Headaches and facial pains are very common and affects nearly everyone at some point in their life. Increasing age, trauma to head or face and conditions like anxiety and depression, over-reliance to pain-killers can contribute to developing headaches. Most of these are self-limiting and last only for a few days or weeks. However, if it is long-lasting, it can be severely disabling and impacts heavily on your quality of life. Most headaches do not signify any major illness and after confirming that there are no underlying medical conditions, a pain consultant would be able to help you control and manage it effectively.

Common Conditions treated at Pain Clinics:

Trigeminal Neuralgia

Occipital Neuralgia

Headache

Migraine

Tension Headache

Cluster Headache

Orofacial pain

There are very few headaches which need urgent medical attention and possibility of scans and other investigations. These include sudden onset severe headache, associated neurological signs like numbness or weakness in arms and/or leg, drooping of side of face, vertigo, loss of control of bowel and/or waterworks, disturbance in vision or hearing, seizures, signs of infection like fever, chills and history of weight loss, cancer, diabetes, high blood pressure and on blood-thinning medications. We need to rule out stroke, bleeding inside the brain, tumours, meningitis and other serious conditions.

However, the vast majority of headaches are not serious except for the symptoms. Common complaints vary between sharp pain, aches, pulsing or throbbing sensation, pain at the top of the neck, tingling or electric-shock like sensations and burning sensations. Migraine is probably the commonest cause of headache with frequent episodes in some and often it is associated with trigger factors, visual or hearing signs and nausea/vomiting.

Most patients are seen and managed by the GP; any acute conditions that need referral are promptly dealt and the chronic headaches are usually referred to a neurologist for a diagnosis.  Pain consultants offer assessment and advice on managing these conditions after appropriate investigations which may include blood tests and scans.  Treatment depend on the diagnosis and various options can be discussed with the patient to suit their preferences.  This may include medications, nerve blocks, treatment with Botox, radiofrequency treatments, physiotherapy and psychological rehabilitation.  Some patients benefit from holistic approaches including acupuncture, laser therapy, TENS machines and other treatment options including mindfulness, meditation and yoga-based treatments.  A small group of patients could benefit from neuromodulation treatment and even fewer patient may require surgical treatment.

Headaches and orofacial pains represent a complex spectrum of conditions and your pain consultant would work with you to make a diagnosis and put together a treatment plan for your condition to give meaningful pain relief and improved quality of life.