Doctor, Why Does My Face Still Ache?: Getting Relief from Persistent Jaw, Ear, Tooth, and Headache Pain
I thought the following quote was exceptionally appropriate because so many chronic pain patients have spent years hearing doctors, nurses, friends, and family members telling them that their pain is “all in your head.” Although Dr. Tanenbaum’s explanations of the causes of facial pain rest on the mind/body connection, he makes it quite clear that this is a physical problem, not a psychiatric or psychological one.
“While the brain’s inability to maintain normal muscle function is the catalyst for your pain, it is important to emphasize that the pain is not “in your head.” Real physical changes have occurred in muscles and their associated nerves and tissues.” (Emphasis mine.)
I have to admit that I expected this to be a difficult read. With many complex muscle and joint interactions; plus the interplay of stress, the mind, and the body to explain; I anticipated many hard to understand medical and dental terms, paired with complicated definitions. Instead I found terms with clear, plain-English explanations that were easy to follow and actually made sense; and drawings that show the interplay of muscles and the areas of referred pain.
Dr. Tanenbaum provides simple, straight-forward explanations of complicated concepts like referred pain; sensitization; and how it is possible to have severe pain without having any structural problems, damage, or disease processes causing it. He spells out how stress, suppressed anger, and the physical habits (like nail-biting, jaw-clenching, tooth grinding, etc.) we develop to deal with them can affect the muscles of the head, neck and shoulders; causing muscle tension, spasms, and referred pain. He also provides an excellent flow chart showing the interactions and feedback loops of a “brain under siege” by long-term stress (recreated here with permission.)
Copyright 2012 by Donald R. Tanenbaum and S. L. Roistacher (reprinted with permission)
I highly recommend this book for anyone who has unrelieved facial pain, especially if you’ve been seeing multiple doctors trying to find a way to ease your pain and getting no results, or having even more pain after treatment. An extra copy for your doctor or dentist can help him/her treat you more effectively, or help you get a referral to an appropriate specialist if that is necessary. I’ve even found that some of the techniques suggested in the book help me manage my fibromyalgia pain, since stress increases central sensitization, which is a factor in both facial pain and fibro pain.
About Dr. Tannenbaum: Donald Tanenbaum is a specialist in orofacial pain. He was the Council Chair of the American Academy of Orofacial Pain 2020-2011, as well as President of the American Academy of Orofacial Pain 2009-2010. He is currently a Clinical Assistant Professor at Hofstra North Shore, LIJ School of Medicine; Clinical Assistant Professor, Department of Oral & Maxillofacial Surgery, School of Dental Medicine at Stony Brook University; and Section Head, Associate Attending Orofacial Pain/Dental Sleep Medicine Department of Dental Medicine Long Island Jewish-Hillside Medical Center New Hyde Park, NY
Disclosure: A free review copy was provided by the author. No other form of compensation has been offered or received for this review.
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Wendy: I am sooo glad you reviewed this book! I have 3 kinds of facial pain and this sounds like a book I would find very helpful in understanding what’s going on (especially the dental pain), and I have neck spasms so there’s another area I would find of interest.
Thanks so much for reviewing this. It’s on my wish list!
I have another type of pain to add to the sensation of referred pain: it is called recruitment pain. When pain signals overwhelm the nervous system a cascade of chemical / electrical reactions occur like those described. These signals can lower the response threshold of surrounding nerves until they fire as well. This often causes synesthesia, and can be described as “pain you can taste” or “it hurts so much i can hear it”. Migraine sufferers often get visual responses to headache. You’ve probably felt a version of it if you try to ignore an itch. Soon enough, you’ll itch everywhere.
Great article. I’m dealing with many of these issues as well..