Headache Treatment

Headaches are classified into two primary categories: primary and secondary headaches.

Primary headaches are not caused by other underlying medical conditions but are disorders in themselves, with common types including tension-type headaches, migraines, and cluster headaches.

• Tension-type headaches - The most prevalent form, often feel like a tight band around the head and are usually associated with stress or muscle strain.
• Migraines - As characterized by severe throbbing pain often on one side of the head, migraines may be accompanied by nausea, light sensitivity, and visual disturbances called auras.
• Trigeminal Autonomic Cephalgias - Including cluster headaches, paroxysmal hemicrania, hemicrania continua, SUNCT, SUNA.
• Other Primary Headaches

Secondary headaches, on the other hand, are caused by other conditions such as vascular disorders, infections, trauma, and other disorders.

In all cases proper classification is crucial for accurate diagnosis and treatment, as each type of headache can require different management strategies.

Headaches and Orofacial Pain

Headaches that cause orofacial pain often originate from musculoskeletal or neurological issues that impact the head, neck, or jaw. For example, tension in the muscles around the jaw, neck, and temples can trigger tension-type headaches, while conditions like temporomandibular joint (TMJ) disorders can result in persistent headaches due to strain and inflammation in the jaw area. Chronic bruxism, or teeth grinding, is another common cause, as it places excessive pressure on the jaw muscles and joints, leading to both jaw pain and headaches. Additionally, neuralgia, such as trigeminal neuralgia, can cause intense facial pain that radiates to the head, resembling a headache.

Conversely, certain orofacial disorders can manifest as chronic headache pain. TMJ disorders, for instance, can lead to referred pain, where discomfort in the jaw and surrounding muscles radiates to the temples and forehead, mimicking a headache. Treating these headaches often requires addressing the underlying orofacial condition, making the role of an orofacial pain specialist vital in managing such cases.

Evaluation, Diagnosis & Treatment

As a leading orofacial pain practitioner, Dr. Kim has trained under the guidance of neurologists, neurosurgeons, pharmacologists and headache specialists. She maintains a position at the forefront of advances in her field.

Dr. Kim conducts a comprehensive evaluation to diagnose patients with headache disorders. The process typically begins with a detailed medical and dental history, including the nature, frequency, duration, and triggers of the headaches, as well as any previous treatments or medications used. She will also perform a clinical examination, assessing the temporomandibular joints, jaw muscles, and facial structures for tenderness, restricted movement, asymmetry, and other signs or symptoms. Diagnostic imaging, such as X-rays, MRIs, or CT scans, may be used to further evaluate the jaw and surrounding tissues if structural issues are suspected.

Treatment Options for Headache Disorders

When treating headache disorders, Dr. Kim takes a holistic approach, including conservative, non-surgical care methods, and collaboration with other healthcare providers, like physical therapists, neurologists, or mental health professionals. Her goal is to ensure the effectiveness of the treatment plan, provide long-term relief, and improve the quality of life for the patient.

Treatment may include

• Physical therapy techniques, such as exercises and manual therapy, to reduce muscle tension and improve jaw mobility.
• Oral appliances like splints or custom-made night guards can help manage bruxism or reposition the jaw to alleviate strain on the temporomandibular joints.
• Medications like nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or low-dose antidepressants to help control pain and reduce inflammation.
• Trigger point and nerve block injections.
• BOTOX® injections.
• Lifestyle, diet, and sleep hygiene modifications.
• Behavioral therapies, such as stress management, cognitive-behavioral therapy (CBT), and biofeedback, can also benefit patients with headache disorders.