Tuesday, April 10, 2012

What is pain?

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

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What is pain?

Pain is a natural systemic reaction. In its basic form, it is a beneficial phenomenon. Without the ability to feel pain humans would not be prepared for situations that can cause bodily injuries. Pain helps humans to learn to avoid dangerous stimuli.

Pain is an uncomfortable feeling that tells you something may be wrong in your body. The sensation of pain is formed when the nerve endings that sense pain are irritated. This is the case, for example, when there is beginning tissue damage. Active substances that irritate the nerve endings are released in this specific area, and they cause a local inflammatory reaction. The irritation is transmitted via nerves to the spinal cord and then higher up to the central nervous system, where the sensation of pain is first formed.

Organs have different nerve endings, and the pain impulses travel to the central nervous system via various nerves. The nerve endings on the skin transmit pain quickly and the pain perceived in the brain corresponds clearly to the origination site. There are fewer nerve endings that sense pain in the internal organs, the impulses travel via slower neurofibrilla, and it is more difficult to locate the pain originating from there.

Short-term pain is called acute and long-term pain chronic pain. Persistent pain sometimes has no useful purpose; it may be just a nuisance. However, it may affect the ability to work and have a negative effect on life.

Different mechanisms that can strengthen or weaken the pain impulses exist at the pain origination site, on the way to the central nervous system and in the central nervous system itself. Generally, the tissue damage that caused the pain will heal, but if there are several factors that increase the pain level, the nervous system may become programmed wrongly, and the pain may become chronic.

The factors that can make one prone to chronic pain are lack of activity and a sedentary lifestyle, long time illnesses, sleeplessness, a learned behavioral model or continuous additional stimuli and psychic factors. Pain processes are linked with the emotional centers in the brain. If a person is depressed or anxious, it may worsen his pains.

When pain becomes chronic, it will be much more difficult to treat and the treatment outcomes are worse. Thus treating pain at the right time efficiently and appropriately is the best prevention of constant pain.

Pain News

The same painkiller is not effective for everyone

The Cochrane Library published an overview of 350 published reviews with 45 000 participants concerning painkillers in pain following surgery or removal of wisdom teeth. No drug gave good pain relief for everybody. The best result was pain relief in 70%, the worst drugs alleviated pain only in 30% of the patients.

Ibuprofen, diclofenac, etoricoxib, celecoxib, naproxen and codeine with paracetamol, gave good pain relief. Etoricoxib, celecoxib, naproxen, diflunisal and oxycodone with paracetamol had a duration of action more than 8 hours.

The results show that several pain medications and combinations thereof, are effective for many, but none of the drugs guarantees relief for everyone. Therefore, one should not be too surprised if they is no immediate good enough analgesic effect. In this situation the drug should be changed to another.

Pain as art

A collaboration with pain specialist Professor Joanna Zakrzewska, Deborah Padfield and facial pain clinicians and patient at University College London Hospital, produced an exhibition MASK:MIRROR:MEMBRANE. It gives sufferers a voice and studies pain as art.

Other painters have also tried to illustrate their pain. Place for pain exhibition.
More pictures of pain art experience.

Sunday, April 1, 2012


Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

Headaches are very common and there are several headache types. Headache may also be called cephalgia. An estimated 80 percent of people suffer from headaches periodically. It is by no means always a sign of an underlying illness—you can get a headache because of a flu, too much partying, overexertion or nagging problems.

There are many headache causes, but it is rare that a headache should signal a life threatening illness, but seeing a doctor is advised if the headache disturbs daily life, or it changes its form. A new and sudden headache symptom should always be looked into promptly. Headache treatment can be effective and there are a lot of efficient remedies for headache, so one has no reason to grin and bear the pain.

Tension Headache

The most common cause for headache is muscular tension. Approximately, a third of Finnish adults suffers from it. It was thought to be caused by excessive tension in the head and neck area muscles, which cuts down on circulation and causes pain.

The exact origination mechanism is not known. According to some theories, tension headache could be due to central nervous system reasons. One explanation is a functional disorder between different areas of the brain.

Patients with tension headache react sensitively to pain. Anxiety and depression are also common with these patients. There are suggestions that those experiencing tension headaches are characteristically more conscientious and perfectionist.

Heredity most probably plays a role in tension headaches. According to one research project, close relatives of those suffering from tension headaches are three times as likely to have the same symptom.

The pain associated with tension headaches is commonly described as a tight band around the head or a tightening, pulling or shooting pain or as muscle stiffness. The scalp may feel sensitive. The sensations are usually felt on both sides of the head but may be on one side only. The pain is mostly felt in the back of the head, forehead, temples and top of the head. Usually the pain begins gradually and gets worse towards the afternoon.

Unlike in migraines, there generally are no visual symptoms like blind spots or flashing lights, vomiting, pain in the stomach, additional feelings on one side of the body, or disturbances of speech. In migraine physical activity usually increases headache, not so in tension headache.

Tension headaches can be periodic or chronic. In the case of periodic headaches, the headache lasts for a few days. If the headache is present more than two weeks per month, it is classified as a chronic tension headache. The periodic headache can become chronic, constant headaches are, however, rare.

There are normally no warning symptoms. The headache is not particularly strong, but can be felt for days and weeks, sometimes longer. The headache is usually continuous and not episodic.

Stress and a busy lifestyle, jaw clenching or depression and anxiety may trigger tension headaches. The symptoms can get worse with a poor posture when working at a computer, driving a car or while performing comparable functions. Sometimes the headache is accompanied by an unpleasant feeling of dizziness and unsteadiness. Nausea may be present as well. Exercising and spending time outdoors generally are helpful. The symptoms normally ease up during the time off from work.

The examination often shows sore muscles sometimes both in the neck and head region. There are no visible signs of disturbance in the nerve functions. If additional examinations like MRI are performed, they usually show no abnormalities. X-rays or MRI may show straightening of the cervical spine as a sign of increased muscle tension.

The treatment usually consists of anti-inflammatory medication, muscle relaxants, antidepressants, physiotherapy, and acupuncture. In the most problematic case hypnosis or biofeedback may be useful in increasing the ability to relax. It sometimes takes time to find the best headache cure, but relief usually can be obtained.

In physical therapy, the initial emphasis is on relaxing the muscles. If harder training is pursued when the muscles are very tense, it may cause a worsening of the symptoms. In milder cases the treatment initially can also include exercise.

As first aid, anti-inflammatory medicines may be used to treat tension headache according to the package instructions. Your doctor may prescribe medication to relieve symptoms as they appear or as a preventive method to decrease intensity and frequency of the headaches.

Correct posture while working and performing housework is important as well as taking short breaks during which one can do light neck and shoulder exercises.

While working at the computer it is important to make sure that there is enough room in front of the keyboard and that the monitor is not placed too high. Avoid using a diagonal work posture. The monitor should be free of reflections. If necessary, one should get glasses that lend themselves to work with computer terminals.

Working in continuous stretches and driving long distances should be avoided. While driving, hold on to the lower half of the steering wheel and try to relax the shoulders whenever possible.

While working, check periodically whether your muscles are too tense, and then try to relax them. If you have a tendency to push your head forward while working at the computer, observe and correct your posture several times a day.

Keep your neck straight while sleeping.

A suitable form of exercise would be one where the muscles contract and relax as a counterbalance to permanent tension. Make sure you are in good general condition.

Hobbies that cause muscle tension, such as crocheting, knitting and reading while lying down should be avoided.

Choose sports where you can exercise the muscles in multiple ways. While swimming, for instance, it would be good to learn different styles such as crawl and backstroke and switch between them. Practice breaststroke so that your head is periodically straight under water. Use a cap and goggles if you don’t want to get water on your hair or in your eyes.
It is important to relax adequately. An orderly lifestyle lessens the symptoms. Avoid staying up too late.


It is easy to differentiate between a migraine and a tension headache in the most typical cases. Unfortunately sometimes the symptoms do not adhere to the textbook versions, and one can experience both symptoms at the same time, and they may feed off each other.

Preliminary symptoms such as vision, hearing, speech or movement disturbances can exist before an actual migraine attack. This so-called aura stage may last for several minutes. Vision disturbances occur in both eyes and may involve, for instance, blurred vision, zigzag figures, a blind spot, tunnel vision, stars or spinning bright light or pain in the eyes. Aura usually develops about 10 minutes before the actual migraine pains. Not everyone, however, has an aura. When the actual migraine attack begins, the aura usually fades away.

Migraine headaches can be severe. They often start on the same side every time and pain is worse on one side. In the classic migraine, the headache is pulsing or pounding and can be accompanied by nausea and vomiting, increased urination, diarrhea, shivering, sweating, chills, trouble finding words, fatigue or loss of appetite, heart symptoms and changes in blood pressure that can be periodic in nature.

Even though functioning may not be possible during the active migraine headache, the time between the episodes is usually asymptomatic. Sleeping, cold or dark environments relieve, and physical exertion will make the pain worse. During the attack light and strong noises disturb the patient, and all senses are keener.

Some patients may have a hangover type of state after migraine attacks when they need to sleep additionally and feel they're thinking is not very clear.

Women are more prone to migraine and heredity plays a big part in its onset. In most cases the symptoms appear before the age of 35, but can begin even during menopause. A daughter whose mother suffers from migraines has a 50 percent likelihood of getting migraines. Migraines can also skip a few generations. Migraine attacks may be triggered by hormone changes during a menstrual cycle or by birth control pills.

Foods like chocolate, red wine, and cheese can trigger a migraine. Some additives such as nitrates, monosodium glutamate, tyramine and aspartame can act as triggers. Marinated foods, foods preserved with vinegar, and fermented foods may trigger a migraine. Nuts, pizza, and very cold beverages or foods have been associated with the onset of a migraine.

This does not mean that all these foods cause headaches in any one person. It can be just one food or substance and in that situation others can be used without restrictions. If a food causes migraine, it will do it every time the food is eaten.

The reason for migraines and other vascular headaches is apparently vascular constriction in the beginning stage and expansion at a later stage. Active substances that cause inflammation-like changes are released in connection with this, and that causes pain.

The cause for this is unclear. It seems that the vascular system of those people who get migraines is more sensitive to stimuli. Migraine in women is a risk factor for disturbances in cerebral blood circulation. This risk is multiplied with the use of birth control pills and tobacco products.

When suspecting a migraine, the most important research method is mapping of the symptoms and a thorough examination performed by a doctor. Modern methods such as computer tomography and an MRI can easily rule out tumors or other serious illnesses as causes of the headache.

Headache journal is a good way to follow your headache symptoms, memorize the duration, location and severity of the pain, medications and their effects and possible outside factors triggering headache. It will be easier for your doctor to find a better cure for the headache.

Rest and medication are the most important parts of treating a migraine. Cold compresses can be used as well. An hour’s rest is recommended even though the symptoms might disappear with medication. It is important to find the right medication. There are many efficient products on the market, and a doctor can help you find the most suitable one for you. If migraines are frequent, a continuous preventive treatment may be necessary. Neurologists are the best experts on migraine and its medication.

Migraine medications to be taken during migraine attacks to stop symptoms that have already begun are most often nonsteroidal anti-inflammatory drugs or NSAIDs, triptans or substances that contain ergotamine. The pain medication can be taken together with an anti-nausea medication or in combinations. If it is necessary the medication can be given in the form of suppositories.

It is best to take pain-relieving drugs when first signs of a migraine attack are felt. For optimal effect, it is good to rest or sleep in a dark room if this is possible.

Preventive medications can also be used. They are usually taken regularly to prevent attacks or to make them less severe.

Acupuncture treatment may sometimes prove amazingly efficient in treating migraines. Biofeedback may be effective in migraine. Relaxation techniques, massage, herbs and vitamins are also used.
If a substance, stimulus, hurry, neck-straining work or stress triggers a migraine, prevention is the best way. This can be difficult, in reality, with other factors than food and sauna going habits. It is hard to avoid stressful situations and work pressure entirely. The least one can do is to use correct ergonomic work posture.

Anyway, triggers should be avoided as much as possible. Self-care should include steady sleeping patterns with enough but not too much sleep. Muscle relaxing exercises can be tried. Some people may get rid of migraines by eliminating episode-causing foods and beverages from their diet. Experimentation is the key here. The triggers can be listed by keeping a headache journal, where notes on attacks and the circumstances leading to them, such as foods or beverages, are noted.

Some experience suggests that prevention of low blood sugar levels may prevent migraines. The method entails eating small meals several times a day in order to keep the blood sugar level stable.

Migraine patients might try stopping smoking and excessive drinking of coffee, as these may make the symptoms worse.

Tension headaches and migraines can often be found in the same person. In this case, one illness may worsen the symptoms of the other. During a migraine, muscles become tenser, which can trigger another tension headache. In this situation, it is advisable to treat both problems simultaneously.

Withdrawal Symptom

When treating migraines and other pain, one must also note that in some people the overuse of medication can cause headaches. This applies to the previously often used ergotamine as well as to all other pain medications, including the new migraine medications. When a person gets used to a medication, it will help the headaches, but over time the low blood level of the medication may cause by itself a rebound-type headache.

Headache may be caused by use of some chemical, for instance an additive, or its termination, also overuse of medication may induce headaches. The more common withdrawal headaches occur with caffeine, estrogen and opioids. Furthermore, nitrates, analgesics, oral contraception medication, corticosteroids, tricyclic antidepressants and many other drugs may cause this problem. Diagnosis of withdrawal headache is usually clear only when other reasons have been excluded and if the headache disappears or improves after withdrawing the substance.

Ergotamine will cause dependence if taken every other day. The understanding of the risk level of pain medication is not as clear. It is estimated that only 20 doses of medicine per month may cause withdrawal symptoms and those who take at least 100 doses clearly increase their risk of incurring problems of this type.

The symptom is usually a continuing low-grade headache that is worst in the morning and is relieved shortly after taking pain medication. Other symptoms such as nausea, anxiety, feeling less alert and energetic and experiencing difficulty concentrating and memory problems may appear. The headache is felt as a dull ache on both sides of the head on the forehead, temples, and the neck.

It is advisable to change the medication with the help of your doctor. Sometimes it may be the easiest to do this in a hospital environment. Most people will be able to lower their use of medication, which will also reduce the frequency of headaches.

Those who drink a lot of coffee may experience a morning headache when the level of caffeine in the blood is low. They may experience headaches during the day for the same reason. Even three cups of coffee a day will cause a caffeine dependency.

It has been demonstrated that stopping daily caffeine intake changes blood flow in the brain. This is likely to give the caffeine withdrawal headache. It has also been registered changes in EEG rhythms in the withdrawal period that are considered to be linked to the fatigue.

In a situation like this it would be advisable to stop drinking coffee. Withdrawal symptoms may appear, but as they pass, the headaches will be reduced as well. If you love coffee, you may start drinking it again after a few weeks, but only a maximum of one cup per day. It is good to remember that other products than coffees also contain caffeine.

Vascular Headaches

It used to be thought that blood vessel dilation is the main cause of the pain in a group called vascular headaches. Cluster headaches serial headaches, migraine and toxic headaches were described as being part of this group.

Less common than migraine are the so-called cluster headaches and serial headaches. The basic causes for these headaches are not known. Probable impetus for the symptoms may be a regulation disturbance in the hypothalamus.

The pain is usually one-sided and very strong. It is accompanied by tearing in the eye region. Nostrils may become stuffy and there may be many episodes in one day. The painful period lasts from weeks to months and is followed by an asymptomatic period during several months or even years. Sometimes the illness may become chronic.

Diagnosis is based mainly on the symptoms. Sometimes at the time of the attack one may see constriction of the pupil, drooping of the eyelid and redness in the conjunctiva. The episode may begin after sleeping, taking a sauna, or drinking alcohol. Rest does not alleviate the pain as is generally the case with migraines; on the contrary, rest may actually worsen the situation.

Initial treatment may be in the form of anti-inflammatory pain medication. If this does not work, the newest migraine medication may give relief. Breathing pure oxygen is often helpful but difficult to arrange in real life. Cortisone has been used in breaking up the period of pain.

Exertion headache

Some people get strong short-term headaches in connection with physical exertion. The reason for this is believed to be vascular. There are three types of these headaches. It may occur in about 1% of people in connection with physical exertion, cough or sexual activity.

The pain starts immediately or very quickly after beginning of the triggering physical activity. The pain is usually very intense and is often described as bursting or explosive. Most people have bilateral pains; the headache may be in any location.

Most exertion headaches are benign but anyone developing a severe headache of this type should be checked by a specialist because sometimes intracranial reasons or other neurological problems may be behind this phenomena.

Sinus Infections, Sinus Headache

Maxillary sinus infections are a very common reason for headaches that cause sufferers to get treatment. Almost a third of the patients at health care centers falls in this category.

The maxillary sinuses are cavities inside the skull. When they get infected, their mucous membranes swell and infectious secretions may collect in them. The maxillary sinus openings may get blocked, which causes pressure as the secretions increase. It is most common to have symptoms in the maxillary sinuses, but the frontal, ethmoid, and sphenoid sinuses may also get infected.

The risk for maxillary sinus infections is higher if a person tends to be allergic, if he has hay fever or asthma, or if he smokes. Maxillary sinus infections often accompany various respiratory infections. Anatomical risk factors include a deviated nasal wall or polyps. A foreign intranasal object, swimming or diving, climbing in high altitudes, flying or pressure injuries may also have an effect.

Headache typically starts when a person has a cold or just after it. The symptoms of a maxillary sinus infection may include, in addition to headaches, a feeling of heaviness in the cheeks or pain in the cheeks or behind the eyes. Pain during vibration or sudden movements may be felt in the teeth or cheek. Because mucus has been collecting during the night, pain may be worse in the morning. Sudden changes in temperature may worsen the pain.

The nose can be stuffy with purulent, yellow or green discharge that can drip down the throat. There may be swollen passages of the nose and also symptoms of infection like mild fever or general feeling of fatigue and not feeling well.

During a doctor’s examination, the patient may have painful sensations when tipping the head forward or when the cheekbones are tapped on. Face may be tender to the touch.

The diagnosis can be obtained with the help of an x-ray or an ultrasound. The best way of diagnosing this problem is a maxillary sinus puncture. Then the symptoms are being treated simultaneously as the bacteria are sampled for their resistance to antibiotics.

The treatment of a maxillary sinus infection usually consists of antibiotics when nasal drops used to shrink the mucous membranes or allergy medication won’t cure the symptoms. If antibiotics don’t work, a maxillary sinus puncture may be a necessary treatment option.

As a self-remedy, nasal drops that shrink the mucous membranes can be used. The best way to administer the drops is by lying down. When the drops have been placed in the left nostril, it is advisable to wait for a moment and turn on the one’s left side in order for the medication to penetrate the maxillary sinus. After placing the drops in the right nostril, one can then respectively turn on the same side.

Nasal drops should not be used long term, because they can cause symptoms of a head cold by themselves.

It is advisable to keep the air humid in one’s home. Steam inhalation several times during the day either in a hot shower or from a container of steaming water is recommended. Warm compresses over the maxillary sinuses may help with the pain. One may rinse the nose with water in the shower.

Some spices are thought to be beneficial for the mucous membranes—try foods spiced with garlic or cayenne pepper.

Psychological causes

Psychiatric illness can be associated and have influence on headache but psychiatric disorders as the main cause of headache are rare. The majority of headaches connected with mental problems just exist simultaneously and independently at the same time. If the headache is caused by psychiatric illness it should occur only during the psychological disorder.

Psychological factors can influence headache pain via various central mechanisms, and pathways. Neurotransmitters may have a role in this linkage. The association seems to go both ways. People with chronic headache have an additional risk to develop depression, and individuals, which have depression seem to suffer headaches more often. It has been shown that soldiers with migraines were twice as likely to have depression, anxiety or post-traumatic stress disorder, than soldiers with no migraines.

A headache connected with depression is often dull and generalized, usually not very severe. It may be worse in the morning and evening. One attack can last anywhere from 15 minutes to days. Headache may last for years or for the entire life. Depressive headaches typically come regularly at the same time of the day or the week, for instance, always on the weekends or on the first day of vacation.

Over 84 percent of people with depression also experience headaches. When the depression is at its worst, the headache is too, and when the depression eases, so does the headache. Sometimes it is difficult for the patient and the doctor to diagnose depression in its beginning stages.

When a person feels tension and fear without known cause he is said to have anxiety. Anxiety reduces the tolerance of stress and may increase stress associated chemicals and trigger headache. It has been estimated that people with anxiety have a high risk to get chronic headache problems. Women are at more risk to have both anxiety and headache.

In addition, other mental health problems may be connected to headaches. If an individual has both headache and depression or some other psychological problem, it makes sense to treat both in an appropriate way rather than use only medication for the headache.

Other causes

Inflammations in the teeth and other structures in the mouth, occlusion disorders as well as eye problems, functional disturbances with the jaw joint and trigeminal neuralgia may also cause headaches. Please see Jaw pain and Face pain for more info.

Headaches During Pregnancy

Headache is a common complaint during pregnancy. They may appear at any time during pregnancy. In the beginning, they may be caused by increasing hormone levels. Of course also lack of sleep, stress and poor postures increasing muscle tension can be blamed in any phase.

Sometimes regular migraine headaches maybe come less severe during pregnancy. This is, however, not always the case. In some cases, the symptoms may get worse. It is important to check the migraine medication when pregnancy is possible to be sure not to harm the child. In the later stages of pregnancy headache can be a symptom of high blood pressure.

Women often experience headaches during their menstrual period. This problem may disappear during pregnancy. Some birth control pill types make migraine symptoms worse, although a minority of the users has fewer symptoms while using the birth control pills.

Brain Tumors

There is often a fear that headaches are associated with brain tumors. People whose single symptom is a headache are seldom diagnosed with brain tumors. Only about 8% of people with brain tumors have a headache as a first symptom. However, up to half of brain tumor patients experience headache.

The typical first symptom in connection with a brain tumor is an epileptic seizure that is not connected to a brain injury or use of alcohol. Most brain tumor patients have also some other symptoms like personality change, double vision or weaknesses, not only headache.

Headaches connected with brain tumors usually have been traditionally thought to appear in the morning before rising and clear up within a few hours, to be of dull and aching quality and to be associated with nausea and vomiting. They have been considered to appear especially when lying down or while sleeping and become with time more frequent and severe or maybe even constant and to be not easily treated.

Fresh headache or changes in headache patterns, severity or location raises concern. Furthermore, new exertional headache, a headache that develops after physical activity like heavy lifting, running or coughing, should be looked at.

Dangerous Headaches

Dangerous headaches include those in connection with a cerebral hemorrhage, meningitis, and encephalitis. The headache is often so strong in these cases that grown up patients usually see a doctor without hesitation.

Signs of an infection are usually present with meningitis and encephalitis. The onset of bacteria-induced meningitis can be very rapid and violent. Usually children get it via droplet infection.

The symptoms associated with this illness include fever, shivering, headache, nausea, and vomiting as well as sensitivity to light and a stiff neck. A child with meningitis cannot bend her head to her knees even with help. Neonatals and young infants may not experience the stiff neck symptom. Irritation and even loss of consciousness may be present also. If meningitis is suspected, the patient must go to the emergency room immediately.

Meningitis or in the other words bacterial infection of the membranes covering the brain and spinal cord and septicemia or infection of the blood, commonly known as blood poisoning is very difficult to diagnose in the early stages. Especially this is the case with children because the first symptoms are usually fever, vomiting, headache and feeling unwell, just like many other mild illnesses.

Meningitis Research Foundation has introduced six symptoms that can help differentiate meningitis and septicemia from other flu-like illnesses. These symptoms are: limb pain, a rash, stiff neck, dislike of bright lights, confusion, and cold hands and feet.

A cerebral hemorrhage is bleeding in the brain caused by the breaking of a blood vessel. It may develop anywhere in the brain. The causes may be, for instance, high blood pressure, malformation of the vessels or brain injury. Sometimes no cause is evident. Large hemorrhages are fatal within a few days in about half of the patients.

Symptoms usually develop suddenly, without warning signs, getting worse over time, often during some activity. They may include neurological symptoms such as loss consciousness, speaking difficulties, balance and movement changes, seizures, etc.

Headache may also be present. It may awaken individual from sleep, increase with change of position, bending, straining or coughing. It may also be mild or absent in the elderly persons.

Headaches should be examined thoroughly at least once. After this the fact that one does not know the reason should not cause further headaches.


Headache associated with convulsions, confusion or loss of consciousness.
Headache associated with symptoms of paralysis.
Headache after head trauma.
A strong headache associated with a high fever and possibly nausea, sensitivity to light and vomiting.
Headache associated with pain in the ears or eyes.
A sudden violent headache that does not get better.

See a Doctor

A change in the character of a previously diagnosed headache.
Headache associated with fever.
Early morning headache possibly associated with nausea or vomiting.
Headache that requires almost daily headache medication.
Prolonged headache that has not been diagnosed earlier.
Recurring headaches in a child.
Headache associated with depression.
Headache that worries the patient.
Headaches associated with female hormonal changes.

Headache, more information:

Mayo Clinic pages about tension headache.
Medline Plus article about tension headache.
Wikipedia about migraine hypotheses.
WebMD Slideshow: A Visual Guide to migraine headaches.
Mayo Clinic about migraine.
Medline Plus pages about migraine.
WebMD about common medications used to treat or reduce the symptoms of Migraine.
Medicinenet.com about cluster headaches.
Mayo Clinic pages about cluster headaches.
Mayo Clinic article about symptoms of sinusitis including headache.
Wikipedia about red wine headache.
EzineArticles.com about headaches after exercising.
Patient.co.uk about withdrawal headaches.
Headaches.org about headache and depression.
WebMD Migraine Headaches and pregnancy.
Merck Manuals about brain turmors.
HealthDesk about brain tumors in children.
Mayo Clinic information about symptoms of a brain tumor including headache.
eMedicine about intracranial hemorrhage.
HealthDesk about aneurysm in the brain.
eMedicineHealth about reasons of hematomas.
Meningitis Research Foundation info about how to suspect meningitis or septicaemia.
FreeMD the anatomy of the head and brain.

Eye pain

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.


The most common reasons for pain in the eyes are various infections. Head colds are often associated with infectious symptoms of the conjunctiva. In this case, the eye feels irritated and the conjunctiva is reddish.

The conjunctiva is normally a transparent top layer membrane covering the eyeball. Its infections can also be caused by allergies or bacteria.

Bacterial infections usually begin with one eye and proceed to the other one. They are associated with eye discharge and redness. If a bacterial infection is not diagnosed, it will be sufficient to give the patient eye drops that shrink the mucous membranes. Local antibiotics are the treatment of choice in bacterial infections.

The eyelids also can often be infected. The sign for the infection of the rim of the eyelid is redness. Changes under the eyelid are more difficult to distinguish. Usually using an antibiotic eye gel will cure the symptoms.

As self-treatment, over-the-counter eye drops meant for reducing irritation can be used to treat infections of the mucous membrane. If there is a problem with eye dryness, there are many over-the-counter products meant for treating this symptom.

Irritated eyes can be bathed with a piece of cloth, dipped in warm water and placed over the eyes for 10 minutes three to four times a day.

Eye secretions from the eye and the eyelashes can be cleaned with a Q-tip dipped in plain water or very mild soapy water.

Discard old eye makeup because it functions as a basis for bacterial growth. It is advisable to replace all substances and objects that have been in contact with the eyes after an eye infection.

Avoid tobacco smoke, smoke in general, and other irritants. Use glasses when it is windy and goggles when swimming.

Rarely the herpes virus can cause a cornea infection. Other symptoms associated with this are sensitivity to light and worsened vision. The pain and a feeling of something extraneous in the eye can initially be mild.

Diagnosing herpes necessitates a visit to a doctor, and dyeing of the mucous membranes, which shows the changes caused by infection. Diagnosing and treating this disease early is extremely important. This way the treatment outcome is as good as possible.

The iris can also become infected. In this case, vision worsens quickly and the eye hurts. Eye is red and the pupil is small. The iris looks unclear. Treatment is cortisone, which usually works remarkably well.

Foreign Object

Foreign objects can enter the eyes. If they do not get removed with lachrymal fluid, they may cause pain. Usually it is easy to see if there is something foreign in the eye. Oneself or another person can check the eye to distinguish. Foreign objects in the eyes cannot always be seen without special instruments.

One can try to rinse the foreign object out of the eye by opening and closing the eyes under water. Sometimes the object cannot be removed without a doctor’s help. Here the doctor will anesthetize the eye to remove the object. If one has an eyelash bent under the eyelid, it may come loose lifting the eyelid off the eyeball and bat your lashes.

Intraocular Tension

Pain in the eye can be caused by a rapid increase in intraocular tension. This may be accompanied by worsening vision, colored rings around light, and pain in the eye and its environment. The person may also feel nauseous.

The eye is red, the cornea is hazy the iris is large and does not respond to light. Measuring shows increased intraocular pressure. Treatment has to be promptly initiated in the case of this illness.

Intraocular tension should be regularly measured after age 40 even though no symptoms exist. A gradual increase in the intraocular pressure is asymptomatic.

Radiating Pain

Sometimes problems in the upper cervical spine may cause pain in the eye area, felt as pain behind the eye. This is usually accompanied by neck pain and worsening of the pain connected to the eye symptoms. The treatment needs to address the underlying reason for pain.


Sudden strong pain in the eye, especially if it is accompanied by vision problems.

See a Doctor

Long-term conjunctivitis that cannot be cured by home remedies.
Repeated eye infections and continued eye irritation.

Eye pain, more information:

Wikipedia page about conjunctivitis.
All About Vision on eye infections.
Netdoctor.co.uk about foreign body in the eye.
Familydoctor.org about Herpes Zoster of the eye.
Medicinenet.com pages about iritis.
Medicinenet.com slideshow of eye diseases.
All About Vision article about glaucoma.
All About Vision about dry eyes.
Patient UK about trigeminal neuralgia.
EyeNet on pain of the eyes due to other than ocular reasons.
SafeMedication.com instruction how to use eye drops properly.
SafeMedication.com instruction how to use eye ointments and gels properly.

Ear pain

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

External Ear Infections

Earlobe infections can cause pain. The infections are perceived as local redness and burning. Treatment usually consists of antibiotics.

The ear canal can infect, or an abscess may form inside it. An infection in the outer ear may be made worse by exposure to wind or swimming. An ear canal infection usually begins with itching and may eventually become painful. An examination shows infectious changes in the ear canal.

Prescribed treatment includes various bacteria-killing drops and ointments. Sometimes it may be required to clean the ear canal by irrigation, which speeds up healing.

Over-the-counter eardrops, that inhibit bacteria growth, can be used as a self-treatment in cases of mild irritation.

Heat in the form of a hot water bottle or a heating pad can be used to relieve pain.

It is advisable to use earplugs in windy conditions or while swimming. The ear canals can be dried out with a hair dryer using low heat setting. Swimming in polluted water is not recommended. Do not use any objects, especially sharp ones, to try to clean the ear.

Middle Ear Infections

A sudden middle ear infection usually causes pain in the ear. This is very common in children. Normally cold or other symptoms of respiratory infections precede the ear infection. If ears start hurting after these, a middle ear infection, also called otitis media, is a possibility.

Little children cannot express pain, but may feel irritable or cry continuously without any other reason. Sometimes the children will pull at their ears. Of course, there are many other reasons for crying than an ear infection.

During examination the doctor will see redness or bulging in the eardrum. If the eardrum gets punctured, it will cause the ear to drain. This usually alleviates the pain for a while.

Pain-relieving ear drops and pain medication can be used to treat milder cases of sudden middle ear infections when the eardrum is not punctured. Follow-up is needed. Antibiotics are often prescribed and in cases where the pain is severe, the eardrum will be punctured to remove purulent discharge from the middle ear.

In cases of prolonged or recurrent middle ear infections, an otitis media secretoria may develop. In these cases, the tonsils are usually removed, and tubes inserted in the eardrum, to increase the air circulation in the middle ear.

Over-the-counter anti-inflammatory medication may be used according to instructions as first aid to alleviate pain. If ear infections repeat in a family, it might be beneficial to ask your doctor to prescribe anesthetizing eardrops as a first-aid treatment.

Eustachean Tube Problems

The middle ear connects to the pharynx via the eustachean tube. In normal conditions, the tube balances the pressure in the middle ear. If cold or allergies cause the mucous membranes swell, this tube obstructs. When the pressure cannot be balanced with the surrounding air pressure, it causes pain. This is quite familiar with even mild colds while flying.

Treatment consists of nasal drops and allergy medication that reduce swelling in the mucous membranes. If you have this problem, it is advisable to take preventive medication before flying.

Swallowing, chewing gum and yawning may open the eustachean tube. One can try to close the nostrils mouth closed and to move air in the pharynx exhaling —this might open the tubes.

Muscular Pains

There are several neck muscles that attach to the base of the skull behind the ears. These areas may become sore and send deceptive radiating pains to ears. If nothing unusual is noted in an ear examination, but pain persists in the site where the muscles attach, the diagnosis will most likely be one of muscular pain. Treatment will consist of medication and physical therapy aimed at relaxing the muscles.

Careful massage and stretching of these muscles or over-the-counter ointments may be used as self-treatment. If the pain just started, cold compresses may work.


Strong ear pain that is not alleviated by home remedies.

See a Doctor

Prolonged pain in the ears.
Ear pain accompanied by ear discharge.
Hearing problems after respiratory infections.

Ear pain, more information:

Mayo Clinic pages about outer ear infection.
Buzzle.com about earlobe infection.
Patient.co.uk pages about middle ear infection.
eHealthMD.com about infection in the middle ear.
MedicineNet.com pages about Eustachian tube problems.
MedicineNet.com slideshow of anatomy of an ear infection.
Livestrong.com article about muscular and other causes of pain in the ear region.
SafeMedication.com instruction how to use ear drops properly.

Face pain

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

Sinus Infections

Sinus infections are a common reason for facial pain. They usually follow a cold. Allergic factors that cause swelling may enable these infections. Untreated dental infections may spread to the sinuses.

The most common of these infections is the maxillary sinus infection. Headache that feels also in the cheeks is the main symptom. Bending the head forward may increase the pain, in the same way like tapping the cheekbones. The diagnosis can be confirmed by an x-ray, ultrasound, CT scan, by puncturing the sinus or sino-nasal endoscopy by ENT physician.

Often the only treatment needed consists of antibiotics and nasal drops or allergy medications that reduce swelling in the mucous membranes. If the pain is hard or antibiotics have not cured the infection, puncturing the sinus may be necessary.

Over-the-counter nasal drops that reduce swelling may be used as self-treatment. It is advisable to deliver these while lying down. When the drops are in the left nostril, it is advisable to wait for a moment and then go on one’s left side in order for the medication to penetrate the maxillary sinus. After placing the drops in the right nostril, one can then respectively turn on one’s right side.

Nasal drops should not be used long term, because they can cause symptoms of a head cold even without any infection.

It is advisable to keep the air humid in one’s home. Steam inhalation either in a hot shower or from a container of hot water is recommended.

Warm compresses over the maxillary sinuses may help with the pain. One may rinse the nose with warm water in the shower.

Some spices are thought to be beneficial for the mucous membranes—try foods spiced with garlic or cayenne pepper.

Trigeminal Neuralgia

Trigeminal neuralgia usually causes a strong one-sided pain in the upper or lower jaw. Older people often experience this problem.

The reason for it is unknown. Touching the area or hard biting may initiate a pain episode. There are regularly no other abnormal findings. However, it is best to have an examination.

Treatment usually consists of medication, electrical pain therapy or acupuncture. Surgery is used not often.

Avoiding facial irritation is advised for patients with trigeminal neuralgia. Keep your face warm in the winter.


Herpes zoster or shingles may also arise in the facial and eye area. The virus itself is in the spinal cord but causes a blistery and painful eczema in the tactile nerve section. The eczema will not migrate over to the other side of the face.

Scarring may be present after the eczema heals. There may be problematic residual pain in the area. In cases where patients are less than 50 years of age or where the eczema was only mildly painful at the start, the risk for residual pain is minor. Patients with fewer than 20 blisters at the onset, run a smaller chance of upsetting residual pain.

Temporal Arteritis

Elderly people often experience a temporal vascular inflammation called temporal arteritis. The symptoms consist of temporal pain, pain while swallowing and biting, miscellaneous general symptoms and vision disturbances.

An examination will reveal hardened temporal arteries that are painful to the touch. Laboratory tests show a raised sedimentation rate. If the diagnosis is uncertain, a biopsy of the temporal artery may be used to verify it.

Treatment should be promptly started especially in cases where there are vision disturbances, so that worsening eyesight would not become permanent. Cortisone treatment will be sufficient under normal circumstances.

Salivary Glands Problems

Pain symptoms may be associated with salivary gland infections. The most common infection is that of swelling of the lower jaw salivary glands caused by mumps. Fever and other general symptoms may be present concurrently. Mumps is most common in children but may infect adults as well if they did not have it in childhood.

Mumps usually heal without medication. Other salivary gland infections require antibiotics. The cause for a salivary gland infection may be an obstructive stone, which will have to be removed.

Anti-inflammatory medication may be used to alleviate the symptoms of mumps. It is advisable to drink plenty of liquids and get a lot of rest.


A strong pain in the maxillary or frontal sinus.
Swelling over the maxillary sinus.

See a Doctor

Headache or facial pain in connection with fever.
Strong one-sided pain in the lower or upper jaw.
Swelling in the jaw, especially if you have had mumps.

Face pain, more information:

Wikipedia article on sinusitis.
Emedicinehealth.com about sinus infections.
Otolaryngology Houston about anatomy of the paranasal sinuses.
Medicinenet.com slideshow of sinusitis.
WebMD on anatomy and conditions of the sinuses.
Patient UK about trigeminal neuralgia.
Medicinenet.com slideshow of shingles.
Emedicine information about temporal arteritis.
Patient.co.uk article about salivary gland disorders.
Emedicine on persistent idiopathic facial pain.
SafeMedication.com instruction how to use nasal sprays properly.
SafeMedication.com instruction how to use nose drops properly.

Jaw pain

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

Jaw Joint Problems

The jaw joint is the most used joint in the human body. It opens and closes over 2,000 times per day in connection with talking, eating, drinking, and snoring. Problems with jaw joints are more common in women than in men, and some have meanly drawn the conclusion that it is due to the livelier conversational tradition of women; however, this is probably not the reason.

When the mouth opens, the head of the lower jaw turns in the joint cavity of the jaw joint and then slides forward. The joint has a disk that helps in performing these motions. The disk is easily injured for instance by vigorous biting or direct trauma.

Functional Disorders

The reason behind a functional disorder of the jaw joint may be malocclusion. If the teeth do not contact symmetrically during biting, uneven stress may develop in the jaw joint, and this may cause symptoms over time.

One possible explanation for problems of the jaw joint may be nighttime grinding of the teeth. The person doing it may not be aware of it, if he lives alone or if his significant other is too polite to mention it.

The symptoms of functional disorder of the jaw joint may be a pain in the place or territory of the jaw joint as well as a cracking or popping sound in the jaw joint. The disorder may also cause headaches and pain in the neck muscles that involve biting and swallowing.

Examination often shows an asymmetrically closing jaw. This can be observed by looking in the mirror and observing the opening and closing of the mouth, following the spaces between the middle front teeth closely. Ideally they should move in a straight line so that they finally end up flush against each other.

Pain and additional noise during activity are often perceived in the jaw joint. The range of motion for the lower jaw may be limited or asymmetric. An x-ray helps to image the lower jaw bones, and if the disk needs to be seen, an MRI would be suitable.

Treatment first concentrates on checking and adjusting bite with the help of a dentist. A soft biteguard as well as muscle relaxants as needed may reduce the tension from nighttime teeth grinding. Anti-inflammatories will reduce the pain and irritation.

Physical therapy via massage and heat therapy can relax the muscles involved in biting. This may sometimes be sufficient. Sometimes the jaw joint needs to be trained in order to return it back to normal range of movement. Acupuncture treatments have proven valuable in treating the pain.

Sometimes excessive muscle tension is the fundamental problem, and it can be treated by biofeedback and hypnosis. Cortisone shots are an option as well. Surgery is uncommon.

The operation of the jaw joint is closely related to the operation of the upper neck. It is therefore advisable to check the functional situation of the upper neck as well as posture and the respective functioning of the jaw joint in cases of neck problems.

It is advisable to eat food that does not require forceful biting during the acute phase of pain. If necessary, only mashed foods or foods in liquid form should be eaten. Chewing gum is also not advised, but there are no restrictions for speaking. Some physicians will recommend quality over quantity in speech.

Over-the-counter anti-inflammatories can be used as a first-aid self-treatment during a short period to tackle problems of the jaw joint.

Cold compresses could be tried at the onset of pain. If that irritates, a hot water bottle or a heating pad may be used to carefully warm the painful area. The muscles around the jaw joint may be carefully massaged.

Avoid extreme positioning of the jaw, leaning against the jaw, resting on your back, reading with the jaw forward, and holding the telephone receiver with your jaw against the shoulder.

Hold your mouth so that upper and lower teeth do not touch. If there is a tendency of teeth grinding at night, trying to relax for example by taking a warm bath is recommended. A dentist can provide the patient with a plastic biteguard that alleviates teeth grinding and reduces the pressure to the jaw joint.

The jaw joint can be exercised while holding the teeth away from each other. On can push the lower jaw forward, pull back and slide it sideways. The mouth should not be opened forcefully, or the teeth should not be pressed forcefully together.

Jaw Dislocation

The jaw can be dislocated during forceful yawning, vomiting or due to a strike while the mouth is open. If the jaw cannot be set back, a doctor can do it by pressing it downwards. The doctor should cover his thumb during this procedure in case the patient inadvertently bites.

See a Doctor

Stronger headaches in connection with problems of the jaw joint.
Difficulties in opening the mouth.
Prolonged joint problems that can’t be cured by home remedies.

See a Dentist

Problems with your teeth.
Jaw joint problems that began after a dentist filled cavities.

Jaw pain, more information:

University of Washington´s article about the anatomy of the temporomandibular joint.
Emedicine about temporomandibular disorders.
Emedicine about mandible dislocation.

Mouth pain

Physical activity is a good way to feel better, get fit and beat pain. You can start your own home with simple free exercise videos for everybody, Tv-Gym.com.

Herpes Simplex

Herpes Simplex Type 1-virus causes infections in the mouth area. The beginning symptoms are itching and burning of the lip. Small blisters then develop, and covered with scabs after about a week. There is often an accompanying bacterial infection, which can prolong the duration of the episode.

Treatment consists of local medications that treats the herpes virus symptoms. They work better if started at an early stage of the symptoms. If there is an accompanying bacterial infection, antibiotic ointments are required.

Mucous Membrane Problems

Different types of changes such as color changes, blisters, and ulcers can occur due to infections and poor hygiene. Sometimes the mucous membrane in the mouth can be injured by food that is too hot. This usually will get better in a few days.

Viral infections can be detected in the mucous membranes in the mouth, and these are usually caused by the herpes virus. The first infection caused by the herpes virus, usually happens in childhood. Various factors such as colds, stress, tooth extraction, and menstrual periods can activate the virus.

Many other viruses can cause symptoms in the mouth area. Many skin diseases such as lichen ruber planus can cause changes in the mouth’s mucous membranes.

Treating the changes in the mouth’s mucous membranes is difficult, because it is difficult to keep the medication in its place. Rinsing with antibacterial rinses is worth trying. Try a moistened teabag to treat ulcers of the mouth.

Tumors of the mouth are also a possibility, so it is recommended to see a doctor when the problems continue.

Avoid foods that are irritating, too hot, or spicy. Some patients get relief from the regular use of dairy products such as yoghurt and sour milk.


The most common reasons for toothache are the development of cavities due to caries. The first symptom may be shooting pains in the teeth when eating sugary foods. As the hole gets bigger, appear shooting pains caused by cold and hot. If eating cold or hot foods or beverages causes prolonged pain, the tooth may be infected at its core.

Toothaches can radiate from the upper jaw toward the temples and from the lower jaw toward the ear. Examination shows that the tooth feels painful when tapped on and during a dental check-up. If necessary, an x-ray will confirm the diagnosis.

It is necessary to have cavities treated as early as possible. Treatment consists of removal of the destroyed tooth tissue and filling the cavity. If the root infects, a root canal may be necessary.

Over-the-counter anti-inflammatories can be used as self-treatment. It is, however, needed to see a dentist. A cold compress can be placed on the painful area.


Gingivitis can also cause pain in the teeth. It may be caused by poor oral hygiene, formation of tartar, poorly fitting dentures, and edges of fillings. If this problem proceeds, the result may be infection of the deep tissue.

Treatment in milder cases consists of improved oral hygiene and removal of irritating local factors. Self-treatment consists of careful brushing and flossing. In tough cases local antibacterial treatments and sometimes even antibiotics may be used.

Tongue Pains

Pain in the tongue may be caused by a fungus. Yeast infections in the mouth can be found in 50 percent of people who have no symptoms. Many factors such as diabetes, lack of vitamin B12 or iron, improperly fitted dentures, antibiotics and poor oral hygiene may make one vulnerable to yeast infections.

Lack of adequate saliva production may be an enabler. Arthritis, the Sjögren Syndrome, or LED may cause a decrease in saliva production. Some blood pressure medications, antidepressants, tranquilizers or allergy medications may cause the same kind of reaction.

The dryness can be treated with mouthwash, ointments or lozenges made for this purpose. Try a local application of vegetable oil. Avoid alcohol-based mouthwashes because they can increase the dryness of the membranes. The same goes for sour and spicy foods.

A yeast infection may appear in the form of red membranes, shiny tongue or a light covering on the tongue and membranes. Try to reduce factors that predispose to infection. Recurrence of infections is common.

Pain in the tongue can be caused by lack of vitamin B12. A third of patients with anemia receive oral symptoms. Intestinal illnesses, dieting or excessive alcohol use may cause pain in the tongue. Patients with the Sjögren Syndrome may experience pain due to dryness of the mucous membranes even if no yeast infection is present.


Pharyngitis is common. It can be caused by viruses or bacteria. When a sore throat combines with congestion or a cough, the reason is most likely a virus. Viral infections are often accompanied by muscle pain. Usually the sore throat is not terribly serious in this case, the fever is reasonable, and the general condition of the patient is good.

The most common viral infections in children are adenoviruses. Mononucleosis spreads via kissing and is common in young people. The lymph nodes in the neck enlarge with mononucleosis and can cause even strong pain and perhaps even difficulty swallowing. There is no medication for viral infections.

If the sore throat persists without there being any other respiratory symptoms, there is a possibility of tonsillitis. Here the tonsils swell, white spots form on them, and a high temperature is likely. Tonsillitis, caused by streptococcus needs treatment in order to prevent complications as infections in the heart, kidneys or joints.

The diagnosis can be confirmed by a throat culture. This helps avoid unnecessary antibiotic treatment. It is difficult to distinguish between a bacterial or viral infection by examination. The treatment for bacterial infections is usually antibiotics.

If antibiotics are not necessary, rest, gargling, and other treatments that alleviate the symptoms are prescribed.

A morning sore throat without any other symptoms is usually due to enlarged adenoids or tonsils. Because breathing through the nose is restricted, sleeping with the mouth open dries the mucous membranes, and causes pain. As first aid, try drinking something warm, which usually alleviates the pain. People who snore, may also experience this kind of morning sore throat, caused in the same way.

When suffering from pharyngitis, it is essential to drink lots of liquids and get enough rest. If necessary, over-the-counter anti-inflammatories or flu medication may be used.

Try gargling with a solution consisting of a tablespoon of salt or baking soda mixed with a glass of water. This alleviates the pain. Some cough medicines can also be used for gargling.

Over-the-counter throat lozenges or drops can be used to alleviate the pain temporarily.

Many people think that taking a lot of vitamin C will speed up recovery.

Throat Abscess

Abscesses may sometimes develop in the upper part of the throat. The symptom in this case is a sore throat that may radiate pain towards the ear. It may be difficult to open the mouth and speaking may be difficult.

Usually this symptom appears after a common pharyngitis. If antibiotics were prescribed for that, the symptoms may temporarily disappear. Examination shows a one-sided swelling in the area of the abscess. Treatment consists of surgically lancing the abscess. In the case of children, the tonsils are often removed concurrently.

Vocal Cords Problems

If there are other symptoms apart from a sore throat, such as hoarseness and possibly a cough, an infection of the vocal cords may be suspected. This is usually treated with antibiotics. Diagnosis can be confirmed by viewing the vocal cords with a speculum.

In the case of infected vocal cords, it is crucial to relax the vocal cords and speak only when necessary. Whispering is more stressful to the vocal cords than normal speech and should be avoided. In the worst phase of the infection, one can use notes in writing.

If the patient starts feeling worse rapidly, has problems swallowing saliva and feels better when the head is tipped forward, it is advisable to visit the emergency room to rule out the possibility of an infection of the epiglottis. The doctor can check the epiglottis with a speculum; if infectious changes are visible, the patient needs to be hospitalized. Antibiotics usually cure the infection.


A sore throat with white spots on the tonsils, but no other symptoms of a respiratory infection.
A sore throat accompanied with worsening general condition and problems swallowing saliva.
A sore throat with a rapid worsening of general condition.
A sore throat people in your immediate surroundings have had pharyngitis that required antibiotics.
Suspicion of an abscess in the throat.

See a Doctor

A persistent pharyngitis.
Changes in the mucous membranes of the mouth that heal slowly.
See a Dentist

Continuing toothache.
Pain in teeth or gums.

Mouth pain, more information:

Wikipedia about cold sores.
Otolaryngology Houston pictures of acute tonsillitis.
Ear, Nose & Throat Health Care Providers pages photos of mouth problems.
Netdoctor.co.uk about toothache.
Mayo Clinic pages about the infection of the tissues that surround and support the teeth, periodontitis.
Wikipedia on inflammation of the gum tissue, gingivitis.
MedlinePlus on tongue problems.
Emedicine about pharyngitis.
Wikipedia on peritonsillar abscess.
Otolaryngology Houston pictures of peritonsillar abscess.
Emedicine pages about vocal cord problems.