Craniofacial Pain

Craniofacial pain is the umbrella term for persistent pain in the head, face, jaw, and neck. It is one of the most commonly misdiagnosed complaints in medicine, because the same pain can come from the jaw joint, the muscles, the teeth, the sinuses, or the nerves, and the location where you feel it is often not where it starts. Dr. Herber completed a mini-residency at the Las Vegas Institute in TMJ disorders, sleep disorders, and craniofacial pain.

What counts as craniofacial pain?

Craniofacial pain covers pain anywhere in the head and face that persists rather than passing. That includes jaw pain, temple and forehead headaches, pain in front of or inside the ear, cheek and sinus-area pain, pain behind the eyes, and pain running down the neck and into the shoulders. Tooth pain with no dental cause belongs on the list too.

Why is craniofacial pain so often misdiagnosed?

Because pain refers. The muscles and nerves of the head and neck share pathways, so a problem in the jaw joint can be felt in the ear, the temple, or a tooth. Patients are commonly treated for migraines, sinus infections, or ear infections for years before anyone examines the jaw. The tests come back normal because the tests are looking in the wrong place.

What are the most common causes of craniofacial pain?

The most common causes seen in a dental setting are temporomandibular joint disorders, myofascial pain in the chewing and neck muscles, and clenching or grinding that overloads both. Bite instability and airway-related jaw posture contribute in many patients. Some craniofacial pain is neurological or vascular in origin, which is outside dental scope and needs a physician.

Is my headache a migraine or is it my jaw?

They can look very similar, and they can coexist. A few patterns point toward the jaw: headaches that are worst on waking, headaches that come with jaw soreness or clicking, pain that worsens through a meal or after a long day of talking, and tenderness when you press the muscles at the temples or in front of the ears. A TMJ evaluation is a straightforward way to rule the joint in or out.

Why does my ear hurt when nothing is wrong with my ear?

The jaw joint sits directly in front of the ear canal, so joint inflammation is frequently felt as ear pain, fullness, or ringing. Patients often see a physician first, get told the ear is clear, and leave without an answer. Repeated ear pain with no infection is one of the clearest signs that the joint deserves a look.

Can craniofacial pain cause neck and shoulder pain?

Yes. The muscles that position the jaw connect into the neck and upper back, and they work as a system. Chronic clenching keeps that whole chain contracted, which is why many TMJ patients also carry constant neck tightness and shoulder pain. Treating the jaw often eases the neck as well.

How is craniofacial pain evaluated here?

Dr. Herber examines the jaw joints, bite alignment, and the muscles of the head and neck together, and takes a full symptom history including what has already been ruled out. The goal of the first visit is to determine whether the joint and muscles are driving your pain. If they are not, he tells you that and points you toward the right specialist.

How is craniofacial pain treated?

When the jaw and muscles are the source, treatment focuses on unloading the joint and calming the muscles rather than on pain medication. That typically means a custom orthotic, targeted exercises, physical therapy techniques, and changes to the habits keeping the muscles contracted. Dr. Herber takes a medication-free, surgery-free approach.

When should I see a physician instead?

Sudden severe headache unlike any you have had, headache with fever, neurological changes, vision loss, or facial weakness need urgent medical attention, not a dental appointment. Dr. Herber will also refer you to a physician or neurologist when the exam points away from the jaw.

Living with facial pain or headaches no one has explained? Call 951-795-4833 to schedule a personalized TMJ evaluation.

This page is general information, not medical advice.