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Question : I am a 60-year-old man. Lately I have been experiencing pain that starts on the lower jaw and goes up the side of my face towards the temple and then to the head. The pain is severe and lasts for about five minutes.
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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January 24, 2013
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A:

The most common cause of episodic face pain is an irritated nerve. Doctors call this neuralgia.

But I would first want to be sure that jaw pain is not a symptom of coronary heart disease. Jaw pain can be a symptom of angina. But the pain would not move higher up into the face. And there would be other features with angina, such as:

  • Pain brought on by physical exertion and relieved with rest
  • Chest discomfort
  • Shortness of breath
  • Sweating with the jaw pain
  • Pain spreading into the left arm or both arms

You haven’t described any of those symptoms. So a type of neuralgia is most likely. If you had shingles in the past, this could be post-herpetic neuralgia. Or it could be a disorder called trigeminal neuralgia, also known as tic douloureux.

Other considerations might include:

  • Cluster headaches. They are more common in men around your age. But it would be unusual for it cause jaw or facial pain. The headache is more throbbing and higher up in the head. So I doubt that’s the cause here.
  • Temporal arteritis. This is an inflammation of blood vessels that causes headaches and jaw pain with chewing. Usually the headaches last longer. And you’d have muscular aches and fever. It is important to at least consider this diagnosis because it requires prompt treatment with prednisone to avoid complications.
  • TMD (temporomandibular disorder). This might be contributing to the symptoms. This is especially true if there is discomfort and tenderness at the point where the lower jaw hinges to the upper jaw. Again, much less likely in your case.

You should call your doctor to discuss your symptoms. He or she can determine how quickly you need to be seen.

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