Tension Headaches and Trifacial Neuralgia: Understanding the Differences

Location of Pain

Trigeminal neuralgia typically affects only the face, specifically one side, and the pain is confined to areas supplied by the trigeminal nerve. It does not extend to the scalp, back of the head, or neck. In contrast, tension headaches can cause discomfort in various regions, including above the ears, behind the ears, the top of the head, and even the back of the neck.

Pain Pattern and Consistency

One of the key features of trigeminal neuralgia is that the pain consistently occurs in the same area on one side of the face. This is often due to a blood vessel compressing the trigeminal nerve. On the other hand, tension-type headaches or migraines may present as one-sided pain but can vary in location from episode to episode. For example, one time you might feel pain on the left side, and another time on the right.

Diagnosis and Evaluation

Experienced physicians can usually distinguish between trigeminal neuralgia and tension headaches based on a thorough patient interview and clinical examination. The nature, location, and pattern of the pain, along with other associated symptoms, provide enough information for an accurate diagnosis. In most cases, advanced imaging such as MRI is not necessary unless there are atypical features or red flags that suggest another underlying condition.