Facial Pain and TMJ Disorders

Facial pain includes treatment for primary headaches such as migraines, tension-type, and cluster headaches. It also includes treatment for various pains in the head and neck caused by nerves such as trigeminal neuralgia, and other neuropathies.

TMJ, which stands for temporomandibular joint, is the joint that connects your jaw to your skull. Any pain, or limitation of opening, can be caused either by the joint, or, more commonly, by the muscles that are responsible for closing your jaw.

A broad outline of the Facial Pain conditions that Dr. O’Beirne diagnoses and treats include:

1. Idiopathic Pain – of unknown cause

  • Neuropathic facial pain disorder
  • Atypical odontalgia and phantom tooth pain
  • Atypical facial pain
  • Burning mouth syndrome
Woman getting massage pain relief on face
TMD Signs & Symptoms

2. Musculoskeletal – arising from dysfunction of the muscles and / or bones and joints

  • Masticatory muscle disorders
  • Myofascial pain
  • Myositis
  • Myospasm
  • Local myalgia
  • Temporomandibular joint disorders
  • Synovitis / capsulitis
  • Osteoarthritis / Rheumatoid arthritis
  • Disc displacement with reduction
  • Disc displacement without reduction
  • Tension-type and Cervicogenic (neck origin) headaches

3. Neuroalgic – functional change in the peripheral or central nervous system or nerve fibres

Episodic (occurs with periods of remission)

  • Trigeminal neuralgia
  • Glossopharyngeal neuralgia
  • Herpetic neuralgia
  • Postherpetic neuralgia
  • Traumatic neuralgia
  • Eagle’s syndrome
Woman with jaw pain
Woman with migraine pain

4. Vascular

  • Giant cell (Temporal) arteritis
  • Carotid artery dissection

5. Neurovascular – arising from nerves and the blood vessels they supply

  • Migraine
  • “Sinus Pain”
  • Cluster headache
  • Chronic paroxysmal hemicrania
  • SUNCT headaches

6. Psychogenic – containing an emotional or psychological component

  • Somatoform disorders
  • Factitious disorders
  • Malingering

7. Other diseases that can cause facial pain

  • Distant pathology (referred pain)
  • Xerostomia (dry mouth syndrome)
  • Trauma and / or surgery to the face
  • Local pathology – Dental decay and abscess, periodontal disease, tumours, and ulcers in the mouth
  • Systemic diseases
Woman holding face in pain
Woman holding head in pain

Do I have Sinus Pain or is it actually a Migraine?

According to research, many people who have pain in the sinus region are actually experiencing migraine or another type of headache. Sinus headache is the most common incorrect diagnosis given to someone who really has migraine.

A study from 2004 found that 88 percent of participants with a history of sinus headache actually met the clinical criteria for migraine.

Sinus headaches are actually rather rare. They typically occur due to sinusitis, which is an inflammation of your sinuses. Is your sinus pain actually an undiagnosed migraine?

Touching my face, or simply the breeze on my face causes severe pain. What’s wrong with me!?

This symptom is caused Allodynia. See below.

What’s Neuropathic Pain?

Neuropathic Pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves become “painful” and may be damaged, dysfunctional, or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and in areas around the injury.

What is Allodynia?

Allodynia is a condition in which pain is caused by a stimulus that does not normally cause pain.

  • pain in response when touched, wind on your face, clothes or sheets touching skin
  • pain in response to stroking lightly
  • pain from normally mild skin temperatures in the affected area
  • pain triggered by normal movement of joints or muscles

“Pain is inevitable, suffering is optional.”

Buddhist Proverb