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Can Migraines Cause Facial Pain

What Is An Aura

Relieving Headaches and Facial Pain Through TMD Treatment!

An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.

Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:

  • Seeing bright flashing dots, sparkles, or lights.
  • Blind spots in your vision.
  • Numb or tingling skin.

Trigeminohypothalamic Tract And The Parabrachial

Although a detailed description of these relay-functions lies outside the purpose of the present review , we will briefly discuss the trigeminohypothalamic tract and the parabrachial-limbic tract.

The trigeminohypothalamic tract originates from specific nociceptive, multimodal intensity-coding wide dynamic range and non-nociceptive neurons, albeit about the 80% of its fibres are axons from nociceptive neurons . The trigeminohypothalamic tract ascends contralaterally in the brainstem but about half of the fibres present a decussation in the lateral hypothalamus, reaching both lateral and medial structures of hypothalamus . While non-nociceptive information are transmitted only by direct pathway, nociception is carried both directly and indirectly to hypothalamus, suggesting a more resistant mechanism to pathological noxae for nociception . Receiver areas of the hypothalamus are those regulating homeostasis and integrating pain with visceral afferent input .

Treatment For Sinusitis And Sinus Headaches

Some aspects of the treatment for sinusitis and sinus headache are not all that different from migraine treatments. The treatment goals are:

  • To reduce inflammation
  • To facilitate drainage of the nasal passages
  • To identify any underlying causes and eliminate them
  • In the case of chronic sinusitis, reduce the number of attacks or flare-ups

These are very similar to migraine treatment goals: reduce the pain of the attack, facilitate the treatment of comorbidities or symptoms that compound the discomfort, identify any triggers and eliminate them, and in the case of chronic migraine, reduce the number of attacks.

Sinusitis treatments include a combination of symptom relief and addressing the cause. They may include:

  • Oral, nasal, or injected corticosteroids
  • Saline nasal irrigation
  • Acetaminophen or ibuprofen for fever and pain
  • Antihistamines
  • Antibiotics
  • Environmental changes such as a humidifier or dehumidifier in the home
  • Immunotherapy
  • Surgery

In cases where a sinus migraine or sinus headache is present, treating the symptoms and condition will usually relieve the headache.

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How Do I Get Head And Face Pain Relief

Head and face pain is best initially assessed by a general practitioner . They will make an assessment and make sure there are no warning signs for something serious.

If they suspect something more serious is causing the head and face pain, they may do some scans or blood tests and make a referral to the appropriate specialist to treat But if no serious cause is diagnosed, the referral may be to a pain specialist for an assessment and therapy with/without the use of advanced pain reduction techniques.

If the face and head pain is mild or improving, GPs may:

  • Reassure that there is no serious cause for concern and advise that the pain should improve with physical activity and simple pain medications.

If the face and head pain persists or returns GPs may:

Contact us to book an appointment with a pain specialist.

Allergy Sinusitis And Sinus Headache Resources

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There are a number of very good resources available for people suffering from allergies, sinusitis, and sinus headaches:

  • Al-Hashel, J. Y., Ahmed, S. F., Alroughani, R., & Goadsby, P. J. . Migraine misdiagnosis as a sinusitis, a delay that can last for many years. Retrieved from
  • Bono, F., Messina, D., Giliberto, C., Cristiano, D., Broussard, G., Fera, F., . . . Quattrone, A. . Bilateral transverse sinus stenosis predicts IIH without papilledema in patients with migraine. Retrieved from
  • Cady, R. K., & Schreiber, C. P. . Sinus headache or migraine? Retrieved from
  • Chronic sinusitis. . Retrieved from
  • C. . Sinus Headaches. Retrieved from
  • December 62:752-754, J. F., & Author: Christopher Boisselle, MD Richard Guthmann, MD, MPH Kathy Cable, MLS. . What clinical clues differentiate migraine from sinus headaches? Retrieved from
  • ENT Health. . Sinus Headaches.
  • Migraine Symptoms. . Retrieved from
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    A Note From Cleveland Clinic

    The good news for headache sufferers is that you can choose from many kinds of treatment. If your first treatment plan doesnt work, dont give up. Your healthcare provider can recommend other treatments or strategies to find the right fix for you.

    Last reviewed by a Cleveland Clinic medical professional on 06/03/2020.

    References

    Talking To Your Doctor About Your Headaches

    Your search for a migraine diagnosis and relief from your headaches usually begins with your primary care provider. He or she may send you to several specialists before you get answers, or you may go directly to a headache specialist or neurologist. In other words, you may find that you are repeating yourself to each new doctor. Dont let this discourage you. Sometimes it takes a little digging and searching to get answers, but it is worth it. Create your own headache file with notes and documentation from doctors visits and tests as well as your migraine diary.

    Dr. Ailani has this advice: Keep track of your headaches, write down when they happen, how long they last, and what symptoms come with the headache.

    She also recommends noting specific characteristics of your headache or migraine by considering these questions:

    • Do you prefer to be in the dark, or in a quiet area with a headache?
    • Do you find your stomach gets upset and smells bother you?
    • Would you prefer to sleep if you could?
    • Do your headaches last several hours or several days?
    • Have your parents, siblings, aunts/uncles, grandparents, and cousins ever had headaches? Migraines tend to run in families, but most families dont discuss this.
    • What have you tried for your headaches? What works or does not work?
    • How have your headaches changed over time?

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    What Is The Prognosis For People With Migraines

    Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.

    What Headache Symptoms Require Immediate Medical Care

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    If you or your child has any of these headache symptoms, get medical care right away:

    • A sudden, new, severe headache
    • A headache that is associated with neurological symptoms such as:
    • Weakness
    • Vision changes
  • Headache with a fever, shortness of breath, stiff neck, or rash
  • Headache pain that awakens you up at night
  • Headaches with severe nausea and vomiting
  • Headaches that occur after a head injury or accident
  • Getting a new type of headache after age 55
  • Symptoms requiring an appointment with your health care provider or a headache specialist

    Contact your health care provider if you or your child has any of the following symptoms:

    • Three or more headaches per week.
    • Headaches that keep getting worse and won’t go away.
    • Need to take a pain reliever every day or almost every day for your headaches.
    • Need more than 2 to 3 doses of over-the-counter medications per week to relieve headache symptoms.
    • Headaches that are triggered by exertion, coughing, bending, or strenuous activity.
    • A history of headaches, but have noticed a recent change in your headache symptoms.

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    Specialized Treatment Options For Headache Migraine And Facial Pain

    Our team cares for many patients each year which empowers countless people to achieve substantial improvement. Some of our specialized treatments offered include peripheral nerve injections, which numb the nerves of the scalp to shut off chronic migraine. On average, the injections can give patients weeks to months of benefit. In rare cases, our team provides occipital nerve stimulation by a surgically implanted device that delivers an electric charge to nerves in the back of the scalp to treat migraine, cluster headache, and other types of facial pain that doesnt respond well to other treatments. This is a treatment few other centers offer.

    We also offer a number of alternative therapies with special focus on nutraceuticals nutritional supplements and vitamin therapies that have anti-pain or anti-migraine suppressing properties. Also available is pain psychology which uses relaxation strategies and biofeedback to reduce migraine. Our clinic embraces a specialized hormone therapy, called bioidentical hormone replacement therapy. This is where a patients hormonal status is monitored and individualized hormonal therapy is provided to normalize the bodys natural cycle and reduce migraine or head pain associated with hormonal dysfunction. We also offer acupuncture.

    Infection Of The Salivary Duct

    The ducts that create saliva can be infected by bacteria and is typically found after surgery in the mouth and in the elderly that take medications that slow saliva production.

    Rarity: Rare

    Top Symptoms: fever, chills, swelling on one side of the face, pain on one side of the face, swollen jaw

    Urgency: Hospital emergency room

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    What Is Trigeminal Neuralgia

    Trigeminal neuralgia , also called tic douloureux, is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain The typical or “classic” form of the disorder causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, in volleys lasting as long as two hours. The atypical form of the disorder , is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

    What Are The Types Of Face Pain

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    The exact type of pain you feel will depend on the cause. A dull, throbbing pain on one side of your face or around your mouth is generally due to problems within the mouth, such as a toothache, cavity, or abscess. If you experience this type of pain, contact your dentist.

    The pain associated with sinusitis feels like pressure or an aching pain across the front of the cheekbones and underneath the eyes. Abscesses and ulcers will often throb at the site of the sore. Headaches and injuries can feel like a stabbing sensation or can throb and ache.

    Because there are many causes of facial pain, talk to your doctor if you experience pain thats unexplainable or unbearable.

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    How Are Migraines Treated

    Migraines that are severe, frequent or accompanied by neurological symptoms are best treated preventively, usually with a combination of dietary modification, lifestyle changes, vitamins and daily prescription medications. Most of our best preventive medications are often used for other medical purposes as well the majority are blood pressure drugs, antidepressants or epilepsy medications. Individual headache attacks are best treated early, often with one or more of the following types of medications: triptans, nonsteroidal anti-inflammatory drugs , anti-emetics , and sometimes narcotics or steroids.

    Migraines typically last a few hours to a couple of days and respond well to specific treatments. However, in some patients, the migraine is particularly severe and long-lasting and may even become chronic, occurring continuously for weeks, months or even years. If improperly managed or left untreated, intermittent migraines may essentially transform into a chronic daily headache, with continuous and smoldering symptoms that periodically erupt into a “full-blown” migraine. This condition is extremely difficult to treat.

    At the Johns Hopkins Headache Center, located at the Johns Hopkins Bayview Medical center, we have expert physical therapists, nutritionists and psychologists who work closely with our neurologists to help manage patients with frequent migraines. Biofeedback and relaxation techniques are available to complement our standard medical treatments.

    Whats A Migraine What Does A Migraine Feel Like

    A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.

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    Persistent Idiopathic Facial Pain

    Persistent idiopathic facial pain, formerly known as atypical facial pain, is a persistent pain that does not have the characteristics of the cranial neuralgias, and is not attributed to another disorder. The incidence is 1/100 000 both sexes are affected equally, but more women than men seek medical care. There is a strong association with functional disorders such as irritable bowel syndrome and psychological distress.

    Pain may be initiated by surgery or trauma to the face, teeth, or gums. It is present daily for all or most of the day, without any identifiable local cause. The pain is often described as a continuous dull ache with intermittent severe episodes, affecting any area of the face, but sparing the joints and muscles of mastication. It is typically deep and poorly localized, and will often have been present for several years. There is no associated sensory loss or other physical signs. Investigations including facial and jaw X-ray do not demonstrate any relevant abnormality. Primary analgesics are ineffective, and lack of response to diagnostic nerve block is a common feature. The analgesic response sometimes observed with tricyclic agents appears to be independent of their antidepressant effect. Long-term support is often necessary.

    Who Gets Face And Head Pain

    Cause For Facial Pain And Headache | Facial Pain Causes | Headache Reasons

    Anyone can get face and head pain, and it can occur at any age, with the majority of first incidents taking place between 20-40 years of age.

    Some people are more likely to develop face and head pain. Here are a few risk factors that might make the development of face and head pain more likely:

    • Older age

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    Getting The Right Diagnosis

    Treating migraines correctly is critically dependent on getting the right diagnosis. Medical practitioners rely heavily on the patients medical history and personal accounts, so its important to note whether family members have a record of migraines. Keeping a pain diary is extremely helpful in identifying patterns such as the connection between migraines and tooth pain. A patient with no history of migraine and sudden orofacial pain could simply have a dental problem, while a patient who experiences new pain that seems related to dental issues could have a long history of mild, as-yet-undiagnosed migraines. As in the case of the patient with atypical migraine, getting effective treatment depends on reaching the right diagnosis, or the pain is likely to persist for years.

    Types Of Headaches And Facial Pain

    There are many different kinds ofheadaches and causes of facial pain, all of which come with a wide range of symptoms.

    There are two types of headaches, primary and secondary. Primary headaches are conditions that exist on their own, unrelated to other illnesses. Secondary headaches are caused by another health condition, such as trauma or disease.

    Types of headaches include:

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    Temporomandibular Joint Dysfunction Disorder

    Temporomandibular Joint Dysfunction is often caused by a variety of factors, including daily habits, your teeth alignment, and even stress. It usually affects one side of the jaw, but in some people it can affect both sides. People with TMJ dysfunction will typically experience pain on one side of the face that is worse with chewing, yawning, or other movements of the jaw. With some simple changes in your daily habits and other at-home treatments, most people with TMJ dysfunction will experience relief of their symptoms within weeks.

    Treatment for temporomandibular joint dysfunction usually includes avoiding eating hard foods or foods that require a lot of chewing. Good posture and relaxation techniques may help relieve tension in the muscles that connect to your temporomandibular joint. In people who clench or grind their teeth, a mouth guard worn at night may also help relieve your symptoms. Pain relievers, like ibuprofen , can also help.

    Rarity: Common

    Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck

    Symptoms that always occur with temporomandibular joint dysfunction disorder: pain, restricted movement, and clicking sounds from jaw

    Urgency: Primary care doctor

    How Are Headaches And Facial Pain Diagnosed

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    Any headache or facial pain that is severe, or interferes with daily life requires a medical assessment by a doctor. Headaches that cause waking from sleep, problems with speech or other functions, or that are worse with coughing or sneezing need an urgent review.

    The doctor will ask questions about the symptoms, how they started, and if there is anything that seems to make the pain better or worse. They may also need to ask more general questions about occupation, overall health and both medical and family history.

    Keeping a detailed diary of the symptoms over a period of time can be very helpful in making a diagnosis. Many causes of headache and facial pain can be diagnosed from these questions and the symptom diary alone.

    In some cases, further investigations may be needed. These may include blood tests, neurological tests or imaging such as an MRI or a CT scan.

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