Germán Sandoval, M.D.

Otorhinolaryngologist Surgeon

Pain in head and neck is produced by a complex variety of causes, neurological, vascular, muscular, joint, ligament or osseous disorders. Sometimes, same symptoms occur, for different diagnosis, which always confuses doctors and patients. Sometimes, these symptoms even defy logics, due to their complex mechanisms. 

There is a clear link between head-neck-back disturbances and symptoms due to muscular tension at those levels, which is known as “Temporomandibular Disorders”. Persons usually report this muscular tension as back-nope stiffness and facial-oral tenseness or tightness, usually along with pain. These symptoms, in early or recurrent stages can even threaten, in a serious way, normal social life, or work performance, and in general, life quality of patients. 

Temporomandibular disorders are the cause, in most cases, of referred pains at ears, head, neck and back. These problems equally affect adults and children; they affect more women than men (nine women per one man). The correct diagnosis of a referred pain depends on its intensity, location, and the duration of the stimulus, which produces chronic pain conditions, that usually fake neuralgic symptoms at ears, face, eyes, forehead, temples, back of head, nope and back. 

Stress usually triggers pain at these mentioned zones. Anxiety and depression are the most common psychological conditions involved; they produce a high muscular activity, that unleashes muscular and osseous peripheral constant irritation.

Headaches and cephalalgias belong to craniofacial pains group. Migraines also belong in that category. Migraines affect one in five women, and one in 20 men. This is unfortunately a common disease, poorly understood and diagnosed. 

On the other hand, there is also a connection between masticatory system and ears, which in presence of a muscular dysfunction, will create painful and non- painful symptoms in this zone. This way, when hyperactivity of masticatory muscles (bruxism) occurs, because of an increased emotional tension, ear muscles are also stressed, making possible even spasm conditions and functional problems within structures connected to muscles in the ear. In this case, patients report clogged ears sensation, noise inside the ears (tinitus), earache and symptoms like subjective hearing loss or even vertigo. All of this belongs in the category of stressed ear symptoms. 

Otorhinolaryngologists must always be supported by experts in oral rehabilitation, and, specifically in Temporomandibular disorders and craniofacial pain, to achieve a sustained clinical success, by an adequate use of modern programmable devices, that allow a diminished muscular activity, together with relief from referred symptoms.

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