At one time or another, most people have experienced pain in their face, jaw or head — a sort of dull ache that's often associated with grinding teeth, clenching the jaw or even debilitating head pain. Called "craniofacial pain," tenderness and discomfort in these areas are remarkably common.
"Unfortunately, craniofacial pain is often underrecognized and undertreated," explains Andrea Sherman, a physical therapist at Henry Ford Health.
Craniofacial Pain Explained
It's not unusual to experience occasional discomfort in the jaw, head and face, particularly when it's associated with sinus issues or minor injuries. According to the National Institutes of Health, this type of pain is the second most common musculoskeletal problem after low back pain. But ongoing or severe pain in the face isn't normal.
Craniofacial pain ranges from mild to severe headaches, earaches, facial pain and stiffness, neck and upper back tension, dizziness, even ringing in the ears, also called tinnitus. Each of these symptoms can interfere with daily living.
Among the most common culprits:
- Facial neuralgias: This family of facial nerve disorders affects the nerves of the face, causing pain across the entire face. For example, the trigeminal nerves control feeling in areas such as the eyes, forehead, cheeks and gums.
- Headaches: Headaches caused by craniofacial issues are not run-of-the-mill head pain. Instead, it ranges from headaches to ongoing pressure and pain across the head and face. What's more, these headaches tend to come with other uncomfortable symptoms, such as pain at the temples and around the ears and eyes.
- Temporomandibular joint (TMJ) disorder (TMJD): TMJD affects the hinge of the jawbone, known as the temporomandibular joint. When TMJD is severe it can lead to problems with the actual joint, making it difficult to smile, speak and even eat normally.
What Causes Craniofacial Pain?
While there's a genetic component to craniofacial pain, lifestyle factors often play the largest role. "People are clenching their jaws and grinding their teeth, even while they're sleeping. In many cases, they have no idea they're doing it," Sherman says. "If you're waking up with headache symptoms, jaw stiffness or facial pain, the question becomes, ‘What are you doing at night?’"
Another key cause: Poor posture. The way your jaw sits rests largely on the position of your neck. For example, if you tip your head back and you touch your teeth together, the contact point is different than if you lower your head all the way to your neck and do the same thing.
"If you spend most of your time with your head in the forward position, you're probably putting excess pressure on your molars if your teeth are in contact," Sherman says. Over time, that can lead to craniofacial pain that requires intervention and treatment."
Treating Craniofacial Pain
Treatments for craniofacial pain and pressure depend on the cause of the pain. For example, if you’re grinding your teeth at night, you might need a dental device that blocks the action. If you're stressed and suffering from tension headaches, cognitive behavioral therapies and mindfulness strategies may help. And if you have headaches originating from poor posture in the neck, physical therapy may be your best bet.
In every case, working with a professional is key. Dentists can create a custom appliance or night guard to limit the effects of clenching. Psychologists and mindfulness therapies can help ease stress-related facial pain. And physical therapists can design a program to help you overcome a functional deficit, such as a postural concern. A physical therapist may be able to help if you can't eat, talk or if you have headaches at the end of the day.
"Trying to figure out what's contributing to the pain can be a big knot to untie," Sherman says. "That's why education and awareness about treatments are the most important things to relay to patients."
Getting Help For Craniofacial Pain
Since figuring out the source of craniofacial pain can be a challenge, it's a good idea to start with your primary care provider. Your pain could be an isolated TMJ issue, or it could be driven by neck dysfunction.
"If there's neck dysfunction, you can't make it go away by going to physical therapy once or twice a week," Sherman says. "You have to start with the foundation; what’s causing the problem?" In fact, Sherman focuses on helping people understand what's going on mechanically so they can figure out how to create an environment of healing for themselves.
Left untreated, craniofacial pain can affect every aspect of your life. But when it's addressed, discovered and removed, your quality of life will dramatically improve. "This is an addressable condition and it's common," Sherman says. "If you're having recurrent headaches, jaw pain, pain in the ears or at the base of the skull, it's important to get checked out by a healthcare professional."
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To find a doctor or physical therapist at Henry Ford, visit henryford.com or call 1-800-436-7936.
Andrea Sherman, is a craniofacial certified physical therapist who sees patients at Henry Ford Medical Centers - Ford Road and Farmington Road.
