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Date of last update: 10/04/2017.

Forum Name: Neurology Topics

Question: Horrible facial pain. Nasal problems or TMJ?

 darkestdays30 - Sun Apr 20, 2008 6:14 am

I've been having horrible pain in my face. Very confused about what's wrong. For years, been suffering from pain in my nose (worst at the top of my nose, tender there and toward the bottom on each side of my face / probley about an inch below my eyes), sometimes also have spasms in my cheeks, & some pain shooting through gums, congestion, air getting blocked in nose, frequent visible blood upon blowing nose, pain in right temple, tingling sensations in face running through back of head.

Things that made me think it was nasal related:

Would wake up during the night with my nose completely blocked from air on both sides, while wearing a cpap. Forced air also worsened the pain. Had to quit wearing cpap.

Tube put down my nose at hospital for evaluation of upper GI bleed put my nose in the worst pain possible. Screemed & cried the entire time. It was nothing short of a nightmare!

Usual response to nitrogen gas causes my body to get numb all over & makes me feel really out of it, sometimes even falling alseep. Last time it was used on me, it did not phase me at all, one side of my nose got blocked up while breathing it through a mask, and it failed to work. That caused my nasal pain to flare up.

Have had alot of relief from pain using Flonase & antibiotic bacterial ointment daily in nose up to two months before pain frequently flared back up. Sometimes responded to antibiotics.

When it's really hot or either winter air makes it get bad. Usually spring & fall I get some relief from this pain.

Gasp for air through my nose all of the time while awake.

Diagnosis: bilateral turbinate hypertrophy, peridoxically curved middle turbinate, nasal passages get blocked from this, post-nasal drip, upper airway resistance syndrome (oxygen drops in sleep/have trouble breathing)

Now why I wonder if it's actually TMJ related.

A few months ago, developed pain at the bottom of my cheeks at the side toward the ears. There is also tenderness/pain below my ears around the bony area on my face on each side. Also been having numbness in my cheeks at times. Have ear pain sometimes without apparent cause. Hurts it a little to open mouth. Comes along with headaches and neck pain. Doesn't hurt to chew. Don't hear clicking or popping when eating, just if opening mouth wide. TMJ physical evaluation by dentist says it's TMJ but what confuses me is I have no problem whatsover with opening of my mouth or my bite.

Haven't been having my nasal problems along with this pain, but until about 2 weeks ago. Now I feel pain throughout my nose again, feels like it's radiating from the pain on each side of my cheeks.

I have been to 2 ENT's, one saying my nasal problems would not cause pain, the other pretending I didn't even have the problem. Pain got unbearable, leaving me swallowing handfuls of ambiem to relieve the pain. Last ENT sent me to a neurologist for evaluation of mild migrane headaches, which was a ridiculous diagnosis, but I went anyways. She said I did not have the symptoms of migranes/headaches and from my symptoms, definately thought it was nasal related.

How could it not be nasal related? It's seemed to me to prove itself to be. Pain getting worse during forced air through my nose. But why am I feeling the pain with this new occurance of jaw pain? Could it all be related to TMJ or could it be both? The only other time I ever had TMJ issues, it was completely medication inflicted, no pain in joints, just in muscles, limited opening of mouth, cleared up after discontinuation of medication. And not once in the past couple years during this nasal pain did I have any pain whatsover in my TM joints. So this makes NO SENSE whatsoever.
 John Kenyon, CNA - Thu Jul 31, 2008 9:02 pm

User avatar Hello -

While the nasal problem would seem to have been diagnosed accurately (I was thinking chronically blocked deep sinus before I got to the part about the turbinates being enlarged and one deviated), so I think that answers that part and that you may well have TMJ as well. There's certainly no rule about not having more than one problem at the same time, and since they affect areas close to each other it would likely cause some confusion and symptom overlap. I'd get the jaw alignment checked for sure, as many with TMJ have rare or totally absent clicking as well as little no no limitation on opening the mouth, but still have numerous other related symptoms, which could most assuredly be overlapping with the pain and discomfort from your nasal/sinus problems, which almost certainly are an entity in themselves.

Good luck to you with this. Please do follow up with us as needed.

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