Millions of people suffer from headaches. This often causes missed work days. less productive days, and less enjoyable days. Migraine is a specific intracranial vascular headache. Many use the term mistakenly to describe other types of headaches. There are many other causes of headache and many of these can be caused by nerve dysfunction.
The occipital nerve is a large nerve in the neck. It can be damaged by such things as whiplash injuries and improper patient positioning during oral surgery. Occipital neuralgia causes pain in the back of the head but this can be referred to other areas. This is because the ganglion interconnects with the trigeminal ganglion in the brain stem. Throbbing is often associated with this type of headache because of proximity to the occipital artery.
The auriculotemporal nerve is located near the ear and the top of the jaw on both sides. Common headaches with problems to this nerve are temple headaches. This nerve is commonly damaged in TMJ surgery. it is usually pounding because it is near the temporal artery.
Another nerve that can cause problem is compression of the ethmoid nerve in the sinuses. An ear nose and throat doctor can diagnosis this problem by seeing if the patient has tenderness when using the instrument commonly used to explore the sinuses.
Another type of neuralgia that can be found involves the supraorbital nerve and can be caused by a head hitting a windshield or a punch to the front of the head. Treatment and diagnosis involves injection of local anesthetic with steroid. The headache can sometimes take years before it starts to present problems.
The infraorbital nerve can also cause problems and is often misdiagnosed as maxillary sinusitis.
Nerve problems causing headaches are different than migraines and need to be treated as such. Diagnosis is made by injection of local anesthetic into the nerve that seems to be the problem. Treatment is directed at reversing the underlying pathology. Entrapments are treated with injectable anti inflammatory medications. Always remember you can’t treat what you can’t diagnosis. Patients as well as doctors need to be proactive in finding a potential source for chronic headaches.