Episode 156. Mid Facial Pain with Dr Andrew Martin (part 2)

Block 6
Written By Andrew Ford

Approximately 1 in 10 adults will experience pain or discomfort in the mid-facial region, with a higher prevalence among females and young adults. Understandably, many patients attribute this pain to sinus issues, given the proximity of the sinuses to the face. However, nasal endoscopy and CT scans have shown that chronic sinus infections are not as common a cause of facial pain as one might think. Sinusitis typically causes significant pain only when accompanied by thick nasal drainage, loss of smell, or nasal obstruction. In these cases, nasal endoscopy usually reveals some drainage or inflammation. Facial pain related to sinusitis is generally alleviated, at least partially, by a course of antibiotics. When sinusitis is ruled out, other potential causes of mid-facial pain should be considered, including:

  1. Tension Headache: This type of headache may manifest as pressure or tightness across the bridge of the nose, forehead, or the back of the head. The face may feel "swollen," and the nose may seem "blocked," though there is no actual breathing obstruction. Tenderness over the forehead and cheeks is common. A low dose of amitriptyline (10-25mg, up to 75mg) taken at night for six weeks typically relieves this pain.

  2. Migraine Headaches: More common in women with a family history of migraines, these headaches can last up to 48 hours and are often associated with nausea. Nasal congestion is also not uncommon. Acute treatment may include antimigraine medications such as sumatriptan (50mg). For frequent episodes, preventative medications like pizotifen or amitriptyline may be effective.

  3. Cluster Headache: This condition, more common in men, causes severe unilateral pain around the forehead, eye, and cheek, often lasting over an hour. The affected eye and nose typically water on the side of the pain. Treatment is similar to that for migraines.

  4. Temporomandibular Joint Dysfunction (Myofascial Pain): Inflammation around the jaw joints can lead to pain, which may be alleviated by rest and simple analgesia.

  5. Neurologic Pain: Conditions such as trigeminal neuralgia, postherpetic neuralgia, and glossopharyngeal neuralgia often cause severe, burning pain and may involve trigger points. Medications like gabapentin can be effective in managing this type of pain.

Dr. Andrew Martin is a practicing ENT surgeon based in Melbourne's southeastern suburbs and Northern Tasmania. He earned his MBBS from The University of Queensland in 2008, following a Bachelor of Pharmacy Sciences with honours from Monash University in 2003. In 2021, he completed his fellowship with the Royal College of Surgeons in Otolaryngology and Head and Neck Surgery in New Zealand, followed by an Advanced Fellowship in Head and Neck Surgery at The Royal Melbourne Hospital in 2022.

Dr. Martin has a special interest in various conditions, including nasal obstruction, obstructive sleep apnoea, ear and balance problems, chronic sinus disease and mid-facial pain, paediatric ENT, and disorders related to swallowing, voice, and the throat. Beyond his medical practice, he is a dedicated family man with two young daughters and enjoys hunting and fishing.

It was a privilege to have Dr. Martin join us for this conversation, where we explored the complexities of mid-facial pain in greater detail. Please join me in welcoming Dr. Andrew Martin to the podcast.

References:

Andrew Ford
Marketing expert Andrew Ford, the founder of Social Star, has discovered the secret of ‘Powerful Branding’. With a fire for unleashing people’s inner brand and developing business models to generate profit from an individual’s passions, Andrew leverages ground-breaking digital and social media marketing techniques to create digital strategies for clients to attract maximum opportunities. Having established a strong name for himself in the field, Andrew blends traditional business techniques with now-necessary tools for entrepreneurs to achieve scale, quality, and influence in their niche. Andrew’s comprehensive business background and qualifications consist of a Bachelor of Business (Marketing) (RMIT 2003), a Graduate Certificate in Management (MBA Executive Program, University of Sydney 2005), and a Masters of Entrepreneurship and Innovation (Swinburne University 2011). Continually on the cutting edge of his own education, Andrew has tested his marketing theories in forums such as the BCG Business Strategy Competition, which he won in 2005 against all Victorian MBA schools, and the Venture Cup Business Plan Competition (Swinburne University 2003), which he won in the Masters category. With experience working at Hewlett-Packard, Sensis (Telstra) and IBM, Andrew also has mentored dozens of junior staffs to help them achieve their professional goals. Meeting and influencing high-profile public figures helped Andrew to realise just how many professionals require more understanding and control of their public brands or appearance, and need help with the skills to use the many amazing free tools at their disposal to generate success. At Social Star, Andrew consults with clients to uncover their personal brand – both where it is today and where it can be tomorrow – and refine and define how that should be displayed in social media in order to attract their perfect target audience. Andrew mentors his clients to rapidly grow their business’ audiences, resulting in larger potential client bases and higher revenue. Applying formulas that integrate over twenty years of Andrew’s business experience and fifteen years of formal business education, Social Star specialises in building clarity and velocity for clients’ brands using the ‘Understand, Build and Leverage’ methodology. ‘Having a Personal Business enables people to have an authentic, congruent connection with their valued clients and partners, using their brand as the bridge,’ says Andrew. ‘I’m highly driven to work with the new breed of entrepreneurs and small business owners – people who have a passion for making the world a better place. Traditional business models are stepping aside as people follow their innermost dreams and my role is to see them operate within their values while creating wealth. Some people think you have to sacrifice what you love to be successful in your business, yet it is actually the opposite. Follow your passion and success will come.’ Lecturing at Swinburne University from 2009 to 2011 on brand dynamics and digital marketing, presenting at numerous conferences, and consulting to hundreds of clients, Andrew has seen his philosophy work that if you follow your unique path, based on your skills, experience, values and goals, you will automatically attract the opportunities you desire and achieve the success you deserve. Living his mantra, Andrew has created a successful business and attracts high-profile clients including musicians, athletes, authors, models, entrepreneurs, professionals and small business owners, helping them find their ‘why’ in their business and fulfilment in their lives. Business for Andrew is more than work, it’s personal. Running a personal business means that he is able to fulfil all of his values rather than separating his life from work. It supports his two boys while providing social opportunities, educational development, fitness opportunities, spiritual fulfilment and many valuable friendships. Social Star has now become the vehicle for Andrew to crystallise his mission in the world, to help people love what they do, supporting his ‘why’, that if more people loved what they did, the world would be a better place.
http://www.andrewford.com.au/
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Episode 155. Allergic Rhinitis and Sinusitis with Dr Andrew Martin (part 1)