HomeAnswersDentistryjaw painI have constant jaw pain, headaches, and vision problems. Why?

What might cause jaw discomfort, swelling, headaches, vision troubles, and face, neck, and shoulder pain?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At December 23, 2022
Reviewed AtOctober 9, 2023

Patient's Query

Hi doctor,

I am having trouble getting the right diagnosis and pain management for the pain and inflammation around my jaw, which causes severe headaches and pain every day. There is constant jaw pain, facial pain, headaches, vision problems, neck and shoulder pain, and problems talking. Also, I am currently taking the tablet Nortriptyline 25. In addition, I underwent MRI and neck X-ray, which were normal. I also got Botox shots but they did not help.

Please help me.

Hi,

Welcome to icliniq.com.

I went through your query and understood your concern.

Do not worry. I am experienced in handling these kinds of cases and I can solve your doubts. Please be relaxed and let me know your dental history first. Did you undergo any RCTs (root canal treatments) or extractions? Do you currently have any decayed teeth or a history of sinus infections?

I saw the tablet you are on and I understand you have not gained a clear picture from the X-ray.

I hope this helps you out.

Kindly revert for further doubts.

Patient's Query

Hi doctor,

Thank you for your reply.

I have visited two ENT consultants, and they found nothing except a bit of a deviated septum. Also, I have had two extractions, one was a dead tooth, and I decided not to have a root canal. The other I told him to take it out wrongly as he said nothing was wrong, but I was experiencing some mouth pain. However, he gave me a night guard and told me that I had TMD, so I visited an expert who said there was nothing to be worried about in my jaw. In addition, he gave me botox, but it did not work. I have pain around my eyes and cheeks every day, and my teeth feel funny.

As days go on, I get migraine-like headaches and have trouble talking, neck pain which sometimes locks with dizziness and hot flushes, and my scalp also hurts sometimes after brushing my hair. Lately, I have felt that my jaw is swollen, and I have difficulty swallowing, but it soon calms down. This has been going on for over two years and has made me depressed by not being able to exercise or enjoy certain things. I do not eat hard foods anymore, but the pain is constant. I was told I had typical facial pain by one doctor I consulted, but the antidepressants are not working, and the pain is severe in my lower jaw and chewing muscles.

I hope you can help me.

Hi,

Welcome back to icliniq.com.

I understand what pain you must be going through. But do not get depressed. Your symptoms seem similar to a nerve compression that might have happened in your face, because of which you are experiencing pain in multiple spots. For example, in conditions like trigeminal neuralgia, what happens is there is a pressing pain that radiates to every part of the face, especially with any stimuli like even air, water, or brushing your scalp. The pain tends to give a shock or a worsened feel. So, I suggest you to stop wearing the mouth guard first. It would be best not to restrict your jaw when you have such compressed pain. However, have you tried checking up with a neurologist or a neuro physician?

ENT (ear-nose-throat) specialist or dentist only diagnoses orofacial problems. But your symptoms are similar to a nerve compression injury. So I suggest you to consult a neurologist.

From a dental point of view, I need to diagnose further. Have you observed any pain radiating from the lower teeth, or if you touch any particular tooth, do you have pain at that point? Also, can you describe your pain, like when you get it? Is it severe or shock-like that you used the word "migraine-like"? However, I want to confirm.

I hope this helps.

Kindly answer my questions accurately for better diagnosis and treatment.

Patient's Query

Hi doctor,

Thank you for your reply.

Yes, I have pain in my lower teeth. I have no problem sleeping and no pain at night (unless I lie on my face). After washing and talking for a long time, the pain starts, and my cheeks are sore when touched. Even wearing glasses gives me a burning sensation across my eyes, and it is painful. I have tinnitus constantly, and sometimes my ears are painful too. Before lockdown, if I got stressed, I would have an aching pain around my eye, but I did not think much of it. About six years ago, I had a bout of cluster headaches which went away after a course of the tablet Sumatriptan. And I have seen a neurologist who put me on the tablet Nortriptyline 10 mg, but that was doing nothing and said it was facial pain, but the pain is getting worse now, and I do not understand why my neck is involved.

Please help me.

Hi,

Welcome back to icliniq.com.

That is a really concerning history. I totally get your point now. Now that you mention cluster headaches, I can definitely tell you that the symptoms are due to nerve compression. Sometimes in an MRI (magnetic resonance imaging), the neurologist cannot exactly determine the cause if there is no lesion. Then you will be put on opioid painkillers if the normal antidepressant does not work and on anticonvulsants sometimes. This can also be due to complex regional pain syndrome, in which you have multiple spot pain in the face. The differential diagnosis of these nerve pain syndromes will be established only by a neurologist. Meanwhile, I suggest you take a muscle relaxant for three days instead of using your mouth guard. You can use this muscle relaxant whenever you need it, but do not take it frequently. You can take it only when the pain worsens. Consult a specialist, talk with them and take the medications with their consent.

Coming to the lower teeth, you say you have pain, but why was no treatment done? Have you tried consulting a dentist? When a tooth has an abscess or is indicated for RCT (root canal treatment), then the pain will definitely aggravate and radiate. Is any of the lower teeth decayed or have you ignored dental treatment?

I hope this helps.

Kindly follow up with the answers.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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