Headache and Facial Pain

UT Southwestern Medical Center takes a multidisciplinary approach to treating headache and facial pain, delivering treatment strategies tailored to each patient’s unique condition and preferences. 

Our experts use the latest scientific advances in pain management to offer help and hope for those times when headaches and facial pain move from being a nuisance to interfering with a patient’s life.

Advanced Care for Chronic Headaches

Everyone gets a headache now and then. But for many people, headaches and facial pain become ongoing problems that seriously affect their lives. 

Specialists at UT Southwestern understand the physical debilitation and emotional stress caused by chronic headaches and facial pain. Our physicians offer expert, compassionate care for patients experiencing pain associated with:

• Cluster headaches
• Idiopathic intracranial hypotension (also called pseudotumor cerebri syndrome), an increased pressure inside the skull that has no apparent cause
• Medication overuse
• Migraine headaches
• Spinal cerebrospinal fluid leaks and spontaneous intracranial hypotension, which can cause headaches and other neurologic symptoms
• Trigeminal autonomic cephalgias
• Trigeminal nerve injury, neuralgia, and neuropathy

Our headache and facial pain team takes a multidisciplinary approach to each patient, bringing experts together from many areas of medicine to deliver compassionate care and the best outcomes possible for each patient.

Patients might be treated by neurologists in our Pain Management Program or by pain management specialists in the Eugene McDermott Center for Pain Management, one of the few pain management centers in Texas with onsite pain specialists, behavioral medicine specialists, and physical therapists.

Our multidisciplinary experts in the Cerebrospinal Fluid Dynamics Program receive referrals from all over the country.

Types of Headache

Headaches are caused by particular nerves in muscles and blood vessels sending pain signals to the brain. Triggers that cause those nerves to activate can vary widely and are not always clear.

Headaches are broadly separated into two categories, primary and secondary. Primary headaches include:

• Migraines
• Cluster headaches
• Tension headaches 

Secondary headaches are usually a symptom of another, underlying disorder, such as:

• Mood disorders
• Anxiety
• Sleep disturbances
• Sinus problems
• Hormonal conditions

Diagnosis

Headache and facial pain care at UT Southwestern begins with a thorough assessment of a patient’s medical history, previous tests and treatments, and current medication list. Evaluations for related or underlying conditions might also be performed.

All new patients are seen by a physician, physical therapist, and psychologist, if needed. At the initial appointment, patients are asked to describe their headaches in detail. They might be asked to describe:

• A typical headache episode (if they are episodic) from beginning to end
• Warning signs, if any
• The location of the pain
• The character and severity of the pain
• Any sensitivity to light, sound, or odors
• How movement or physical activity affects the pain
• Other symptoms that accompany the headache
• Any triggers such as food, beverages, environment, or stress
• How the headaches affect overall quality of life
• Whether any other family member has headaches

Patients are encouraged to keep a headache diary and bring it with them to their first appointment.

Treatments

After the initial evaluation, UT Southwestern physicians partner with each patient to develop a personalized plan of care. 

Depending on each patient’s specific condition, our specialists might prescribe medications that halt the headache process after it has started, or preventive medications that reduce the frequency and intensity of headaches. Medications are prescribed in a variety of forms, including injections, nasal sprays, and oral tablets.

In addition, UT Southwestern’s specialists might also prescribe other approaches to treating and managing pain, such as:

• Acupuncture
  
• Biofeedback therapy
  
• Botox injections
  
• Cognitive behavioral therapy (CBT)
  
• Emerging surgical treatments
  
• Facet and epidural blocks
  
• Headache education
  
• Medication
  
• Nerve blocks
  
• Nutritional counseling
  
• Occipital nerve stimulation
  
• Physical therapy
  
• Relaxation techniques
  
• Stress management 

Clinical Trials

Patients at UT Southwestern often have the opportunity to participate in clinical trials, which give them access to new treatments before they are available to the general public. Talk to our doctors for more information about current clinical trials.