Brain Pain: Tracking Triggers Key to Headache Cure

Lifestyle sleuthing is the best way to corner the prime suspects behind headache pain, says noted Encino dentist Allan Melnick. Armed with the facts, medical professionals can customize treatment to free patients from debilitating migraines, TMJ and tension headaches.

Los Angeles, CA, May 11, 2011 --( April showers bring May flowers…and pollen, allergies and sinus headaches. The flowers are things of beauty, but the headaches can be beastly.

“At this time of year, pollen allergies are a prime suspect when sinus pain and pressure are present,” says Dr. Allan Melnick, a noted clinical dentist in Encino, Calif. “Springtime headaches cause a lot of grief, but it’s important to track down the true source of all the pain. It could be pollen, but it also could be a migraine or jaw joint malfunction – which need something other than a decongestant.”

Non-migraine headaches affect nine out of 10 Americans, according to the American Council for Headache Education. A whopping 40 million Americans are affected each year by sinusitis, reports the Cleveland Clinic, a hospital known internationally for its medical research and treatment. Another 20 million people report jaw or lower facial pain, and the National Headache Foundation estimates that 30 million people are plagued by migraines.

Headaches typically fall into five categories:

Migraine headaches
Temporomandibular joint headaches (TMJ)
Sinus headaches
Cluster headaches
Tension headaches

Different things trigger headaches, including stress, caffeine, weather changes, alcohol, hormone fluctuations and allergens like pollen, mold and second-hand smoke, says Melnick, a former UCLA dentistry professor. Vascular and neuromuscular factors are linked to most headaches, he noted, and – in some cases – genetics.

“I see lots of patients with TMJ in my Encino office,” says Melnick. “Sometimes, we can pin the pain on a specific incident – like an elbow to the chin in a sporting accident. Other headaches are due to clenched teeth and stress or something as simple as a yawn gone wrong. Regardless of the cause, the pain can be debilitating.”

Sinus headaches occur when the membranes lining the sinuses become inflamed and swollen, says Melnick. Bacterial or fungal infection linked to a cold, allergies or malformation in the nasal cavity are the typical cause. Antibiotics and decongestants are used to treat the infection and minimize swelling that is causing pressure and pain.

On the other hand, migraines, cluster headaches, TMJ and tension headaches are usually linked to overworked muscles and an incorrect bite, says Melnick.

“The jaw is supposed to work in a relaxed and synchronized way. However, if the teeth don’t come together correctly, the masseter muscle in the jaw has to work overtime,” explains Melnick. “Pain radiates into the jaw, ear canal, neck and temple. In cluster headaches, the temporalis muscle seems to be involved. It’s the fan-shaped muscle that starts behind the eye and spreads up over the ear and temple area. The pain is intense and chronic. Often physical therapy – things like massage and chiropractic treatment – can offer some relief, but the underlying triggers will need to be determined.”

Migraines are the most intense variety of headache, causing nausea, extreme light sensitivity, vomiting and asymmetrical pain patterns. Women are particularly vulnerable. Triggers seem to vary, but nerve and vascular impingement are suspected, along with muscle tension. Food, hormones, medicines and stress are often linked to pain episodes. Drug intervention and lifestyle changes typically are required.

Headaches are a major source of physical stress, work absenteeism and loss of work place productivity. Researchers at Maryland’s AdvancePCS Center for Work and Health and Geisinger Health Systems in Pennsylvania found that 13 percent of a large workforce sample experienced loss of work productivity due to pain. The most common pain complaint noted among the 28,902 working adults studied was headache – at 5.4 percent. Back pain (3.2%) and arthritis (2%) were the second and third most common work day disruptors. Pain conditions among the employed cost the economy more than $61 billion per year, the study stated.

“Figuring out your personal headache triggers is the way to lower the number of headaches and their severity,” says Melnick, senior dentist for “That means you need to keep a health diary, see your dentist, and get a full workup at your personal physician’s office. Then, armed with information, we can fit you with an NTI mouthpiece for TMJ, send you to an allergist or dietician, or suggest yoga, massage, antihistamines or another therapy.”

Allan Melnick DDS
Allan Melnick