Complex Head and Neck Pain: Possible Causes and Solutions - Neurology

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Pain in the neck, occipital region, temples, eyebrows, and cheekbones?


Hello doctor, last Wednesday I carried two bottles of formula, each weighing 1.6 kg, home by bike.
It was noon and the sun was very strong and glaring.
After getting home, I started to have a headache.
I initially thought it was due to lack of sleep or the intense sunlight, so I have been going to bed at 11 PM and getting a full 8 hours of sleep, plus a one-hour nap in the afternoon.
However, the headache has not improved.
The pain starts from the back of my neck, radiates to both sides of the back of my head, and then to my temples.

I have noticed that while I am falling asleep, I tend to grind my teeth, and my head tilts to one side.
Sometimes, the temple on the side where I grind my teeth has a sharp pain, and there is tenderness when I press on the area below my cheekbone.
The bone around my eyebrows is also sore, not extremely painful, but there is discomfort when pressed.
When lying down, I feel discomfort from the back of my head to my shoulders, and there is pain in the back of my head.
Additionally, my upper left wisdom tooth area has been experiencing gum inflammation recently, and while sitting, I feel throbbing pain in the temple on the wisdom tooth side, with pain extending from the back of my head to my neck, and tenderness in the cheekbone area.
If I shake my head, I feel pain from the back of my head to my temples.
The right side of my nose is also congested.
These symptoms seem quite complex.
Is it an issue with my neck? Should I change my pillow? Is it due to high eye pressure, wisdom tooth problems, teeth grinding, or possibly a cold? I saw online that these could be symptoms of sinusitis, but I am not sure if that applies to me.
I am feeling very uncomfortable and am unsure where the problem lies.
Thank you for your help!

A, 20~29 year old female. Ask Date: 2022/11/14

Dr. Jiang Junyi reply Neurology


Hello Ms.
A: You mentioned that "when lying down, I feel very uncomfortable from the back of my head to my shoulders, and my head hurts when I lie down.
Additionally, my gums around the upper left wisdom tooth have been inflamed recently, and I experience throbbing pain in the temple on the same side while sitting, along with pain from the back of my head to my neck." Your symptoms suggest the possibility of multiple inflammatory conditions involving the cervical spine, myofascial pain, and gingivitis.
Clinically, non-steroidal anti-inflammatory drugs (NSAIDs) may be considered to alleviate inflammation and reduce pain, provided there are no contraindications such as a history of peptic ulcers, allergies to NSAIDs, or impaired renal function.
It is advisable to change positions every 15 minutes to allow the neck tissues to rest; maintaining any position (including normal ones) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.
After the acute pain phase, it is recommended to develop a routine of gentle neck stretching exercises every 15-20 minutes at angles that do not provoke discomfort, including movements up, down, left, and right.
I suggest consulting a neurologist or a rehabilitation specialist for further evaluation and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2022/11/14

More Info


Understanding the complexities of head and neck pain can be quite challenging, especially when multiple symptoms are present. Based on your description, it seems that your pain may stem from several interrelated factors, including muscular tension, dental issues, and possibly sinus-related problems.

Firstly, the pain radiating from the back of your neck to the temples and the sensation of tightness in the jaw could indicate muscle tension or strain. This is often exacerbated by poor posture, especially if you spend long hours in front of a computer or engaging in activities that require you to lean forward. The act of clenching your jaw, which you mentioned occurs during sleep, can lead to tension headaches and discomfort in the temples and neck. This condition is known as bruxism, and it can cause significant strain on the muscles involved in chewing and can lead to headaches.

Additionally, the pain you experience in the area of your wisdom tooth, along with the inflammation of the gums, suggests that dental issues could also be contributing to your discomfort. Infections or inflammation in the teeth or gums can lead to referred pain, which means that the pain is felt in areas other than where it originates. This could explain the pain in your temples and the pressure you feel in your head.

Furthermore, the sinus congestion you mentioned could also play a role in your symptoms. Sinusitis, or inflammation of the sinuses, can cause pain and pressure in the forehead, cheeks, and around the eyes, and it can also lead to a feeling of fullness or pressure in the head. The fact that you have nasal congestion on one side may indicate that sinus issues could be contributing to your overall discomfort.

Given these potential causes, here are some recommendations to help alleviate your symptoms:
1. Posture and Ergonomics: Evaluate your workspace and ensure that your computer screen is at eye level to reduce neck strain. Consider using a chair that provides good lumbar support.

2. Jaw Relaxation: Be mindful of your jaw position throughout the day. Try to consciously relax your jaw and avoid clenching. You may also benefit from a mouthguard, which can be prescribed by a dentist to prevent teeth grinding at night.

3. Dental Consultation: Since you have mentioned issues with your wisdom tooth and gum inflammation, it would be wise to consult a dentist. They can assess whether the tooth needs to be treated or extracted and can provide guidance on managing gum health.

4. Sinus Care: If you suspect sinusitis, consider using saline nasal sprays or a humidifier to help relieve congestion. Over-the-counter decongestants may also provide temporary relief, but consult with a healthcare provider before starting any new medication.

5. Physical Therapy: If muscle tension is a significant issue, physical therapy may be beneficial. A therapist can provide exercises to strengthen neck muscles and improve flexibility, which can help alleviate pain.

6. Stress Management: Since stress can exacerbate tension headaches, incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine may help reduce overall tension.

7. Sleep Hygiene: Ensure that you maintain good sleep hygiene by going to bed and waking up at the same time each day, creating a restful environment, and avoiding screens before bedtime.

If your symptoms persist or worsen despite these interventions, it is essential to seek further evaluation from a healthcare professional. They may recommend imaging studies, such as X-rays or an MRI, to rule out any underlying conditions that could be contributing to your pain. Remember, it’s crucial to address both the symptoms and the underlying causes to achieve long-term relief.

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