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Doctor, Why Does My Face Still Ache, Donald R Tanenbaum, tmj book

Causes of Facial Pain: The Psycho-Muscle Connection

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: February 28, 2012

The Muscle Connection is Key

In my upcoming book, Doctor, Why Does My Face Still Ache?,” we explore puzzling questions that do not have simple or anticipated answers:
• Why would a person experience a constant toothache when the tooth that hurts is completely fine?
• How does someone gradually lose the ability to open his or her mouth or talk when there hasn’t been a direct injury to the area, or medical disease diagnosed?
• Why does someone experience non-stop aches or pains in their face when a medical evaluation suggests that nothing is wrong?

Unfortunately in the search for answers, many practitioners tend to overlook the muscle connection when it comes to the cause of facial pain. But considering how much of the face is made up of muscles, it’s beneficial to know how muscles can be affected by factors such as emotional issues and the stress of life-challenges. In the book, I call this state a “Brain Under Siege.”

Facial Pain and Emotions

A brain is under siege when it is faced with many challenges, which may include but not limited to:
• Economic uncertainty
• Loss of control relating to illness, aging parents, work relationships, etc.
• Inability to express fear and anger
• Pressure to “Keep Up with the Joneses”
• Marital and or relationship turmoil

For patients experiencing one or more (or perhaps all) of these stressors, the toll it can take on jaw and neck muscles could directly cause facial pain. I realize that many people might want to reject this theory. Our culture is such that we often look for external or structural causes of facial pain. Even medical professionals are tempted to ignore these connections to muscle pain, perhaps because they’re uncomfortable posing sensitive questions to their patients. But this doesn’t mean that a connection doesn’t exist.

Of course there are many causes of facial pain, and in many cases traditional methods of relieving this pain works fine. But each patient needs to be evaluated individually, and all aspects of what causes facial pain need to be taken into account. Most facial muscle pain sufferers can be helped, and it often requires patient insight and participation so the proper treatment can be applied.

Though we often wish it were so, sometimes facial muscle pain can’t be solved by the patient simply walking into the office and saying, ‘Doctor, fix me.’

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problemsTMJreferred painnerve pain, and migraines. Find out more at

DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

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