sided head pain with some variation of one-sided symptoms such as runny nose, nasal congestion or stuffiness, red eye, tearing eye, droopiness of the eyelid, puffiness or swelling around the eye, facial sweating or flushing, or clogged ear feeling? These symptoms are called autonomic symptoms, and they are a central part of several distinct headache syndromes. The headaches that occur with this combination of features are distinct types of headaches, all requiring different treatments. Therefore, it is important in differentiating them to ensure proper treatment and less misery!




TRIGEMINAL AUTONOMIC CEPHALALGIAS (TACs)

There is a class of headaches called the trigeminal autonomic cephalalgias (TACs), and all are terribly painful. There are 4 types of headaches within the TAC family, and include cluster headache, hemicrania continua, paroxysmal hemicrania, and SUNCT / SUNA (Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing / Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms). All of the TAC syndromes warrant preferably a brain MRI and MRA to exclude other causes such as pituitary lesions, aneurysms, or other abnormalities.

 

The TACs all share 2 common and core features. 1st, they are characterized by a severe headache that is strictly one-sided and focused around the eye, behind the eye, below the eye, in the temple or forehead areas. 2nd, they must include at least 1 autonomic symptom on the same side of the headache [lacrimation (runniness/tearing of the eye), conjunctival injection (redness of the eye), facial sweating or flushing (skin turning blushed), nasal congestion, rhinorrhea (runniness of nose), sense of ear fullness, eyelid edema (swelling), or partial Horner’s syndrome (miosis (pupil becomes small)) and/or ptosis (droopiness of the eye)].

 

So how do you differentiate these headache types when they all have similar features? Differentiation between them is based purely on their headache attack duration and pattern. So, it is actually quite easy to differentiate them as contrasted below.

 

CLUSTER HEADACHE

Cluster headache is the most common TAC syndrome and is discussed and detailed further here. It is characterized by attacks of severe unilateral (one-sided) orbital (around the eye), supraorbital (above the eye), and/or temporal pain lasting 15 to 180 minutes if untreated. There is either agitation/restlessness with the headache attack and/or at least 1 autonomic sign or symptom on the side of the headache as described above. Headache attacks typically occur from 1 every other day to 8 per day for more than half the time during a cluster cycle.  Chronic cluster headache is defined by attacks that occur for more than 1 year without remission, or with remission periods lasting less than 1 month.

 

Cluster headache attacks occur in “clusters”, or cycles, of frequent headache attacks. These cycles of cluster attacks may last for weeks or months before they go away completely. Within a cluster cycle, patients may get multiple attacks during the day or overnight. They often classically wake the patient up in the middle of sleep, usually around the same time every night or morning. The patient often gets up and paces around the house in agitated misery. They certainly can occur during the day as well. Remission periods can last months to years. Cluster cycles often occur at a predictable time of year, such as season changes (Fall and Spring are most common). Men tend to be affected 3 times more than women, but it is seen in both men and women. It is a severely painful headache, and has been termed “suicide headache” because of the pain severity.

 

Treatment of cluster headache is detailed further here.

 

HEMICRANIA CONTINUA

Hemicrania continua a continuous daily one-sided headache (side-locked, does not alternate sides) of at least 3 months duration with moderate to severe exacerbations. There should be either agitation or restlessness and/or at least 1 autonomic sign or symptom on the side of the headache as described above. Although not included in the criteria, sometimes patients describe a sensation such as something irritating in the eye on the side of the headache, such as sand, grit, or a hair, but nothing is found. Hemicrania continua is discussed and detailed further here.

 

To make the full diagnosis of hemicrania continua, the patient must respond completely to a therapeutic trial of indomethacin (a specific anti-inflammatory (NSAID) medication), used in a very specific way (“Indomethacin trial”). For this reason, this headache is 1 of 2 types of “Indomethacin-sensitive” headaches because Indomethacin is typically the only thing that works (paroxysmal hemicrania is the other Indomethacin-sensitive headache). The diagnosis of hemicrania continua is confirmed by the headache completely stopping after reaching a specific dose of Indomethacin.

 

Besides indomethacin, other treatments of hemicrania continua are detailed further here.

 

PAROXYSMAL HEMICRANIA

Paroxysmal hemicrania is characterized by attacks of severe unilateral (one-sided) orbital (around the eye), supraorbital (above the eye), and/or temporal pain lasting 2 to 30 minutes. There must be at least 1 autonomic sign or symptom on the side of the headache as described above. The attacks have a frequency of more than 5 per day for more than 50% of the time when the disorder is active.  Chronic paroxysmal hemicrania continua is defined by attacks occurring for more than 1 year without remission, or with remission periods lasting less than 1 month. Paroxysmal hemicrania is discussed and detailed further here.

 

To make the full diagnosis of paroxysmal hemicrania, the patient must respond completely to a therapeutic trial of indomethacin (a specific anti-inflammatory (NSAID) medication), used in a very specific way (“Indomethacin trial”). For this reason, this headache is 1 of 2 types of “Indomethacin-sensitive” headaches because Indomethacin is typically the only thing that works (hemicrania continua is the other “Indomethacin-sensitive” headache). The diagnosis of paroxysmal hemicrania is confirmed by the headache completely stopping after reaching a specific dose of Indomethacin.

 

Besides indomethacin, other treatments of paroxysmal hemicrania are detailed further here.

 

SUNCT / SUNA

SUNCT/SUNA are two variations of a rare type of headache called short-lasting unilateral neuralgiform headache attacks, and they are discussed and detailed further here. Short-lasting unilateral neuralgiform headache attacks (which include SUNCT and SUNA) are characterized by moderate to severe unilateral (one-sided) orbital (around the eye), supraorbital (above the eye), and/or temporal pain. The duration of the pain lasts for 1–600 seconds (1 second to 10 minutes, although most often about 5 seconds to 4 minutes), and may occur as single stabs, series of stabs, or in a sawtooth pattern. There must be at least 1 autonomic sign or symptom on the side of the headache as described above. Attacks must have a frequency of at least one per day for more than half of the time when the disorder is active. However, the attacks generally occur in a very high daily frequency when active, sometimes even up to 200 attacks per day or 5-6 attacks per hour.

 

SUNCT and SUNA both share the above criteria. The difference between the two is that SUNCT requires both conjunctival injection (redness of the eye) and lacrimation (runniness/tearing of the eye), whereas SUNA requires only 1 or neither of these 2 features.

 

Treatment of SUNCT / SUNA is detailed further here.




MIGRAINE

Migraine is not a TAC syndrome, but it can sometimes have overlapping characteristics with the TACs in terms of its one-sided nature and associated autonomic features in some patients. For this reason, I have included it in this discussion. Migraine is discussed and detailed further here. The autonomic symptoms seen in migraine are not required by criteria for diagnosis, in contrast to the TAC syndromes which do require these symptoms for diagnosis. In some patients with migraine, their headache attacks can have some of the autonomic features described above. For many patients, migraine also activates the sinus pathways, so sinus symptoms of sinus/facial pressure, congestion and drainage are common. This is often misdiagnosed as “sinus headache”. However, if there is any throbbiness, pulsating, or pounding, it is almost guaranteed to actually be of a migraine origin rather than of a sinus origin.

 

Migraine headache attacks last 4 to 72 hours if untreated or unsuccessfully treated. There must be 2 of the following 4 features present: a unilateral (one-sided) headache, pounding/throbbing/pulsating quality, moderate-to-severe pain intensity, and worsening by routine physical activity. There must also be 1 of the following 2 features present: nausea and/or vomiting, or both photophobia (sensitivity to light) and phonophobia (sensitivity to sound).

 

Treatment of migraine headache is detailed further here.

 

 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.




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Last updated on October 1st, 2021 at 01:12 pm

HEADACHE CHART AND HEADACHE LOCATION MEANING FOR DIFFERENT TYPES OF HEADACHES.

@Neuralgroover

 

I can picture it now. You’re sitting there late at night breaking out into a cold sweat, heart racing, convincing yourself a brain tumor is the cause of your headache as you are Googling a variety of terms for your headache location meaning such as…




…temple headache, headache behind eye, headache behind eyes, headache on top of head, headache in the temples, headache back of head, headache in front of head, headache on one side, front of head headache, headache on right side, headache on left side, headache in temple, headache forehead, pain behind eye, headache behind the eyes, headache and nausea, pain behind eyes, headache on left side of head, headache on right side of head, headache in back of head, front head headache, headache temple, headache at the front of head, stomach upset, left side headache, right side headache, headache behind right eye, temples headache, headache behind left eye, nausea and headache, pain in head, sharp pain in head, neck pain and headache, constant headache, head pressure, ice-pick headache, headache front, pressure headache, sex headache, exertion headache, cough headache, right temple headache, left temple headache, throbbing headache, headache meaning location, frontal headache, types of headaches diagram, headache types chart, pounding headache, headache locations chart, headaches in eyes, pain top of head, headache above left eye, headache map, headache above right eye, etc., etc., etc…

 

Ok, I think you get the point. Sound familiar? Now that you’ve earned your honorary Doctor Google degree, let me help provide some direction for you and your headache self-research quest to determine types of headaches and location, areas of headaches, and headache location meaning.

 

But let me tell you a BIG secret…

 

Headaches are not diagnosed based only on their location. They are diagnosed by the “company they keep”. In other words, the characteristics, patterns, and associated symptoms that go with the headache are the more important key pieces of information which narrow down the most likely headache types. Headache location by itself without any other information is actually quite useless. The International Classification of Headache Disorders (ICHD3) classifies every headache type according to the headache and all of the associated features. Each headache type must match a specific set of characteristics and associated symptoms set forth in the criteria, and headache location is only one of many features taken into account.

 

By combining the headache location with associated symptoms, patterns, and characteristics of the headache, it can then be more accurately narrowed down. This in turn makes choosing the correct treatment more accurate and effective. This is absolutely key. The end result is that you are on the more appropriate path to improvement rather than someone throwing “headache” pills randomly at a headache that they haven’t given a specific name to, and the treatment they are using may not be the treatment that your specific type of headache needs (and sometimes it can even make it worse). I see this scenario in my headache clinic every day given the shortage of headache specialists. This is why I created a FREE headache and facial pain symptom checker as discussed further down.

 

Let’s take migraine as just one example, which is discussed in much greater detail here. Migraine can vary widely in its location between patients and between attacks within the same patient. Any one of those Googled headache location terms listed at the top could potentially represent migraine. Those locations could also represent many other specific types of headaches as well, and they would require a much different type of treatment or evaluation than migraine would. The headache location doesn’t fully match with migraine until you combine it with the required criteria of associated symptoms that make the migraine diagnosis which may include a combination of symptoms such as nausea, sensitivity to light (photophobia), sensitivity to sound (phonophobia), throbbing or pounding pain, moderate to severe pain intensity, worsening with exercise, one sided predominance, and of course ruling out other more concerning “secondary” causes of the headaches. So clearly, Googling the headache location alone doesn’t help you figure out the cause or type of the headache at all, nor the most effective treatment. The bottom line is that location of pain alone doesn’t narrow down the type of headache or facial pain that you have. The associated symptoms and patterns that go with the headache are the keys to the possible headache types.

 

Thus, I created a FREE headache and facial pain symptom checker. The purpose is to help you with more personalized self-research with a list of possible headache types to discuss with your local doctor in hopes of helping you and your doctor have a better discussion of possible headache types, as well as better treatment considerations. Remember, any type of headache and facial pain requires an office visit and physical examination with your doctor. This symptom checker tool is purely educational to provoke thinking of a variety of headache possibilities. However, bad causes of headache can present as mild and simple headache disorders such as migraine. So, a visit to your doctor to evaluate your headache is a mandatory step that you must do.

 

When you are trying to narrow down the type of headache or facial pain you may have, these are the additional characteristics and symptoms that you need to take into consideration, and are the key questions a headache specialist will ask you in the office. Go through the following list of headache features, think about each one, and write down your responses. If you have different types of headaches, it is important to focus on and think about only one type at a time (even though they are typically different manifestations of the same underlying headache disorder).




1) Location of pain.

As mentioned above, pain location is only one of many important characteristics of a headache disorder, but without factoring in the associated symptoms, patterns, and characteristics, it is quite useless alone. I have broken down 8 general patterns of headache and facial pain locations to choose from. Go through the following headache location charts and pick the one that is most consistent with your headache or facial pain location. These are screenshots from the first step of the headache and facial pain symptom checker algorithm. There may be some variation to your attacks and the location may vary between different attacks, so pick the one which summarizes the areas involved overall for the particular type of headache you are analyzing.

Forehead, Cheek, Temporal (not variable)

  • The headache is 100% always on 1 side only.
  • It never alternates between 1 side and the other side.
  • It never involves both sides of the head at the same time.

Forehead, Cheek, Temporal (variable)

  • The headache is variable in location.
  • It may alternate between 1 side or the other side of the head at different times.
  • It may commonly occur more often on 1 side or the other, however, it is not 100% always on the same side.
  • It may sometimes involve both sides of the head at the same time as well.

Chin

  • Beneath the angle of the lower jaw, back of the throat or tonsils, back/base of the tongue, inside ear, or deep in the ear.

Parietal-Occipital (not variable)

  • The headache is 100% always on 1 side ONLY.
  • It NEVER alternates between 1 side and the other side.
  • It NEVER involves both sides of the head at the same time.

Parietal-Occipital (variable)

  • The headache is variable in location.
  • It may alternate between 1 side or the other side at different times.
  • It may commonly occur more often on 1 side or the other. However, it is not 100% always on the same side.
  • It may sometimes involve both sides of the head at the same time as well.

Whole Side of Head (not variable) (Forehead, Cheek, Temporo-Parietal-Occipital)

  • The headache is 100% always on 1 side only.
  • It never alternates between 1 side and the other side.
  • It never involves both sides of the head at the same time.

Whole Side of Head (variable) ((Forehead, Cheek, Temporo-Parietal-Occipital)

  • The headache is variable in location.
  • It may alternate between 1 side or the other side at different times.
  • It may commonly occur more often on 1 side or the other. However, it is not always on the same side. 
  • It may sometimes involve both sides of the head at the same time as well.

Whole Head (not variable) (Forehead, Cheek, Temporo-Parietal-Occipital On Both Sides At the Same Time) 

  • The headache is never on 1 side only. It always involves the whole head on both sides at the same time. 

2) Frequency of the headache or facial pain attacks.

How often do the attacks of headache of facial pain occur? Once per day and several days per month, 8 different attacks per day, etc.? Is there a pattern to the attacks, such as a seasonal occurrence?

 

3) Duration of the headache or facial pain attacks.

When you get an attack of headache or facial pain, how long does each individual attack last until it goes away completely if it is untreated or unsuccessfully treated? 30 minutes, greater than 4 hours, 15 minutes, several days, etc.?

 

4) Description and characterization of the headache or facial pain.

How would you describe the pain of the headache or facial pain if you had to put it into words? Throbbing, pounding, pulsating, achy, excruciating, pressure, electrical, shock, burning, sharp, stabbing, ice pick stabbing, etc.?

 

5) Associated neurological symptoms.

Is the headache associated with visual disturbances such as lost vision, flashing lights, shapes, zig-zags, colors, wavy lines, kaleidoscope, jagged edges, etc.? Is there numbness or tingling in an area of the body associated with a headache attack such as on one side of the face and body? Is there weakness on one side of the body with the headache? Are there problems speaking or getting words out with a headache attack?

 

6) Additional symptoms.

Is your stomach upset or do you feel nauseated or sick to your stomach with a headache attack? Do you vomit? Do you feel sensitive to bright light and/or loud sound when the headache is at its worst (where you would prefer to be in a dark quiet area if you had the chance)? Does an eye turn red or tear excessively during a headache attack? Does your nose run or get congested on one side during a headache attack? Does your eyelid droop on one side or does it get puffy around an eye on one side with a headache attack?

 

When you are done going through and thinking about all of these headache characteristics, patterns, and associated symptoms, take a run through this FREE headache and facial pain symptom checker algorithm questionnaire which I created to help you with more personalized self-research with a list of possible headache types and treatments to discuss with your local doctor. From there, you will be directed to the most common and effective treatments for you and your doctor to consider together, which vary widely depending on the specific type of headache. For example, for migraine there are a wide variety of effective treatments for aborting (taking something “as needed” to stop) a migraine attack including triptansgepants (Ubrelvy, Nurtec), ditans (Reyvow), and neuromodulatory devices, If the frequency of attacks is high, there are many effective  preventive migraine treatments consisting of medications, CGRP monoclonal antibody (mAb) treatments (Aimovig, Ajovy, Emgality, Vyepti), Botox, natural supplements, herbals and vitaminsneuromodulatory devices, yoga and meditation, acupuncture, acupressure and pressure points.

 

Good luck, and I hope this tool leads you in a better direction of more educational and useful discussions with your doctor regarding possible headache types and more effective treatment considerations!

 

Do me a HUGE favor and if you have found this headache symptom checker tool helpful and it led to a more successful outcome of narrowing down your headache types and treatments when you saw your local doctor, PLEASE let me know and drop me a message here or on Twitter!!




 

IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

FIRST, LET’S DECIDE WHERE TO START:

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR THE LATEST INFORMATION, HOT TOPICS, AND TREATMENT TIPS, VISIT OUR FREE BLOG OF HOT TOPICS AND HEADACHE TIPS HERE. THIS IS WHERE I WRITE AND CONDENSE A BROAD VARIETY OF COMMON AND COMPLEX  MIGRAINE AND HEADACHE RELATED TOPICS INTO THE IMPORTANT FACTS AND HIGHLIGHTS YOU NEED TO KNOW, ALONG WITH PROVIDING FIRST HAND CLINICAL EXPERIENCE FROM THE PERSPECTIVE OF A HEADACHE SPECIALIST.

 

IF YOU DON’T HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR POSSIBLE TYPES OF HEADACHES OR FACIAL PAINS BASED ON YOUR SYMPTOMS, USE THE FREE HEADACHE AND FACIAL PAIN SYMPTOM CHECKER TOOL DEVELOPED BY A HEADACHE SPECIALIST NEUROLOGIST HERE!

 

IF YOU HAVE AN EXISTING HEADACHE, MIGRAINE, OR FACIAL PAIN DIAGNOSIS AND ARE LOOKING FOR FURTHER EDUCATION AND SELF-RESEARCH ON YOUR DIAGNOSIS, VISIT OUR FREE EDUCATION CENTER HERE.

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Last updated on October 1st, 2021 at 01:26 pm

STOP LETTING YOUR CHRONIC MIGRAINE AND CHRONIC PAIN DEFINE YOU AND YOUR BRAIN PLASTICITY.

@Neuralgroover

Background

I see the worst of the worst headache, migraine, chronic migraine, facial pain, fibromyalgia, and chronic pain from many states and countries. I see patients who have been debilitated by pain, patients whose pain has destroyed their family, marriage, work life, social life, and the ability to function normally. They are void of hope and have lost all self-esteem and confidence, replaced by depression and seclusion. They hide in the shadows of life. They come into the office with dark sunglasses, hoods up, appear detached, soft-spoken with little to say, and have fully committed themselves to the mindset that they will never get better. And they won’t because they don’t allow their brain to develop the plasticity to escape out of that mindset and behavior. We’ll talk about this concept and brain plasticity more later. I have seen patients who slide into this mindset commit suicide because they see no way out. These patients are rampant and come from all walks of life; professionals such as attorneys to blue collar workers to the jobless. It is an equal opportunity nightmare of chronic pain syndromes. These patients evolve from a once normal life and function to one of minimal to no ability to function normally in life, career, or relationships. I have seen plenty of people pull out of this described rut of a chronic pain lifestyle. It’s possible, but it takes work. Most importantly, it takes the step of convincing yourself that it is possible and will be done, and then readjusting your behaviors, mindset, and thought process accordingly. Give yourself no other option than improvement and realize that there is always hope for improvement. The placebo response in clinical trials involving pain patients (and similar in other subgroups) averages around 30%! That means on average, 30% of pain patients will develop significant improvement despite taking a placebo (fake) treatment. This happens because they convince themselves that they are using the new treatment, and thus they convince their mind that they are improving, and they do! Your mind is the most powerful weapon in your battle against your chronic pain, so learn to use it to your advantage.




Let me be clear that chronic pain is real, it is valid, it can be debilitating, it shouldn’t be ignored or overlooked, it can validly negatively impact all aspects of life which can be out of the control of the patient. I profoundly empathize with these patients. However, there is a lot that is in control of the patient which they often do not realize, and that is my purpose for this blog article. Specifically, they do not realize that they are creating a self-fulfilling prophecy of never improving in pain or function, directly related to their behavior and mindset. No, this discussion doesn’t apply to everyone and all cases, but I would say it does apply to the majority of patients.

 

Many of these patients create websites, blogs, and social media accounts dedicated and centered around their chronic pain experiences. Their chronic pain becomes their persona, and who they are. It redefines them. This can certainly be helpful to others to learn about similar pain experiences and to feel that they are not alone, and I think it is fantastic that other patients can have these outlets and sources to share their experiences. However, it can also become a dominating way of life which dissolves away any thought, hope or attempt at improving their pain and overall function. These patients get to a point where living any other way besides centered around their chronic pain would seem abnormal to them. They focus their life, their daily activities, their restrictions, their abilities, and their relationships around their chronic pain. It defines them and dictates their life. They are chained and restrained from this focus. This behavior begins to feed into itself and they continue down a path where there becomes no chance at improvement because they don’t allow their mindset or focus to see that as a valid option, and thus do not initiate behavioral changes to try to influence positive changes.

 

This phenomenon is also reflected in patients who have chronic daily headache, chronic pain, chronic neck pain and whiplash syndrome related to a motor vehicle accident, work related injury, or some other event where they were injured. If there is litigation (lawsuit) involved, it is well known as a clinical predictor that they will rarely improve, because of potential secondary gain (financial, disability, etc.) from their pain, which their subconscious maintains focus on. There have been studies supporting this correlation as well. This phenomenon is not seen in other countries which are not as litigious and ready to sue over anything. We used to have a large unique chronic pain rehabilitation program which was very effective and helpful to many patients. A large focus of this program was on behavioral changes to influence improvements in overall pain and functional abilities. However, patients were excluded from entry if they were involved in any ongoing lawsuit related to their pain, because these patients invariably never got better until the lawsuit was settled and done, and it would be much more beneficial and cost effective to them after legal issues were resolved. We would then admit them following the conclusion of their legal battles if they continued to have chronic pain issues. I have seen many patients reverse their course from that dark reclusive patient scenario described above with the right mindset and approach.

 

How does pain behavior influence brain plasticity and your chances of improvement?

Anatomically and physiologically, this reclusive and socially isolated behavior and mindset of telling yourself that it is impossible for pain to improve or that one cannot function and live a normal life with chronic pain becomes a self-fulfilling prophecy. DON’T LET THAT HAPPEN!! This is solidly based in scientific and biological evidence. Behavior influences cellular, molecular, and physiological changes in the body and brain. Studies have shown that behavior (such as pain limiting behavior, social avoidance, etc.) causes structural and circuitry changes in the brain, which can be lifelong. Social behavior can also cause changes in the brain, although this can be more reversible. These structural changes in the brain and the circuitry of the brain, influenced by behavioral changes (behavioral neuroscience) and mindset, are called brain plasticity. Essentially, plasticity refers to the nervous system’s ability to constantly modify its organization, structure, function, and circuitry connections in response to experiences, behavior, and an endless list of other influencing factors such as pain, stress, diet, emotion, medications, and many other things. Brain circuits related to chronic pain overlap with circuits involving anxiety, depression and some mood disorders. Mood disorders such as depression can affect the plasticity of chronic pain, and likewise chronic pain can influence plasticity of depression and other mood disorder circuitry.




Treatment and conclusions of chronic pain

Treatment is difficult, requires patience, and involves treatment trial and errors (if one treatment doesn’t work, another is tried). The single most important treatment involves you, your behavior in how you respond to your pain, your mindset, and attitude which all in turn influence your brain plasticity positively, and chances of improvement. Do not let your pain define who you are and what you are able to do. Expectations are important in that you should realize that (typically) there is no quick fix or “cure” (but if you stumble across one, which can happen, great!). Learning to live, deal, and function with the chronic pain is vital. If you realize this and make it a primary goal, it can in turn lead to improvements over time by modulating your brain plasticity and electrical circuitry. Most preventive treatments can take 2-3 months to see effects, and there is no way to expedite that. Hang in there and be patient.

 

Chronic migraine, fibromyalgia, and some other chronic pain syndromes often cluster together. The way to look at these types of chronic pain syndromes is that the neurological system is “hyperactive”, “overactive” or “hypersensitive”. So, the goal is to try to “turn down the volume” of this “hypersensitive” neurological system with medications or other types of treatments.  Never conclude that there is no possibility of improving. Remain active physically, socially, emotionally, and maintain active relationships. Treating depression or mood disorders is very important, and a good psychiatrist can make a big difference with this. Chronic migraine and chronic daily headache should have appropriate treatments which may include preventive treatments, CGRP mAb once monthly treatments, supplements and natural therapies, neuromodulation devices, eliminating rebound (medication overuse headache), and using appropriate abortive (as needed) therapy such as triptans, gepants and ditans. Most importantly, remain hopeful. There is always hope and there are constantly new types of treatments becoming available. You can do this!!!




IF YOU HAVE HEADACHE, MIGRAINE, OR FACIAL PAIN AND ARE LOOKING FOR ANSWERS ON ANYTHING RELATED TO IT, A HEADACHE SPECIALIST IS HERE TO HELP, FOR FREE!

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