Dr. Shapira's Chicago Headache Blog

The Sphenopalatine ganglion block can be used to prevent and/or relieve headaches and Migraines. I have used it for many years in my office as an adjunct for treating headaches and migraines in patients. While it is not effective for all patients there is a subgroup that remarkable relief from pain and a second group that can stop a migraine before it becomes full blown.

The real beauty of SPG blocks is that they are simple and safe and I teach patients how to use them at home when they need them. The block is done with a Q-tip with lidocaine. The q-tip is gently place in the nostril until the lidocaine soaked cotton tip is adjacent to the SPG. This is left in place for 20-30… Read Full Post

Transformed Migraine (common Migraine) usually has a history of beginning as episodic migraine attacks which increse in frequency. This occurs over aperiod of months to years and the Transformed Migraine (TM) occur frequently, often daily and are a combination of vascular and Tension-type Headaches. The TM can very from mild to moderate severity with epsodes of increased severity. These headaches usually begin in teen years or early 20's. Transformed Migraine attacks are frequently accompanied by nauseau, phonophobia (sensitivity to noise), photophobia (sensitivity to light) which lessen over time. A large porportion of patients are women with 90% of whom have a history of migraine… Read Full Post

Ruby: Headache in right temple. Throbbing in teeth and tm joint. Neck pain. Had a splint put in 10 days ago. Went for Pt, massage, chiro and today pain management dr who I didn't like much and jumped to wanting to do a nerve block. Just trying to find the right person to treat me. Chronic grinder, had crowns put on all uppers and didn't make night guard fast enough. Tmj dentist only does splints and says jaw position is 80% better. Help! Haven't been able to work in almost 2 weeks.

Dr Shapira Reponse: Dear Ruby,

I am sorry to learn of your ordeal.

Normally it is relatively easy to decrease pain rapidly but it does not sound like you were dealing with a… Read Full Post

David: I have had continous Headaches for 3-4 months now. sides and back of head mainly. Earache and eye ache as well

Dr Shapira: David, you have given me only minimal infformation on what treatment you have received or any special circumstances when the pain started. The good news is the symptoms you describe indicate that you probably have headaches of muscular orgins. Tension-Type Headaches (TTH) are commononly associated with the jaw and neck muscles. Achy type pain as you describe in your ears and eyes is nearly always referred muscualar pain.

An excellent approach is to visit a Neuromuscular Dentist who is also trained in using Vapocoolant spray to treat Myofascial… Read Full Post

I recently received a e-mail from a patient with the following complaint:

intense jaw pain on left side, swollen jaw and cheek, no dental issues per dentist and endodontist...tmj or trigeminal neuralgia?

The question TMJ or Trigeminal Neuralgia is very limited. 95% of all pain that patients experience is muscle pain. Many patients have severe or even excruciating pain but their TM Joints are normal. These are neuromuscular problems and may have many contributing factors. Trigeminal Neuralgia is rarely the cause of pain and when it is there is usually very specific triggers. The pain usually comes and goes going from normal to intense pain after stimulating trigger.

THIS IS AN INTERESTING ABSTRACT ON TREATMENT OF ANKYLOSING SPONDYLITIS AND TMD TREATMENT COMBINED

I have a patient who we treated many years ago with neuromuscular dentistry who had ankylosing Spondylitis as did his father. We started with a diagnostic work-up that included EMG and MKG and use of ULF TENS to relax trigeminally innervated muscles and created a dianostic orthotic. The patient finished his case orthodntically and has been stable for close to 20 years. The Ankylosing spondylitis resolved (Was this because of neuromuscular dental treatment or an incidental occurence?)

The patient firmly believes the neuromuscular dentistry "saved him" He later married and we… Read Full Post

Studies have shown that hypermobility syndrome is associated with chronic headache disorders. This new study shows that 75% of study group with the syndrome had migraines compared to only 43% of controls.

Patients with Chronic Daily Headaches, Migraines, Tension-type headaches, myofascial pain and associated headaches, atypical migaine, classic migraine almost always are headaches related to the masticatory system, the trigeminal nerve and TMJ disorders(TMD). These problems are often best addressed by the use of a diagnostic neuromuscular orthotic that has been shown in various studies to give some improvement in close to 100% of patients. Almost all studies of orthotics (of all… Read Full Post