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Forum Name: Headaches

Question: Headache and facial pain, swelling


 tdtd - Fri Jan 02, 2009 10:46 pm

Hello,

I am afraid I am going crazy. For a few months the left side of my face has been in pain, with my left cheek oftex turning red or flushed. It has worsened over the last few weeks with headaches.

I went to my dr who gave me some anti biotics for a sinus infection, even though they were only midly infected, and he ordered a scan which showed nothing

I went to the ER one night when it hurt really badly, and the ER doc did a whole head ct scan, showing nothing. He prescribed ibuprofen and pain pills.

The pain is mostly in my left cheek, and spreads to my temple. the left side of my face is slightly swollen, and my eyes feel like they are going to pop at times.

I have a history of high BP, and take lisinopril. I am tired of taking ibuprofen.

Pinch nerve? MS? sinuses screwed up? any ideas would be helpful, it is getting hard to cope with.
 John Kenyon, CNA - Tue Feb 17, 2009 10:54 pm

User avatar Hi there -

This sounds very much, first of all, like it might be due to a dental problem rather than the second-most-likely cause, which would be a sinus problem. Sometimes the two can co-exist and cause this sort of thing, with an abcess either at the root of the tooth or in the form of a fistula into one of the sinuses nearest the affected tooth.

Normally antibiotics would be a short-term fix for this, but a dental and ENT workup together would probably yield the best result. Also, a specific CT of the sinuses would be indicated, as "CT of the head" can be fairly non-specific and aimed at the cranium rather than the sinuses. Sometimes this misses all but the most gross sinusoidal cysts.

Since you did, at the time, have some sort of sinus infection, this is probably related to that, but the larger problem may well be a tooth. This is usually what will cause swelling, pain and discoloration in the cheek.

Probably, since you had so little luck with the ER (because they are going to look for the most serious things first, and not finding them, move you down the ladder), a dentist may well be your best bet right now. A well equipped dental practice will even be able to do a panoramic x-ray of both the full mouth (teeth) and sinuses.

I don't think there's much likelihood this is due to a pinched nerve, and the swelling and discoloration (among other things) argue against early MS. Think tooth, then sinus, perhaps tied together via an abcess.

Good luck with this. Please keep us updated.

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