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Diagnosis of Migraine & Headache Types

Facial Pain

  • By Sarah

    Hello All!

    I have been experiencing migraines since my junior year of college- about 5-ish years ago. Since then, my migraines are getting more and more frequent. I have all the usual symptoms- nausea, light & sound sensitivity, and headache pain in the crook of my right eyebrow and nose. Within the past year, however, facial pain is a growing symptom/issue. The pain runs along my cheek bones (both sides) and the sensations feels as if someone if pushing in on my face. The face pain not necessarily debilitating but I can’t seem to shake it. With this facial pain, I always have nausea and I grow tired/grumpy very quickly. In this same breath, I don’t always have the headache pain when my face hurts.

    I subconsciously push on my cheek bones (applying pressure hurts but also feels good… weird) when the pain starts and that’s when my family knows that I am beginning to have a headache.

    Does anyone else experience this? I told my dr. about the facial pain and she looked at me like I was crazy. Am I making this up in my brain? This is starting to affect my daily life and what I do. If anyone has any experience or leads that I could follow up with that would be greatly appreciated.

    All the best,
    Sarah

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  • By owieithurts

    Hi Sarah,
    Ohmygosh, today is the first day I have ever had facial pain with a migraine and here I am reading your post about it! How weird! I have a migraine, hard to read to type this, and parts of my face hurt – cheeks below my eyes feel tender, but it doesn’t feel like sinus pain or pressure (I’ve had sinus infections before) and between my eyebrows.

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    • By gary

      Yes mine usually start at my hairline and comtinue down the side of my face, and can continue into my arms and behide my eyes I can go from a 3-8 in 20 -30 minutes it’s aweful

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  • By Sarah

    Jimillercat!

    I hate that you have this pain but am glad that i’m not suffering alone when it comes to odd facial pressure. Did you feel any other symptoms. What are your triggers?

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  • By owieithurts

    Sarah,
    Hope your pain is gone by now. I know, doesn’t it help to have someone else who knows what it’s like to share the pain? My main trigger is weather – changes. Not much I can do about that! I always joke that I am more reliable than the weatherpeople on tv and the radio! Ha! Also, other changes like way too little or way too much sleep, or when meal times are really off schedule. What are your triggers? Re: other symptoms, sometimes nausea, often light is too bright, sometimes sounds are too loud, some odors are too intense…I could go on and on… How about you?

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  • By Rockin mama

    I also experience facial pain with migraines. My neurologist thinks I have neuralgia that triggers migraines. Regardless, I’ve had this pain for years. My migraines were mainly triggered by monthly hormones & weather changes. I’ve reached menopause, but now my migraines are chronic. And I still can’t do anything about the weather. Winter is the worst for my migraines here in Ohio.

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  • By Sarah

    Jlmillercat-

    I had a migraine early this afternoon but luckily no facial pain. Just the standard ache in the crook of my nose and eyebrow, nausea, light/sound sensitivity, and usual fatigue. Took my imitrex and some phenergan to sleep it off. All is well now.

    I believe that my triggers are weather changes and certain cheeses but there could be more. I also believe that I have some alcohol intolerance. If the weather is rainy/cloudy or if the temp swings 10 degrees either way, I’m bound to get a migraine.

    Luckily, I am becoming more aware of my body and have noticed a pattern of behavior when a migraine is coming on. First, I have this extreme urge to lay down. My body becomes so fatigued and I become extremely irritable. My sense of smell is also heightened and I usually get over stimulated by noise and light. I don’t always have facial pain but when I do, its really hard for me to shake it. As odd as it seems, sometimes my nose gets plugged on the side of the pain and then my nostril seems to become just ever so swollen. Crazy, right?

    Not every symptom happens every time so its hard to pick out the exact pattern. I will always try everything to alleviate the pain before taking meds. For instance today, I woke up and felt a twinge of something but thought I just needed caffeine but guzzling a cup of jo didn’t help. I then got caught up doing some work on the computer and forgot to eat. I had a banana and a breakfast bar but the twinge was growing greater. The pain in the crook of my head and nausea finally went over the edge and I couldn’t concentrate on my screen. At that point, I took some meds and ate my standard baked potato (I always crave them during headaches and they are easy to go down on a tumultuous belly). After a few hours of hibernation and I was fine for the rest of the day.

    Angreed65-
    What does your neuralgia feel like? I’ve read a bit of literature on the internet and it seems as those the pain is awfully debilitating. My pain feels as if someone is taking the palms of their hands and pushing as hard as they can on my cheekbones. But the pain is not the bones themselves but the area underneath them. Strange sensations! Very rarely does the facial pain leave me debilitated. I’m just really, really uncomfortable.

    When this facial pain comes on, I will always have nausea but I sometimes won’t have the my standard migraine pain in the crook of my eyebrow and nose. Is yours the same? What causes your neuralgia?

    Also, how did you bring this neuralgia idea up with your MD? Or did they suggest that neuralgia could be the cause? I’m wondering how to speak with my nurse practitioner so that she will validly hear my concerns.

    Thoughts?

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  • By Rockin mama

    Hi Sarah,
    The neuralgia and my migraines are locked on my right side. The neuralgia is in the lower part of my eye socket. It can travel up to my temple, which is also where my migraine pain is. (I’ve started having scalp pain the last couple of years now too.) It starts as a burning ache, and I tend to rub my face to relieve the pain. I also getting a burning pain in my right nostril, and my right eye droops sometimes. Co-workers can even tell when I have a migraine by my droopy eye. I also get a burning, boring pain in my right eye. The facial pain can be tolerable for awhile but it eventually wears me out. I can often work through it, but it’s really difficult in the winter as the cold weather seems to heighten the pain. January & February are the worst. Weather changes are my biggest triggers.
    My neurologist actually brought up the neuralgia diagnosis. He said the neuralgia triggers my migraines. I started seeing him in June 2014 & was diagnosed with chronic migraine. I’m on my second preventative, Cymbalta … It worked really in September, but the weather was absolutely beautiful the whole month. Cymbalta seems to be working in that my migraines are less severe, but I still sometimes have 3 a week that require Imitrex.
    I hope this is helpful for you … It’s been helpful for me to write about it in detail.

    Take care,
    Angie

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  • By KSvendsen

    I have a migraine all the time and my right eye droops because of it. From time to time I also have facial pain around my right eye. It’s been three years with this constant pain that no one seems to be able to do anything about.

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  • By tammay

    I know this is an old thread but I’m doing research on the connection between facial pain and migraine and came across it and wanted to add that I have also been experiencing more of this in the last 4 months or so. Up until then, I have had monthly migraines on my left side but then I started having sometimes a strong dull ache on my face on the left side where I get migraines. The pain doesn’t reach my head or temples or the usual places that I have pain when I have migraine. It’s in the areas many people mention here (cheekbone, back near the ear and down along my jawline both upper and lower). They are fleeting pain rather than a constant ache as with my migraines.

    When it first happened about 4 months ago, I went to a doctor and he diagnosed it as allergies and gave me a prescription for nasal spray (which didn’t help) and antibiotics (in case it blossomed into a sinus infection, which it didn’t so I didn’t take them). I did mention to the doctor about my migraines but he didn’t think there was a connection nor did he seem to be too concerned (probably because I mentioned that my migraines are about once a month so they aren’t very frequent). I continued to take Advil every 4-6 hours and that actually did help take the pain away (when it doesn’t always help with my migraines). After about 4 weeks, the facial pain went away but a few days ago it came back (maybe because of weather changes here in West Texas – we’re supposed to be getting a snow storm this weekend and the temperature is slowly dropping).

    I do think it’s related totally to migraine. I am checking out whether it might be related to a tooth abscess, as my teeth aren’t in great condition, but I won’t know about that until after the holidays, as I have a dental appointment only in a few weeks. But I don’t think it’s related, since the pain travels around. Yesterday, for example, I had the facial pain traveling on my left side and in the evening it suddenly went to my right and this morning I have a regular migraine on the right side with a little facial pain on the left side (which is why it makes sense to me that this is all migraine related).

    I guess I’ll keep taking Advil and once I get the diagnosis from my dentist (to see if it’s related to teeth issues), I’ll proceed from there. If it’s not related to my teeth, I’ll be seeing a doctor again (a different one this time) and see if maybe it might be a neurology. My twin sister has trigeminal neuralgia so it’s not entirely out of the question.

    Tam

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  • By Katie M. Golden Moderator

    Hey Tammay,
    Your facial pain could absolutely be Migraine related. Often Migraines are misdiagnosed as allergy or sinus issues. There are a bundle of nerves called the sphenopalatine ganglion that sit kind of behind your nose and sinus cavities. When they become inflamed, it can be very painful and can cause a Migraine.

    There is a treatment called an SPG block that is administered through your nose that helps to calm down the nerves. The treatment can last for a few days or a few weeks. I’ve not personally done it, but I talked to my doctor about it and will probably try it soon.

    You should really see a neurologist for this issue. Your GP is not going to have extensive knowledge of Migraine issues.

    Here is an article that explains facial pain:
    https://migraine.com/blog/facial-pain-explained/

    I hope this helps!
    -Katie
    Migraine.com Moderator

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