Dr. Shapira's Chicago Headache Blog

Neuromuscular Dentist in Chicago, IL Accepting Patients Nationwide & Worldwide

Sphenopalatine Ganglion Block (SPG Block) and Headaches, Migraines, Cluster Headaches, Chronic Daily Headaches and New Persistent Headaches

September 15, 2018
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Headaches and Migraines are almost 100% caused by the Trigeminal Nervous System.  This is accepted by all specialties of medicine who deal with headache patients.

The Spenopalatine Ganglion Block, Pterygopalatine Ganglion Block or SPG Block is known to be one of the safest and most effective means of preventing and treating migraines and tension headaches.

The Spenopalatine Ganglion is the largest parasympathetic ganglia in the head.  The other ganglia are the Ciliary Ganglion, the Submandibular Ganglion and the Otic Ganglion.

The Sphenopalatine Ganglion was made famous by the best selling book, "Miracles on Park Avenue" where it was explained how SPG… Read Full Post

Why haven't I Heard of SPG Blocks Before?

August 22, 2018
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The Sphenopalatine Ganglion Block has been used for while over a century.  So, why does it seem like nobody has ever heard of it until recently and why is it changing now.

According to an article in the Pain Practitioner in 2004, "Sphenopalatine Ganglion Blockade: A Review and Proposed Modification of the Transnasal Technique Report of Technique" by  Robert E. Windsor, MD, and Scott Jahnke, DO  the accepted uses of "the SPG block are sphenopalatine neuralgia, trigeminal neuralgia, atypical facial pain, acute migraine, acute and chronic cluster headaches, herpes zoster involving the ophthalmic nerve and a variety of other facial neuralgias. The mechanism by which… Read Full Post

Are Trigger Point Injections More Effective Than Botox In Treating TMD (TMJ) Myofascial Pain

July 16, 2018
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A recent study in Pain. 2011 Apr 21 looked at botulinum toxin type A for treatment of persistent myofascial TMD pain. Saline was used as the placebo-control in this double blind study. The crossover study examined 21 patients Myofascial TMD with inadequate pain control.

The study was done to evaluate the effectiveness of botulinum toxin type A for treatment of persistent myofascial TMD pain but actually showed that Saline is normally considered an excellent placebo because there are no direct biological changes associated with saline. There was statistically no advantage to botulinum toxin type A over saline.

I hypothesize that the improvement in pain showed in the study… Read Full Post

Headaches Since I was a teenager worsening and becoming excruciating .

July 01, 2018
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Tell us about your headaches... Stephanie I've been suffering from headaches since I was an early teen. It was around the age of 17 that they began to worsen. I noticed when I would stand up or sit down quickly, I would get these excruciatingly, sharp pains in one area in my head- generally, the right side. It feels almost like someone is using a crowbar to pry open my skull. Now my headaches have progressed as I have gotten older. Now when I start getting those headaches the excruciating pain comes out of nowhere. I'll be walking across the room and I get the "crowbar" feeling- very intense, very brief. But I'll still have a constant, underlying headache with bursts of pain. I've… Read Full Post

TMJ AND POSTURE: THE INTIMATE CONNECTION BETWEEN CHIROPRACTIC PROBLEMS AND TMJ DISORDERS (TMD) ARE CRITICAL.

April 09, 2018
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PATIENTS LIVING WITH TMJ DISORDERS, CHIROPRACTIC DISORDERS, HEADACHES AND MIGRAINES are alll suffering from the same underlying disorders. It is well recognized that it is impossible to achieve long term successful treatment without addressing both the dental, TMJ and Trigeminal components in conjunction with with the Chiropractic aspects of care.

Atlas Orthoganal Chiropractic or NUCCA chiropractic focus on the first two vertebrae. Both are excellent techniques but I usually prefer working with A/O chiropracters as they take a more universal approach to care. Many NUCCA chiropracters think that they can correct everything even though research at the prestegious Las Vegas Institue… Read Full Post

HEADACHES AND MYOFASCIAL TRIGGER POINTS: HIGH POWER ULTRASOUND VS TRIGGER POINT INJECTIONS EQUIVILANT FOR TRAPEZIUS MUSCLE TPs

April 03, 2018
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I have found that trigger point injections are extremely effective in reducing tension-type headaches and frequently can completely eliminate them when combined with a neuromuscular orthotic. This current study from the Archives of Physical Medicine and Rehabilitation shows high-power ultrasound as effective as trigger point injections in treating the Trapezius muscle.

The Trapezius muscle is a large easily treated muscle that can cause referred headache pain. Trigger point injections took less therapy sessions but there was equal effectiveness to both treatments. When treating headaches many of the muscles that cause tension-type headaches are not good candidates for high-power… Read Full Post

DANGERS OF WISDOM TOOTH REMOVAL: PARESTHESIA, MPD, TMD, TMJ DAMAGE AND HEADACHES ARE THE PRIMARY CONCERNS OF WHEN REMOVING MANDIBULAR THIRD MOLARS

March 25, 2018
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DANGERS OF WISDOM TOOTH REMOVAL: PARESTHESIA & TMJ DAMAGE ARE THE PRIMARY CONCERNS OF WHEN REMOVING MANDIBULAR THIRD MOLARS

THIS IS A REPRINT OF A SLEEP AND HEALTH JOURNAL BLOG. I THINK IT IS IMPORTANT TO UNDERSTAND THAT THERE MAY BE A RELATION BETWEEN CHRONIC HEADACHES, MIGRAINES AND TMJ DISORDERS AND REMOVAL OF WISDOM TEETH. I BELIEVE THERE IS A BETTER ALTERNATIVE.

The removal of mandibular third molars frequently results in associated morbidities, the most concern is about paresthesia or permanent numbness from nerve damage. I have also frequently seen patients with TMJ disorders (TMD) such as joint locking, clicking or pain after removal of wisdom teeth. Chronic… Read Full Post

cluster headache and SPG (sphenopalatine Ganglion block) Block

March 19, 2018
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I have been a strong advocate of utilizing sphenopalatine ganglion blocks to treat cluster headaches, acute and chronic daily migraines, sinus headaches and chronic daily headaches. The following Pub Med abstract is a case report on utilizing lidocaine (an extremely safe drug) to do SPG blocks for cluster headaches.

The Ptsosis (wikipedia...Ptosis (from Greek Ptosis or πτῶσις, to "fall") is a drooping or falling of the upper or lower eyelid ) as well as the pain responded to the block. It is important to note that SPG… Read Full Post

Dental Implants, Missing Teeth and Headaches

March 17, 2018
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Patients missing one or more permanent molars are more prone to headaches and TMJ disorders. Missing just a single first molar has been shown to double the resk of headaches, sinus pain and /TMJ disorders. When the molars are missing there can be drastic increases in headaches and TMJ disorders. Patients with loss of vertical dimension are more prone to morning headaches, sleep apnea and migraines.

Dental Implants are frerquently used to replace missing teeth when treating headaches and migraines associated with TMJ diorders.

Neuromuscular Dentistry, Central Sensitization and Trigeminal Neuralgia: Is Neuromuscular Dentistry an ideal method to prevent central sensitization?

February 23, 2018
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A new article in Medical Hypothesis (see Pub Med abstract below) on Atypical Trigeminal Neuralgia discusses the pathogenisis of Central Sensitization in patients with Trigeminal Neuralgia. A percentage of patients with Trigeminal Neuralgia will have pressure on the trigeminal nerve either from blood vessels or tumors usually in the area of the foramen ovale.

Many patients who have trigeminal neuralgia have no overt cause for the disorder. When there is a tumor or blood vessel creating undue pressure on the nerve a surgiclal approach is usually corrective but the central sensitization may remain. This article postulates that time is of the essence and the longer the pain persists… Read Full Post