Facial Pain/TMJ

What Causes Facial Pain?

Facial pain can result from a range of conditions, some readily identifiable, and others originating from no apparent disorder or damage. Typically, facial pain presents after dental or sinus surgery, or as a result of trauma to the skull or face. Other common causes include, but are not limited to:

Also known as tic douloureux, this condition causes extreme and sporadic pain after the fashion of a series of electric shocks. The trigeminal nerve is one of twelve nerves at the base of the brain with three branches that can cause pain throughout the face and head. The sensations are so intense as to be physically debilitating.

This condition is a complication of shingles, which causes deep burning pain that can last from 1-6 months. The discomfort can be so severe as to disrupt sleep and even appetite. Although not characterized by the rash and blisters common in shingles, the postherpetic neuralgia is equally painful.

TMJ is a malfunction of the temporomandibular joint that controls the jaw. It causes pain and tenderness that grows worse when eating or speaking. The pain is described as dull or burning, and typically radiates toward the ear and the side of the head.

These headaches most often affect men in their twenties. They occur at night after 1 or 2 hours of sleep and are deep, and radiating with pain located in the forehead, temples, cheek, neck, or ear.

Migraines are the second most common form of headache after tension headaches and are characterized by a deep, pulsating pain and extreme sensitivity to light and sound.

The International Headache Society has also identified Persistent Idiopathic Facial Pain as a pain that presents daily and persists for hours. It normally flares in a limited area on one side of the face and may radiate outward. There is no associated sensory loss and, in fact, no physical evidence of the source of the pain and no abnormal lab tests.

Each of these conditions requires a different corrective or management approach, although all will likely include some use of pain medications.

At Neurological Associates, our Los Angeles neurologists specialize in the treatment and diagnosis of facial pain including trigeminal neuralgia,  postherpetic neuralgia, TMJ and migraine headachesDr. Chang and Dr. Jordan diagnose and treat patients with facial pain disorders. If you suffer from facial pain in Los Angeles and need a specialist, contact one of them to schedule an appointment at 310-829-5968.

What is Temporomandibular Joint Disorder (TMJ)?

Symptoms and issues with the muscles and joints that connect the lower jaw to the skull are called “temporomandibular” and are commonly referred to as TMJ. These disorders are associated with pain and difficulty chewing.

A temporomandibular joint sits on each side of the human skill just in front of the ear. Physical stress on the structures around this joint, including the cartilage, muscles, adjacent ligaments, blood vessels, nerves, and teeth can all play a role in or be affected by TMJ.

Often, the cause of these issues is unknown, but may be related to a poor bite, orthodontic braces, stress, tooth grinding, poor posture, poor diet, insomnia, arthritis, bone fractures, dislocation, and structural birth defects.

Symptoms of Temporomandibular Joint Disorder

TMJ symptoms may include, but are not limited to:
  • Discomfort or actual pain while chewing, biting, and even speaking
  • Clicking, popping, grating, and grinding sounds with jaw movement
  • An inability to completely open or close the mouth
  • Dull, aching pain across the face with specific pain and tenderness in the jaw
  • Earache and / or headache

Diagnosis and Treatment of Temporomandibular Joint Disorder in Los Angeles

Often TMJ sufferers visit more than one physician to get an accurate diagnosis of their condition. Certainly a full dental exam is indicated with X-rays and other tests primarily to rule out conditions like ear infections, nerve-related issues, sinus problems, migraine or other stress-headache issues, and neuralgia’s.

Because the results of these physical exams are often completely normal, TMJ diagnoses are based largely on patient-reported symptomology. The initial treatments are normally aimed at behavior modification and symptom management and will include a regimen of gentle stretches or massage motions to relax the jaw muscles. This may require the assistance of a physical therapist to learn the correct techniques.

Certain actions are to be avoided like singing, yawning, and gum chewing. Moist hot and cold packs often provide relief as do appliances such as bite guards to stop unconscious habits like tooth grinding while asleep.

In the short-term, over-the-counter pain medications are used and often anti-inflammatory drugs, muscle relaxants, and antidepressants are prescribed. In severe and difficult cases, Selective Nerve Root Injections, Platelet Rich Plasma (PRP) or Alpha-2-Macroglobulin (A2M) may be used. Rarely are surgical procedures warranted.

While a chronic and troublesome condition, most people with TMJ do find techniques that provide relief or that eliminate the problem completely.

If you would like to learn more from our facial pain specialists in Los Angeles, please contact us today.

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