Headache
Chronic Headaches, Facial Pain, or Jaw Tension?
You may be living with a headache disorder—often misdiagnosed, but highly treatable.
Headache disorders are among the most common neurological conditions, and many stem from—or are worsened by—problems in the jaw, face, neck, or sleep.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we specialize in identifying the root causes of headache pain and providing targeted, non-surgical relief for patients across the Seattle area.
Learn About Headache Disorders
What are headache disorders?
Headache disorders are conditions that cause recurring or persistent pain in the head, face, or neck. While most people experience an occasional headache, chronic or frequent headaches, especially those that disrupt daily life, may signal a more complex condition.
These disorders are generally classified into:
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Primary headaches, where the headache itself is the condition (e.g., migraine, tension-type headache, cluster headache), and
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Secondary headaches, which are symptoms of another underlying issue, such as TMJ disorders, cervical spine dysfunction, sleep apnea, or sinus disease.
At Advanced TMJ Maxillofacial Pain & Sleep Center, we recognize that headache pain can stem from many overlapping systems: tight jaw or neck muscles, irritated cranial nerves, poor sleep, or jaw joint dysfunction. Unlike isolated headaches, these disorders are often chronic, multifactorial, and may not respond well to over-the-counter medications alone.
That’s why proper diagnosis—based on a full evaluation of your muscles, joints, posture, sleep, and medical history—is crucial. Understanding what kind of headache you have is the first step toward finding real, lasting relief.
What types of headache disorders exist?
A. Primary Headache Disorders
These are not caused by another medical condition. They are often chronic and may run in families:
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Migraine: Typically one-sided and pulsating, often accompanied by nausea, light/sound sensitivity, or visual disturbances. Triggers include stress, hormonal changes, sleep disruption, and jaw clenching.
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Tension-Type Headache (TTH): Feels like a dull, tight band or pressure around the head. Often linked to muscle tension, stress, poor posture, or teeth grinding.
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Trigeminal Autonomic Cephalalgias (TACs): Includes severe, stabbing headaches like cluster headaches. These often occur around one eye and are accompanied by nasal congestion, tearing, or eyelid drooping.
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Other Primary Headaches: Such as hypnic headaches (“Alarm Clock Headache”), cough headaches, and exertional headaches.
B. Secondary Headache Disorders
These result from another health condition—some benign, some serious:
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TMJ Disorders & Myofascial Pain: Dysfunction of the jaw joints or tight facial muscles can refer pain to the temples, eyes, or head.
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Cervicogenic Headache: Originating in the neck, this headache is often misdiagnosed as migraine or tension-type.
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Medication Overuse OR Rebound Headache OR Withdrawal Headache: Chronic use of pain meds, especially opioids or triptans, can cause rebound headaches.
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Giant cell Arteritis: an inflammatory disease of the blood vessels, most often affecting the arteries in the head, that can cause severe headaches, vision problems, and other serious complications if untreated.
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Sleep Apnea and Sleep Disorders: Poor oxygenation, interrupted sleep, or bruxism can lead to frequent morning or tension-like headaches.
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Post-Traumatic Headaches: Headaches after head or neck injuries (including whiplash) may persist for weeks or even months.
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Neurological or Vascular Conditions: Such as idiopathic intracranial hypertension (IIH), Chiari malformation, or aneurysm-related issues. These may require imaging and urgent care.
At our clinic, we use the internationally accepted ICHD-3 classification to guide diagnosis and tailor care. This ensures your treatment is matched precisely to your headache type, whether it’s related to nerve, muscle, joint, vascular, or systemic dysfunction.
Who is affected by headache disorders?
Headache disorders are among the most widespread neurological conditions—affecting millions across all ages and backgrounds. However, certain groups are more vulnerable due to hormonal, anatomical, psychological, or lifestyle factors.
Groups Commonly Affected:
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Women aged 20–50: Migraines and tension-type headaches are far more prevalent in women, often influenced by hormonal shifts (e.g., menstruation, pregnancy, menopause).
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People with chronic stress, anxiety, or PTSD: Psychological conditions can heighten pain sensitivity, promote muscle tension, and increase the risk of chronic daily headaches.
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Individuals with TMJ disorders or myofascial pain: Jaw dysfunction and muscle strain often mimic migraines or tension-type headaches and may go misdiagnosed for years.
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Patients with sleep disorders: Conditions like obstructive sleep apnea and bruxism can contribute to early morning or tension-like headaches.
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Those with neck injuries or whiplash: Trauma to the cervical spine can cause cervicogenic headaches that persist long after the initial event.
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Children and adolescents: High academic stress, poor posture from screen use, airway issues, or early signs of migraine are common in younger patients.
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Older adults: While migraines may decrease with age, new types of headache can emerge—such as temporal arteritis or medication-overuse headaches.
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Patients with neurological or systemic conditions: Headaches can be secondary to disorders like IIH, Chiari malformation, brain tumors, Parkinson’s disease, or autoimmune disease.
Why this matters:
Recognizing who is at risk helps prevent misdiagnosis and guides earlier, more effective interventions. If you fall into any of these groups and experience persistent or unusual headaches, it’s worth a comprehensive evaluation—especially if your symptoms haven’t responded to conventional treatments.
What are common headache symptoms?
Headache symptoms can vary greatly depending on the type of disorder, but there are common patterns that may help differentiate between primary and secondary causes. While occasional headaches are usually harmless, persistent, severe, or unusual symptoms may indicate a deeper issue that needs proper evaluation.
Common Symptoms:
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Throbbing or pulsating pain, often on one side of the head (common in migraines)
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Dull, pressure-like pain across the forehead, temples, or back of the head (seen in tension-type headaches)
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Sharp, stabbing pain behind the eye or in the temple (typical of cluster headaches or neuralgias)
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Facial pain that mimics dental, sinus, or ear issues
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Sensitivity to light, sound, or smells
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Nausea or vomiting, especially with migraines
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Aura symptoms – visual changes, tingling, or speech difficulties before a headache
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Pain worsened by movement, jaw use, or poor posture
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Referred pain to the neck, jaw, or teeth: often indicating TMJ or myofascial involvement
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Morning headaches, possibly related to clenching, bruxism, or sleep apnea
Why it’s important:
Because headache symptoms often overlap with TMJ disorders, sinus infections, neuralgias, or even dental problems, many patients get treated for the wrong condition. Accurate diagnosis starts with understanding the nature, frequency, and associated features of your headache—something our clinic specializes in.
How are headache disorders diagnosed?
At Advanced TMJ Maxillofacial Pain & Sleep Center, we take a holistic, evidence-based approach to diagnosing headache disorders—especially those involving the jaw, neck, or face. Many patients come to us after years of misdiagnoses or partial relief because their headaches weren’t properly evaluated.
Our Diagnostic Process Includes:
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Comprehensive history taking: We ask detailed questions about your headache frequency, duration, triggers, pain characteristics, sleep quality, past trauma, medications, and any coexisting medical conditions.
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TMJ, jaw, and cervical spine exam: We assess jaw joint function, bite alignment, jaw movement, and tenderness in facial and neck muscles.
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Trigger point palpation: We check for tight muscle knots that may be referring pain to the head or face.
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Posture and airway screening: Forward head posture, bruxism, and sleep apnea often contribute to headache patterns.
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Review of prior imaging or referral for new tests: If needed, we may coordinate with neurologists, ENT specialists, or imaging centers for advanced diagnostics (MRI, CBCT, sleep studies, etc.).
Why this matters:
Because many headache disorders are multifactorial, a one-size-fits-all approach often fails. By identifying structural, muscular, neurological, and behavioral contributors, we’re able to personalize your treatment and help you break the cycle of chronic pain.
When is a headache a medical emergency?
Most headaches are benign, even if disruptive. However, some headaches signal a serious underlying problem—such as bleeding, infection, or increased intracranial pressure—and require immediate emergency care.
Red Flag Symptoms That Require Urgent Medical Attention:
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“Thunderclap” headache: Sudden, severe pain that peaks within seconds—often described as the worst headache of your life. Could indicate brain hemorrhage or aneurysm rupture.
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Headache with fever, stiff neck, or confusion: May be a sign of meningitis or brain infection.
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Headache after trauma, especially in older adults or people on blood thinners.
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New headache in people over 50, especially with vision changes or jaw pain—may indicate temporal arteritis.
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Progressive headache with vomiting, blurred vision, or balance issues: Could suggest a brain tumor or raised intracranial pressure.
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Facial drooping, slurred speech, or weakness: Call 911—these may be signs of a stroke.
If you have these symptoms:
Please do not call our clinic. Go to the nearest emergency room or call 911 immediately. Timely medical evaluation can be life-saving.
At our clinic, we focus on diagnosing and managing non-emergent but complex or persistent headache disorders. If you’ve been struggling with chronic headaches that aren’t improving with traditional medications, we can help by investigating further.
How are headache disorders treated?
At Advanced TMJ Maxillofacial Pain & Sleep Center, we take an integrated, multidisciplinary approach to treating headache disorders. Our goal is not just to mask the pain, but to treat the root cause—whether it’s related to muscles, joints, nerves, sleep, or posture.
Why choose us for headache care?
At Advanced TMJ Maxillofacial Pain & Sleep Center, we take a comprehensive, evidence-based approach to diagnosing and treating complex headache disorders in the Seattle area.
Our care goes beyond symptom relief. We dig deep to uncover the true cause of your pain.
Led by Dr. Hemamalini Chandrashekhar, a board-certified Orofacial Pain specialist and dual-trained Oral & Maxillofacial Surgeon, we bring a unique expertise that bridges the gap between dentistry, neurology, sleep medicine, and headache care.
We specialize in:
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TMJ-related headaches
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Myofascial and tension-type headaches
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Migraine management
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Sleep-related morning headaches
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Post-traumatic and cervicogenic headaches
Many of our patients come to us after years of misdiagnosis, having tried dental work, ENT care, or medications with limited relief. We offer advanced diagnostics—including TMJ imaging, muscle assessments, and airway screening—and collaborate with neurologists, sleep physicians, and physical therapists to build a tailored care plan just for you.
Serving patients across Seattle, Bellevue, Kirkland, Shoreline, Kent, Auburn, Puyallup, and surrounding areas, our goal is simple: lasting relief and restored quality of life.
