Head & Facial Pain
Imaging-led assessment for complex head, face and jaw pain.
Why Diagnosis Comes First
Imaging-led clarity for complex head, face and jaw pain.
Head and facial pain often involves multiple overlapping systems — neural, musculoskeletal, vascular or treatment-related — and can be easily misinterpreted. Jaw dysfunction may present as headache. Cervical spine issues may mimic migraine. Neural pain can resemble dental disease. Prior treatment can also contribute to ongoing symptoms.
At MBR Health, high-resolution imaging and careful clinical correlation are used to define the true source of symptoms. This distinction is what allows treatment to become more precise and purposeful.
The source matters
Common causes of head & facial pain.
- Temporomandibular Joint Dysfunction (TMJ)
Disorders of the jaw joint can generate far more than local jaw discomfort. They may present facial pain, headache, ear pressure, clicking, restricted opening, or pain with chewing. In many patients, TMJ pathology coexists with muscular overload and cervical tension, making accurate structural assessment important.
- Trigeminal & Occipital Neuralgia
Trigeminal neuralgia causes sudden, sharp, electric-like facial pain, often triggered by touch, chewing, speaking or brushing teeth. Because the pain can feel as though it is coming from the teeth or jaw, it is sometimes initially treated as a dental issue before the underlying nerve cause is recognised.
- Migraine & Vascular Headache
Not all headaches are simply “migraine,” but migraine remains one of the most important causes of recurrent head pain. It may be associated with throbbing pain, nausea, visual disturbance, light sensitivity, or sound sensitivity. In some patients, vascular and cervical contributors overlap, and careful imaging helps determine whether there is more than one process at work.
- Cervicogenic Headache
Pain referred from the upper cervical spine can produce headache patterns that are easily confused with primary headache disorders. It may radiate into the occiput, temple, orbit, or face, and is often accompanied by neck stiffness or asymmetrical movement restriction. Unless the cervical contribution is recognised, treatment can remain frustratingly incomplete.
- Post-surgical or Post-radiation Pain
Pain after surgery, trauma or radiotherapy requires a particularly disciplined approach. Scar tissue, nerve irritation, altered biomechanics and treatment-related soft tissue change can all generate chronic pain, burning, pressure, altered sensation, or tissue sensitivity. These patients are often complex not because the pain is unclear, but because the anatomy has changed.
- Intracranial Hypertension & Hypotension
Abnormal intracranial pressure (elevated or reduced) is a frequently underdiagnosed cause of persistent headache, often identified only after other causes have been excluded. Idiopathic intracranial hypertension and spontaneous intracranial hypotension produce characteristic brain, CSF flow and parenchymal changes that advanced 3T MRI can identify, supporting accurate diagnosis in patients where standard imaging and conventional investigations have been unremarkable.
- Chiari Malformation
Chiari Malformation is a structural condition in which brain tissue extends into the spinal canal at the base of the skull, disrupting normal cerebrospinal fluid flow at the craniocervical junction. It is a recognised cause of persistent headache that may be worse on coughing, straining or exertion. Other symptoms may include neck pain, balance disturbance, arm and hand symptoms.
How we investigate
Headache & Facial Pain
MRI of the head is a common and valuable first-line investigation for headache and facial pain, providing comprehensive structural assessment without ionising radiation. In most cases a non-contrast 3T MRI is performed first and is often sufficient to evaluate many clinically important causes of head pain.
A non-contrast 3T brain MRI is particularly valuable for ruling out:
- Space-occupying lesions
- Demyelinating conditions including multiple sclerosis
- Stroke and cerebrovascular disease
- Migraine-related white matter changes
- Inner ear conditions
- Pituitary pathology
- Sinusitis and paranasal sinus disease
- Features of intracranial hypertension and hypotension
- Chiari malformation
- Inflammatory conditions (DWI)
Where findings require further characterisation or specific clinical indications warrant it, IV contrast or additional advanced sequences, such as NerveVIEW, may be recommended.
NerveVIEW MRI
For patients with suspected nerve-related head or face pain such as occipital or trigeminal neuralgia, or cervicogenic headache, a standard brain MRI may not provide sufficient detail to identify the underlying nerve pathology.
NerveVIEW MRI is an advanced, high-resolution nerve imaging protocol that provides dedicated imaging of the head, brain and the trigeminal and occipital nerves. Where cervicogenic headache is suspected, this assessment may also include imaging of the cervical spine and associated nerves. NerveVIEW is performed with IV contrast, which enhances visualisation of nerve inflammation and other changes that may not be apparent on standard imaging.
Best for: unilateral head or face pain that may be sharp, shooting, stabbing, burning, or electric shock-like pain. May also be indicated for numbness, tingling, weakness.
Quantitative 3T MRI for CSF Volume
Abnormalities in cerebrospinal fluid volume and distribution are an increasingly recognised cause of head and facial pain, including idiopathic intracranial hypertension and spontaneous intracranial hypotension — conditions that may be missed on standard brain MRI. At MBR Health, quantitative MRI using NeuroQuant and SyMRI can be performed alongside your standard brain MRI examination to identify CSF volume changes and brain parenchyma volume changes associated with increased or decreased intracranial pressure. NerveVIEW with intravenous contrast is also available where dedicated nerve assessment is additionally indicated.
Dynamic MRI for TMJ Conditions
The temporomandibular joint (TMJ) is one of the most complex joints in the body, and many TMJ conditions only become apparent when the joint is assessed in motion rather than at rest. At MBR Health, dynamic MRI of the TMJ assesses the joint in real time during controlled movement, providing functional information about disc position, condylar movement and joint behaviour that static imaging alone cannot offer.
Best for: clicking, locking or limited jaw motion, gradual or achy jaw pain, pain worse with chewing or yawning, or where prior imaging has not identified a clear cause for facial or jaw pain.
3T MRI Facial Filler
Facial filler complications are an increasingly recognised cause of facial pain and neuropathy. Filler material injected near facial nerve branches may cause nerve compression, inflammatory reaction or granuloma formation — resulting in persistent pain, numbness or altered sensation. At MBR Health, advanced MRI provides detailed assessment of filler deposits, adjacent nerve anatomy and inflammatory change, supporting accurate diagnosis and management planning for patients experiencing pain following facial filler procedures.
Spectral CT Sinuses
Chronic sinusitis, sinonasal inflammation and inner ear pathology are recognised but frequently overlooked causes of head and facial pain. Spectral CT provides superior assessment of the paranasal sinuses and temporal bones compared to conventional CT. Where soft tissue inner ear assessment is additionally required, MRI can be performed as a complementary examination at MBR Health.
Ultrasound Salivary Glands
Salivary gland pathology is an underrecognised cause of facial pain and swelling. Conditions including salivary gland stones, duct obstruction, inflammatory sialadenitis and salivary gland tumours can present with facial pain or discomfort that may be difficult to distinguish from other causes on clinical examination alone. At MBR Health, ultrasound is the preferred first-line investigation for salivary gland assessment, providing real-time evaluation of gland morphology, ductal dilation and stone detection.
Best for: facial or jaw pain or swelling, worsening at meal times, lump or mass in the cheek, jaw or neck, suspected salivary gland stone or blocked duct.
Treatment Philosophy
Precision-first care for neural, joint and post-treatment pain.
Our philosophy is straightforward: before any intervention, the anatomy and the pain pattern must make sense together. Where appropriate, we use image-guided regenerative procedures to target structures that are inflamed, sensitised or structurally compromised – including selected nerves, joints and soft tissues. The intention is not simply to suppress symptoms, but to modulate the local biology, support recovery, and improve long-term function.
Depending on the clinical context, treatment may include PRP or autologous cellular therapies, delivered with careful imaging guidance to the relevant target. These therapies remain in investigational regenerative procedures and are not standard-of-care treatments. At MBR Health, they are performed in accordance with applicable TGA exemption criteria for autologous human cell and tissue products.
Multiple Sclerosis on 3T MRI Why Precision Delivery Matters
In sensitive anatomy, precision is essential.
Head and facial pain often involve small nerves and complex structures, sometimes altered by prior treatment. In this setting, accuracy is fundamental to safe and effective care.
At MBR Health, procedures are performed under advanced image guidance, including CT and MRI where appropriate, to define anatomy clearly and guide precise delivery. This supports a more targeted, anatomically informed approach to treatment.
“Head and facial pain often sits in anatomy that is both complex and unforgiving. When diagnosis and delivery are aligned, treatment becomes less about guesswork and more about precision.”
Dr Zane Sherif, Specialist Radiologist
Common Questions from Patients
Frequently Asked Questions
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