Head and facial pain: understanding your symptoms

Headaches and facial pain affect millions of people. They can originate from several sources: the jaw, neck, inner ear, or even a previous concussion. The good news? Most of these conditions respond very well to physical therapy. This guide helps you identify where your pain is coming from so you can better target your treatment.

You may have recurring headaches, dizziness when turning your head, or pain that radiates from your jaw to your temple. These symptoms can be frustrating and sometimes frightening. It's normal to feel concerned. Understanding their origin is the first step toward relief.

How can I find out where my headache is coming from?

Head and facial pain generally originate from four main sources: jaw disorders (TMJ), cervical headaches, vestibular problems (vertigo), or the aftereffects of a concussion. Each source has distinct characteristics that help identify it.

Your body sends specific signals depending on the source of the problem. Pain that worsens when you chew suggests a jaw problem. Headaches that start at the base of the skull point to the neck. Dizziness when changing position often indicates a vestibular problem. Learning to recognize these patterns allows you to communicate better with your healthcare professional.

Let's now look at each source in detail to help you identify yours.

Is my pain coming from my jaw (TMJ)?

Temporomandibular joint (TMJ) disorders cause pain in the jaw, temples, and around the ears. Tell-tale signs include cracking when opening the mouth, difficulty chewing, and pain that worsens after meals or upon waking up.

The TMJ is the joint that connects your lower jaw to your skull. It works every time you talk, eat, or yawn. When this joint is disrupted, it can cause pain that sometimes feels like an earache or headache.

• Your jaw cracks or clicks when you open your mouth
• You experience pain when eating hard foods
• You wake up with a tight or painful jaw
• The pain radiates to the temple or ear.

If this sounds familiar, your pain could be caused by TMJ. Rest assured, this condition responds very well to specialized physical therapy. Muscle relaxation techniques and specific exercises can significantly reduce your symptoms. To learn more, check out our comprehensive guide to jaw pain and TMJ.

But perhaps your pain seems to come from somewhere else. Let's look at headaches of cervical origin.

Is it a headache or a cervicogenic headache?

Cervicogenic headaches are headaches that originate in the neck. They account for approximately 15 to 20% of all chronic headaches. The pain typically starts at the base of the skull and radiates toward the forehead or behind the eye, often on one side only.

Unlike migraines or tension headaches, cervicogenic headaches have a mechanical origin. The joints and muscles in your upper neck (C1 to C3 vertebrae) can irritate the nerves that connect to your head. The result? Pain that seems to come from the head but actually originates in the neck.

• The pain begins after prolonged sitting (computer, driving).
• Turning or tilting the head triggers or worsens the headache.
• You have neck stiffness along with the headache.
• The pain is always on the same side.

The good news? Studies show that the cervical flexion-rotation test is 91% accurate in identifying these headaches. Manual neck treatment combined with exercises offers excellent results. For more information on this topic, see our guide to headaches and migraines.

What if your main problem isn't pain but rather a feeling of dizziness?

Is it dizziness or vertigo?

Vertigo and dizziness affect 35% of adults over the age of 40. Vertigo causes a spinning sensation, as if the room were spinning around you. Dizziness, on the other hand, creates a feeling of floating or imbalance without any spinning sensation.

The vestibular system in your inner ear functions like a gyroscope. It informs your brain of the position of your head. When this system is disrupted, you may experience intense dizziness, a feeling of pitching, or difficulty balancing. It's unpleasant, but most of the time, it's treatable.

• You experience intense dizziness when lying down or standing up.
• Turning your head quickly causes a spinning sensation.
• You feel unsteady when walking, especially in the dark
• The dizziness appeared after an ear infection or trauma.

Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. It occurs when small crystals move around in the inner ear. The good news? Treatment using repositioning maneuvers is successful in 80 to 92% of cases, often after just one session. Our guide to vertigo and dizziness explains the different causes and treatments.

To understand this specialized approach, check out our article on vestibular physical therapy.

If your symptoms began after a blow to the head, another cause is possible.

Is it related to a concussion?

Post-concussion symptoms can persist for weeks or months after a head injury. Between 10 and 30% of people who have suffered a mild concussion develop prolonged symptoms: headaches, dizziness, fatigue, and difficulty concentrating.

A concussion can disrupt several systems simultaneously. Your vestibular system, your vision, and your neck muscles can all be affected. This is why post-concussion symptoms are often complex and varied. Don't be discouraged: with the right support, recovery is possible.

• Your symptoms began after a blow to the head or body.
• You have headaches accompanied by cognitive fatigue.
• Screens and crowded places worsen your symptoms
• Do you have problems concentrating or remembering things?

Physiotherapy specializing in concussions combines several approaches: vestibular rehabilitation, cervical treatment, and a gradual return to activities. Our guide to concussions details the stages of recovery.

When should you see a physical therapist?

Consult a healthcare professional if your symptoms persist for more than a week, affect your daily activities, or recur regularly. A physical therapist can assess the source of your pain and recommend treatment tailored to your situation.

The beauty of physical therapy for these conditions? We can often identify the source of the problem during the initial assessment. Whether your pain comes from your jaw, neck, or inner ear, specific tests can pinpoint the exact source.

• Headaches that change your lifestyle
• Dizziness that prevents you from driving or working
• Jaw pain that limits what you can eat
• Symptoms that persist after an accident or blow to the head

Don't wait until your symptoms become chronic. The sooner you seek treatment, the better the results are generally.

When should you seek emergency care?

Some symptoms require immediate medical evaluation. Go to the emergency room if your headache is the most severe you have ever had, if it comes on suddenly like a thunderclap, or if it is accompanied by neurological symptoms.

• Severe and sudden headache ("the worst of my life")
• Weakness or numbness on one side of the body
• Difficulty speaking or understanding
• Double vision or loss of vision
• Severe neck stiffness with fever
• Loss of consciousness

These symptoms are rare but may indicate a serious condition requiring immediate attention.

How can Physioactif help you?

Our physical therapists are trained to evaluate and treat head and facial pain. We use specific tests to identify the source of your symptoms and customize your treatment plan.

• Comprehensive assessment to identify the source of your pain
• Treatment of TMJ disorders using manual techniques and exercises
• Vestibular rehabilitation for vertigo and balance disorders
• Treatment of cervicogenic headaches
• Post-concussion recovery program

You do not need a doctor's referral to see a physical therapist in Quebec. If you suffer from headaches, jaw pain, or persistent dizziness, we can help you regain your quality of life.