16 Different Causes of Facial Pain and Treatment Strategies

Sinus headaches and chronic sinusitis are very common complaints of patients presenting to an ENT office. However, many patients with such complaints end up having a problem completely unrelated to the sinuses. Indeed, not all facial pain is a sinus issue.   Here are 16 different causes of facial pain from the common to the rare neurologic headaches along with the "typical" pain distributions and general treatment strategies for each. Keep in mind that the pain distributions are g…

3/25/2021 0

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Hot Pepper Nasal Spray Treatment for Migraines and Sinus Headaches

Image by  Tomascastelazo Capsaicin is the ingredient in hot chili peppers that gives it the heat and burn. It is also known to be effective for a variety of pain relief uses. The capsaicin nasal spray version (see below) available over-the-counter, is thought to work for sinus headaches, migraines , cluster headaches, and even severe nasal congestion by desensitizing the trigeminal nerve (which is accessible through the nose) and reduces CGRP (calcitonin gene-related peptide), thus reducin…

5/10/2018 0

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Migraines Pretending to be Sinusitis

It is shocking to me just how many people suffer from migraine headaches. Even more surprising is just how many people present to an ENT clinic with complaints of a persistent sinus infection when really the sinus pain is actually due to a migraine . In fact, there are some estimates that up to 80% of patients who present to an ENT clinic with primary complaint of sinus headaches or chronic sinusitis ultimately are proven to be suffering from migraines instead. See references below. Thi…

10/15/2017 0

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Can Headaches Trigger Nosebleeds?

Image courtesy of stockimages at  FreeDigitalPhotos.net Ignoring high blood pressure headaches which can potentially rupture blood vessels in the nose leading to a nosebleed, can headaches in and of itself trigger nosebleeds? I encounter a few patients a year who report that a particularly bad headache triggered their nosebleed, also known as epistaxis . But can this actually be true? After all, headaches are common and nosebleeds are common. As such, statistically, two common events …

3/16/2017 0

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Allergy Sufferers also Have More Severe Migraines

Many people suffer from migraines . Many people also suffer from allergies . What may have been suspected but is now clarified is that those individuals who suffer from BOTH allergies and migraines have much more frequent and severe headaches than those who do not have allergies. [ link ] Based on a survey response from 5,849 patients who suffer from migraines, over two-thirds also suffered from allergies. From this group, researchers found that the odds of experiencing more frequent headac…

11/27/2013 0

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Intra-Nasal Trigger Point Injections for Facial Headache

Do you suffer from a stabbing headache in the areas denoted in red? Do these headaches seemingly come out of nowhere one day? Perhaps started after a viral upper respiratory infection? You may be suffering from a condition known as  contact point headache  or a type of neuralgia involving one of the nerve plexuses found inside the nose: • Anterior ethmoid neuralgia (Sluder's neuralgia) • Sphenopalatine ganglion neuralgia (Pterygopalatine ganglion neuralgia) This type of headache …

8/14/2012 2

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Migraine Headaches Associated with Allergies & Response to Allergy Shots

A recent study published this month in the journal Headache reported an association of migraine headaches with allergy severity and response to allergy shots ... but only in those less than 45 years of age. The study suggested that lower "degrees of atopy" (or allergy) were associated with less frequent and disabling migraine headaches in younger subjects while higher degrees were associated with more frequent migraines. The administration of allergy shots was associated with a…

1/22/2011 0

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Botox Approved for Migraine Headaches in the United States

On October 15, 2010, the FDA approved botox for use in migraine headaches . It is hoped that eventually, this procedure will soon be covered by most health insurance companies rather than the few who do so now. Dr. Chang has been performing botox injections for migraine headaches since 2005 along with for wrinkles, spasmodic dysphonia , cervical dystonias, oral-mandibular dystonias, etc. Read the NYT article on the FDA approval here . Read the FDA announcement here .

10/16/2010 0

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Botox for "Sale" Due to Market Influences of Supply and Demand

The NYT wrote a somewhat humorous article on Oct 7, 2010 regarding botox injections for wrinkles from both a supply (physician) and demand (patient) viewpoint. In NYC, one can now find neon colored signs advertising botox specials! Read the NYT article here . Of note, our clinic performs botox injections not for just cosmetic reasons (wrinkles), but also medical reasons including migraine headaches , TMJ , spasmodic dysphonia , torticollis, etc.

10/07/2010 0

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UK First Place in the World to Approve Botox for Migraine Headaches

Wall Street Journal reported on July 9, 2010 that the United Kingdom has become the first country in the world to approve botox injections for migraine headaches . The U.K. approval could shortly precede a decision on migraine treatment from the U.S. Food and Drug Administration. Botox treatment for migraines can be obtained currently in the US, but is rarely covered by insurance. Dr. Chang has been performing botox injections for migraines since 2006. Read the WSJ article here .

8/03/2010 0

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FDA Potentially to Approve Botox for Migraines

As reported in MSNBC today, FDA regulators seem inclined to approve Allergan Inc's wrinkle drug Botox to prevent migraine headaches in millions of Americans, industry analysts said, based on information the drugmaker released on Monday. That would be great news for current patients of mine who receive botox for migraines. However, once FDA has approved botox for migraines, it may take awhile before it becomes an insurance "covered" procedure. Read the MSNBC article here .…

8/03/2010 0

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NYT: Can Foods Trigger Migraines (and Other Symptoms)?

The New York Times published a story on July 26, 2010 discussing how foods can indeed trigger migraines . The story quotes a study where patients were tested for IgG food allergies and their diet modified to either include or exclude the suspect foods. What they found is that diet restriction based on IgG antibodies is an effective strategy in reducing the frequency of migraine attacks. Patients should be aware that IgG food allergies are NOT the life-threatening allergies that may can ca…

7/28/2010 0

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Why Does Brain Freeze Occur With Eating Ice Cream and Other Cold Treats?

Believe it or not, this has been the topic of research in the past and even has a medical diagnosis called "sphenopalatine ganglioneuralgia". To sum it up, there are two theories behind this phenomenon: 1) Blood vessel phenomenon: Blood vessels constrict when any part of the body is exposed to cold temperature and dilates when it gets hot. This simple fact can be applied to the biological cause of brain freeze as well. Upon contact with ice, the blood vessels in the roof of the mo…

10/29/2009 0

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NYT: Plastic Surgery May Cure Migraine Headaches???

The New York Times on Sept 2, 2009 published a story " Plastic Surgery May Also Ease Migraine Headaches ," in which a modification of the facelift may improve and in some patients, even cure migraine headaches. The research abstract describing this surgical treatment for migraine headaches upon which the NYT story is based on can be read here . So far, the only patients who are candidates for this type of surgery are those who respond positively to Botox injections and where the t…

9/02/2009 3

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