Q: Good evening doctor. I’m having headache with pains on the side of my face, ears sometimes with my neck. I feel like heat on my face. Went to a doctor and ‘he’ said it’s allergy. He gave me antibiotic – at that I got relief but it started again. Please, I need your advice
A: Headaches with facial pain can be due to an infection of the neck, teeth or jaw coinciding with a headache or due to some chronic conditions or nerve disorders. Common causes include
Tension headaches: This is the more common type of headache seen as the everyday sort of headache. It affects both sides of the head as a constant ache and sometimes feels like pressure is being applied to the head or neck. Its causes are not very clear but they can be triggered by stress, hunger, dehydration, etc they can last a couple of minutes to several hours but are not severe enough to stop regular activities. Resting and sleeping well, eating properly and staying hydrated can help prevent this.
Migraines: These are felt as severe throbbing pain at the front or side of the head. Some people may experience other symptoms like nausea, vomiting and being sensitive to light. The pain lasts from a couple of hours or can stretch on for days. Thus, it is more severe than the tension headaches and can stop an individual from carrying out their daily tasks. Some find that they need strong medication prescribed by doctors to get relief but others are relieved by using over the counter medications.
Cluster headaches: These cause severe pain around one eye and are associated with red or watery eyes and a blocked nose or runny one. They tend to occur for one or two months at a time at about the same time of the year. Most times medications do not work for these headaches. Your doctor will prescribe specific treatment courses.
Neuralgia: Typically, the term neuralgia refers to peripheral neuralgia which is a painful condition due to damage of peripheral nerves by injury or disease. Symptoms of this condition include burning, prickling, or stabbing sensation felt anywhere in the body, and most commonly in the neck or the face.
Occipital and trigeminal neuralgia typically affect the head and face.
In occipital neuralgia, pain is felt on one or both sides of the head, the back of the head or at the base of the skull mimicking the symptoms of a migraine, complete with light sensitivity and pain with movement of the head. This happens when the occipital nerves, which run from the top of the spinal cord upward to the scalp, become injured or inflamed, resulting in a constant aching throb. Causes include injury, inflammation, or tight muscles that put pressure on the occipital nerves.
In trigeminal neuralgia, facial pain described as similar to an electric shock can be felt on any part of the face including the lips, jaw, eyelids, cheeks, nostrils, or forehead. It is caused by injury to the trigeminal nerves that control sensations in different parts of the face. The pain can be triggered by shaving, brushing the teeth, washing the face, or even applying makeup.
Problems of the temporomandibular joint (TMJ): The TMJ is found in front of the ears on both sides of the head, connecting the lower jaw to the skull. This joint enables eating and speaking by opening and closing the jaw. Disorders of this joint lead to stiffness and pain in the face, jaw, and neck, along with clicking and locking of the jaw. The latter symptom leads to difficulty with opening the mouth to eat or speak. Causes include teeth grinding, arthritis, congenital structural problems within the jaw.
Myofascial pain syndrome: This is associated with a dull ache radiating to the teeth, jaw, or ears, with difficulty in opening the mouth widely and chewing. Causes include jaw trauma, teeth grinding, infection, jaw clenching, stress and anxiety
I am a sucker for second opinions. Please seek a second opinion and make sure you are getting the help you need.
All the best!