Facial Pain

Head and neck pain may be caused by a number of factors, including poor posture, trauma, nerve disorder, or any combination thereof. In most cases, the pain may be temporary and relieved quickly by over-the-counter medications without any further treatment. When the pain persists for weeks or months without substantial relief from medication, it has evolved into a chronic pain state which requires intervention by a trained professional.

Dr. Besharati is trained to evaluate the source and cause of your pain so that it is managed effectively. Often, the pain is muscular in origin and can be managed with a combination of medications, physical therapy, and behavioral management. Musculoskeletal pain in the neck is a very common trigger for a migraine headache, and proper management often decreases the frequency and intensity of migraines along with the amount of medication necessary to manage migraines.

Chronic pain arises due to complex changes in the way the nervous system detects, transmits, and interprets pain. When a more complex nerve involvement exists, a biopsychosocial or interventional approach will be necessary for pain management. In most cases, a combination of non-opioid medications and cognitive behavioral therapy will effectively manage a nervous system disorder. If a procedure such as nerve decompression or a complex nerve block is required, a referral to an interventional pain management specialist will be provided for you

Neuralgia is a type of neuropathic (nerve illness) pain that is paroxysmal, or episodic. Trigeminal neuralgia is the most common of the neuralgias, which all have the same characteristics but occur in different locations. Glossopharyngeal, geniculate, superior laryngeal and occipital neuralgia are other neuralgias that occur in the head and neck region.

Because neuralgia is triggered by the stimulation of peripheral nerves, topical and local anesthetic will temporarily block the pain. During an attack, anesthetics can be used to provide rapid relief and assist in making a proper diagnosis. Longer pain relief can be achieved with oral medications in combination with cognitive-behavioral therapy. In some instances, surgical care may be indicated.

An MRI of the brain is required whenever neuralgia is present to identify potential causes of the symptoms.

Trigeminal neuralgia is characterized by severe, intense, sharp stabbing or electrical pain affecting the trigeminal nerve. The attacks of pain usually occur on one side of the face, last only seconds, and most commonly affect the area around the upper and/or lower jaw. The pain is usually triggered by movement, contact, or thermal changes, making normal daily activities such as talking, shaving, or applying cosmetics an extremely painful experience.

Glossopharyngeal neuralgia affects the throat, ear, tongue, and teeth on one side and is triggered by normal activities such as coughing or swallowing.

Geniculate or Nervus Intermedius neuralgia affects the sensory portion of the facial nerve with trigger points in and around the ear. Once triggered, the pain is felt in the eardrum, the ear canal and the outer portion of the ear.

Superior Laryngeal neuralgia involves a branch of the vagus nerve and can be difficult to distinguish from glossopharyngeal neuralgia because it is also triggered by coughing and swallowing in addition to sneezing, yawning, or vocal training. Pain is felt in the submandibular area and may radiate to the ear, eye, or shoulder.

Occipital neuralgia is not true cranial neuralgia because it involves the greater and lesser occipital nerves that are branches of cervical spinal nerves C2 and C3. The attacks of pain are triggered from the back of the head and radiate upward over the top of the skull.

Neuropathic pain can range in intensity and intrusiveness, but the symptoms of neuralgia are severe enough to require treatment. As an Orofacial Pain Dentist, Dr. Besharati has training and experience in the assessment, diagnosis, and treatment of all types of neuropathic pain involving the head and neck region, including neuralgia.