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What Causes Severe Persistent Headache?
Question: I have had headaches almost every day for nearly five months. They are concentrated in the "ENT" region with pain, burning and pressure in and behind my eyes, nasal area and ears. I have seen my primary MD several times and the headaches did help me learn that I have higher BP which is now controlled with a small small dose of amlopidine over the past three months. (PS..I am 5 feet 6 in and weigh 264..morbidly obese, but I have lost 25 pounds in four months and cont to slowly lose through diet and ex). Headaches have not subsided. Been through several rounds of antibiotics for congestion and sinus issues and also have seen an ENT who did a recent (1 week ago) CT of my sinuses following the latest round of antibiotics and the ENT stated my ears and sinuses are clear. Sinuses are small but clear. (His bedside manor was terrible and I'm pretty sure he is only interested if surgery is warranted). I do wear eyeglasses which I should probably wear more often, however, for years I have only been able to wear them for short periods of time due to it becoming very uncomfortable as the glasses (all kinds..I have tried many different frames) sit where I fractured my nose 17 years ago (I had 4 non-displaced fractures with no tx other than pain meds and ice). I was told by a dentist years ago that I have TMJ disorder, and I have noticed my articular discs are "out of line" upon opening and closing my mouth, but never had any other issues. I know this is a very long history, but I am guessing I have answered many questions that you might have had. My somewhat random question is...is it possible to develop arthritis in the nasal region, or is the pain from my TMJ issues, or could it be a simple fix with contacts? I have tried contacts before with little success!! Any advice is appreciated!!
Brief Answer:
TMJ issues are most likely cause for your headache.
Detailed Answer:
Hello,
Welcome to Health care magic
I am Dr Dadapeer k an ophthalmologist and I answer health problems related to eye.
I reviewed your history.
It seems from the history that you are having headache for last five months and you have undergone thorough evaluation to find out the underlying cause for headache.
My views are as below.
The common causes we need to rule out in your case as cause for headache are blood pressure, sinus related problems, eye problems, nasal injury and TMJ disorder.
Since your blood pressure is under control this rules out elevated blood pressure as a cause for your headache.
Since the CT scan of the sinuses are normal this rules out sinusitis and ENT problems as cause for your headache.
Since you are wearing eye glasses and still the headache is persisting this rules out refractive error and eye related causes as a cause.
Arthritis does not develop in nasal bone and since the injury was long back and since it was simple non displaced fracture, this rules out nasal bone injury as a cause.
Hence I think the TMJ disorder is responsible for your chronic headache and requires attention and treatment by dentist.
Hence I advice you to consult your dental doctor for further evaluation and treatment.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
With regards
TMJ issues are most likely cause for your headache.
Detailed Answer:
Hello,
Welcome to Health care magic
I am Dr Dadapeer k an ophthalmologist and I answer health problems related to eye.
I reviewed your history.
It seems from the history that you are having headache for last five months and you have undergone thorough evaluation to find out the underlying cause for headache.
My views are as below.
The common causes we need to rule out in your case as cause for headache are blood pressure, sinus related problems, eye problems, nasal injury and TMJ disorder.
Since your blood pressure is under control this rules out elevated blood pressure as a cause for your headache.
Since the CT scan of the sinuses are normal this rules out sinusitis and ENT problems as cause for your headache.
Since you are wearing eye glasses and still the headache is persisting this rules out refractive error and eye related causes as a cause.
Arthritis does not develop in nasal bone and since the injury was long back and since it was simple non displaced fracture, this rules out nasal bone injury as a cause.
Hence I think the TMJ disorder is responsible for your chronic headache and requires attention and treatment by dentist.
Hence I advice you to consult your dental doctor for further evaluation and treatment.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
With regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your response. This is what I am thinking also. Hx: I have Masters in Science of Physical Therapy and I have been doing my own research as well. My area of experience for years is mainly geriatric, so I am needing some help with this. The issue with seeing a dentist is that I am also a military wife. Tricare assists very little with dental issues, but will assist with other "medical issues". At our prior location (station), I feel this issue could have been resolved due to my great medical connections. I feel I could benefit from tx from a skilled PT for these TMJ issues, but just want confirmation of this to reduce my worry of anything major. Could my primary MD help me to figure this out?
Brief Answer:
Your Primary MD can diagnose this.
Detailed Answer:
Hello
Thank you for the follow up question.
Your primary Physician will be able to diagnose this based on examination and investigations like X ray or CTscan findings.
Hence you can consult your primary Physician and if there is a need for intervention you need to consult dental doctor specialized in faciomaxillary field.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
With regards
Your Primary MD can diagnose this.
Detailed Answer:
Hello
Thank you for the follow up question.
Your primary Physician will be able to diagnose this based on examination and investigations like X ray or CTscan findings.
Hence you can consult your primary Physician and if there is a need for intervention you need to consult dental doctor specialized in faciomaxillary field.
Hope I have answered your question and the information is helpful to you.
Do write back to me for further questions.
Thank you
With regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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