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Tuesday, December 29, 2015

Facial Pain Relief in Chicago: Expertise in Trigeminal Nervous System is needed for Effective Treatment of Facial Pain, Migraine and Chronic Daily Headaches

Chronic facial pain is often seen in a very different light than other chronic pains.  For a long time Atypical Facial Pain was considered a psychiatric diagnosis   It is been reclassified and is now considered a trigeminal nerve or other cranial nerve disorder.

This type of pain is frequently associated with long term suffering and frequent misdiagnosis.  I have been treating chronic atypical facial pain for over 30 years in my Gurnee and Highland Park offices.
To learn more visit my office websites;
Highland Park:  www.ThinkBetterLife.com
Gurnee:   www.DelanyDentalCare.com

The ICD 10 coding for atypical facial pain or persistent idiopathic facial pain is as follows.
13.18.4Persistent idiopathic facial pain [G50.1]G44.847  
Previously used termsAtypical facial pain

THE DESCRIPTION OF THIS PAIN IS VERY SIMPLE AND COULD EASILY BE A MYOFASCIAL OR TMD CONDITION.  IT IS CONSIDERED DIFFERENT THAN HEADACHES OR MIGRAINES

Description:

Persistent facial pain that does not have the characteristics of the cranial neuralgias described above and is not attributed to another disorder.

Diagnostic criteria:

  1. Pain in the face, present daily and persisting for all or most of the day, fulfilling criteria B and C
  2. Pain is confined at onset to a limited area on one side of the face1, and is deep and poorly localised
  3. Pain is not associated with sensory loss or other physical signs
  4. Investigations including x-ray of face and jaws do not demonstrate any relevant abnormalit

POSSIBLY THE BEST METHOD OF CLASSIFYING THESE PAINS MAY NOT BE THE DESCRIPTION OF THE PAIN BUT RATHER WHAT THE PAIN RESPONDS TO.


SPB Blocks have been used for years to treat headaches, migraines and other pain disorders.  Sluders neuralgia was origiinally described in 1908 but is sometimes considered the original TMJ diagnos prior to the diagnosis of Costen's syndrome.  

The diagnosis of contact point headaches also known as Anterior Ethmoid neuralgia, pterygopalatine ganglion neuralgia, Sluder's Neuralgia and sphenopalatine Ganglion neuralgia often presents as pain of unknown orgin .  It can respond to SPG Blocks but in general is very resistant to diagnosis.

This condition may be a nerve compression syndrome but it can spread pain anywhere in the opthalmic or maxillary divisions or the Trigeminal Nerve.

The pain follows a similar pattern as trigger points in pterygoid, masseter and temporalis muscles.  It can sometimes be relieved by decongestants such as Afrin that shrink the nasal tissues.

Neuromuscular Dentistry in conjunction with SPG Blocks, Trigger Point injections, Spray and Stretch, prolotherapy is still the most effective approach to chronic facial pain.

All work should begin with reversible therapy and permanent changes should only be done after extended relief of pain.

#ChicagoMigraines, #ChicagoContactHeadache, #ChicagoSPGBlock, #ChgicagoImprovingQualityof Life, #IllinoisFacialPain

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posted by Dr Shapira at 1:22 PM

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