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Identifying the Cause of Chronic Headache Pain

headacheIn my 39 + years of practice, I have worked with hundreds of patients who have suffered from chronic headaches and migraines. Their common solution is to relieve symptoms with pain medication that “makes their headache go away.” But it does not solve the cause of their condition and soon their pain returns.

Often it appears that their repetitive actions are driven by misconceptions about the effectiveness and safety of pain medications. As stated by the FDA, “pain medications are safe and effective when used as directed. However, misuse of these products can be extremely harmful and even deadly.” And most pain medication labels indicate that long term use is not recommended.

Following are a few misconceptions that I commonly address with patients:

Over-the-counter medications treat the cause of headaches.
Headache pills mask pain by telling your brain that the headache isn’t there. They convince the brain that the pain is gone for a period of time. This is the reason that — after the medication wears off– your headache comes right back. The real cause of your headaches remains untreated and you continue to suffer.

Headache medication isn’t harmful.
Many headache sufferers don’t know that the medication they take is not completely safe. In fact, some side effects can be worse than the headaches. The pills that disable your ability to feel headaches are also disabling a little hormone in your body that’s a messenger to your brain. If you disable the hormone from doing that one job, it will also be disabled from other jobs. Pain medication is also very hard on your liver and kidneys, and as previously stated, excessive use can be extremely harmful and even deadly.

Anxiety, stress and emotions cause headaches.
You may think that your natural level of stress is causing your headaches. Being stressed and living with these emotions is part of life. However, it is not the cause of migraines, facial pain and/or headaches. In fact, some of the associated body pain is probably causing (and/or enhancing) your stress and making it worse. Medication seldom increases the body’s ability to respond to stress appropriately, and often decreases your body’s natural ability to fight disease.

Your problem is where your pain is.
There are a large number of factors that can lead to headaches and they don’t always start in the brain where you feel the pain. A proper diagnosis of the cause is of utmost importance for treatment and resolution. Specialists who standardly diagnose the cause of headaches and migraines include neurologists, pain management specialists, and as one of the most common causes of headaches is the temporomandibular joint (or TMJ), dentists with advance training in TMJ disorders.

Headaches that originate and/or are felt in the muscles of the face, forehead, back of the head or eyes, are vascular in nature. Many medical professionals blame vascular headaches on the trigeminal nerve which runs through the temporomandibular joint. Jaw misalignment or joint dysfunction can infringe on the nerve and cause headache pain.

For decades, medicine and dentistry have overlooked the TMJ as a potential source of problems. With today’s new technologies and increased understanding, dentists with specific, advanced training in TMJ disorders can diagnose through targeted CT scans and MRIs, and can successfully treat the majority of these cases. In fact, if a TMJ disorder is determined, long-term relief is achievable 95% of the time.

You may have TMJ dysfunction migraines and headaches if you answer “yes” to any one of these questions:

1. Do you ever have headaches and/or migraines?
Possible cause: Pressure of the ball (condyle) of the jaw joint pushing on weak bone structure at the rear of your jaw.

2. Do you ever experience dizziness?
Possible cause: Lack of blood flow to the brain when blood vessels are obstructed by the misalignment of the jaw.

3. Do you ever have ringing in the ears and/or ear aches?
Possible cause: Pressure on the ear canal from the jaw.

4. Do you ever feel severe pain all over your head, or severe jaw and/or facial pain?
Possible cause: Pinching of the nerves that hinge at the rear of the jaw.

5. Do you ever have pain in your neck and/or shoulders?
Possible cause: Adaptation or compensating to relieve other pain; most TMJ sufferers experience neck and/or shoulder pain.

6. Do you ever have clicking or popping of your jaw joint (TMJ)?
Possible cause: Lack of cartilage at the rear of your jaw.

7. Do you ever hear grinding sounds?
Possible cause: Irregular bone surface at the rear of your jaw.

As Albert Einstein stated, insanity is doing the same thing over and over again and expecting different results. If you want to rid yourself of chronic headache pain, I recommend looking for solutions which will treat the cause, not the symptoms. A proper diagnosis by a medical doctor or dentist trained in pain management is the first step in treating the cause – not just the symptoms – of your headaches or migraines.

Dr. Leonard Feld is a TMJD specialist with offices in Los Angeles, San Jose, Phoenix and Indian Wells. He is the co-founder of the TMJ & Sleep Medicine Network (www.itsmn.com) and can be found at Indian Wells Smile Center. Call 760-341-2873 or you can visit www.DocFeld.com for more articles and information. Dr. Feld’s philosophy is always a conservative, non-invasive, non-surgical treatment. 

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