History
Patient had a 5-month history of right side pain in her upper cheek region, which came on during a period of heightened stress at work. Investigations ruled out dental cause. CT scan showed up a nasal polyp which was thought to be the cause of the patient’s symptoms but did not respond to 2 courses of antibiotics or a course of nasal steroids. Neurological causes were also ruled out and the patient was prescribed a drug for nerve pain which she stopped after 5 days as she said she could not function properly.
Examination
The patient was self-referred for treatment as she was not getting anywhere despite seeing various medical specialists. She described a constant ache in the region of her right cheek bone with an associated hot and sometimes swollen sensation in this region. She also experienced headaches on the right side of her forehead. She reported a right sided ‘ear ache’ and hot sensation. Her symptoms were worse at the end of the day. The patient had a night time teeth clenching habit. She described her bite (how her teeth meet) as feeling abnormal. In addition, she also experienced episodic neck ‘stress’ requiring treatment but never associated that with her other symptoms.
Response to very specific Physiotherapy Treatment
The patient responded very well to 5 treatments to all associated musculoskeletal structures, some of which reproduced her exact upper cheek pain. Provocative postures and activities were also modified to help the patient prevent recurrent episodes. The patient is now pain free.