Since around 2003 I have experienced pressure around the bridge of my nose and occasionally headaches. As this pain would come and go I did nothing about it and eventually it became part of my life. Also each morning I wake up with an incredibly dry mouth which I also experience when drinking alcohol (as a result I have stopped drinking alcohol) and if I do not eat food for a number of hours. In 2008 I stopped smoking (not sure that this has any relevance) but after a few weeks this pain became more noticeable so I finally decided that it was time that I did something about it. I went to see my GP who suspected sinusitis. Over the following 6 months I tried antibiotics, many nasal sprays and nasal drops all without success (with the exception of the very first spray that I tried which did improve matters but only for a few days). I have also tried nasal irrigation daily for a number of months, I used a mix of water, salt and sodium bicarbonate but had no improvement. I have tried a facial sauna daily for several months in order to help clear any blockage but again no improvement. I was then referred to the local hospital where I have undergone both a CT scan and a rhinoscopy which both showed no blockage. As a result sinusitis has now been ruled out.
Currently the pain is persistent, there is pressure on the bridge of my nose and between my eyes all of the time. The head pain comes and goes but at the moment is pretty constant too although at times it is more noticeable than others. The dry mouth in the morning is still here, I have to drink a pint of water as soon as I wake up to remove the horrible taste in my mouth.
This is currently where I am, the consultants and doctors I have seen do not know what to suggest, I am at my wits end. I have looked at a few different sites but nobody seems to have my symptoms, can anybody relate to what I am experiencing? Can anybody shed some light on where I can go from here?

Many thanks
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First Helper ds_pain
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Users who thank clayton1302 for this post: eo333 

replied May 21st, 2010
hi,

my problem is similar to yours. for 2 years, constantly, have severe pressure and pulsating (according to heart beat) nerve throbbing in nose, also accompanied by pressure/nerve pain in the sinus area and generalised dull frontal headache. But main thing is the severe pressure in nose and centre of forehead and constantly nerve pulsating sensation in nose.

so far ct scan revealed concha bullosa and deviated septum in my nose, but my specialists mostly mentioned that they are unlikely to cause the pain I'm suffering. Does ur ct scan reveal any anatomical variant like mine? What is ur progress thus far? So far I'm still suffering my pain with no answers.
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replied February 5th, 2013
I know this is an old post, but what has your outcome been? I have the same thing but concha bullosa on both sides and they most certainly CAN cause all the problems you were having. That's why doctors surgically remove them. I hope you get back to me Smile
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replied October 26th, 2010
Hi Eo,

Seems like a long time since I posted my original comment, I too came on here because I was at my absolute wits end. Not long after I posted I was put onto a course a medication called amitriptyline by my doctor. I immediately noticed an improvement but it wasn't sustained and after a few days got the nasal pain back although a bit better than before. I spent several months trying different doses before finally finding one that worked better than the others, but I still had some pain. Then my doctor put me on a course of gabapentin to run alongside the amitriptyline, again an immediate improvement which although it tailed off after a few days still left me feeling better than I had before. Again I adjusted my dose of each medication before finding a dose that had a massive sustained improvement. I have kept with this dose for the last month or so and although I still get occasional pain my symptoms have improved dramatically. This I where I am at the moment, I have been told that I will need to stay on this dose for around 3 months before being able to gradually reduce until I am off altogether. Both drugs at higher doses are used to treat different illnesses but at lower doses are used to treat stress. I talked this over with my doctor whose first question was, "when you first noticed this pain what was going on in your life, were you subject to any stress?" Thinking back to that period it was incredibly stressful, without doubt the most stressful, prolonged period of my life. With a chronic (long term) stress illness once you have it even when you get to a stage whereby you are no longer under any stress the symptoms and pain stay with you because it is now part of a cycle. With stress illnesses you need to break the cycle. The way to do this is by taking the medication over a sustained period, doing this allows your mind to experience what it is like to be without this pain over a long period of time. Then, when you slowly decrease your medication the pain stays gone as the cycle has been broken. I should mention that you have to get your dosage of each medication spot on. If you take too much of one then it won't work. If you don't take enough of one then it won't work. Both have to be right before you start to get a sustained improvement and although it takes time you will know when you start to feel better, you're body, and more to the point your nose will tell you.

I really do hope this has been helpful, if this does not sound like you then I wish you well in the future. I know how much something like this can affect your life. If you have any further questions then let me know.
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replied October 29th, 2010
Many thanks for posting, clayton. I have previously tried gabapentin, but not amitriptyline. It didn't work for me, but I did not experiment with different doses.

I'm glad you found something that seems to be working. Personally, I don't like the "stress" explanation. I view that as a copout for the doctors. My symptoms didn't start during a stressful period. (And I've certainly had my normal share of stressful events in life, which never caused me any unusual physical symptoms.) But that is only my personal view.

I'd appreciate it if you could update us in the future to see whether your current course of treatment works in the long-run. Thanks again.
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replied June 1st, 2011
Hi,

Clayton1302, how has your treatment continued to work? eo333 or bullyboo, have you found anything to help your pain or any specialists that have helped? I've posted a similar message to a different thread about anterior ethmoid nerves, but thought I'd post here as well. I'm at wits end and am looking for help anywhere I can find it.

I have symptoms remarkably similar to yours. I had pain start out of the blue at the bridge of my nose 7 years ago. The pain is extremely bad and also is often at my temples and around my eyes. The only thing I’ve found that helps is chewing on something such as gum. Chewing on gum is the only way I’ve been able to put up with this pain for 7 years. Is your pain helped by chewing? Do you have any idea why it might be helped by chewing?

After the pain started 7 years ago, my ENT did find a sinus infection in my left sphenoid sinus. He performed nasal surgery to drain the sinus, widen the opening, and fix a deviated septum. Now, my CT scans are clear of anything my ENT thinks might cause this pain.

I’ve read the article mentioning Dr. Malekzadeh. The pain in that article sounds exactly like what I experience as well. Unfortunately, I saw she wasn't able to help you bullyboo on a different thread. I have also read about Dr. Behin and how he treats contact point headaches. On his website it says they perform surgery to remove the middle and superior turbinates and perform an ethmoidectomy to get rid of these types of headaches. The theory is that the turbinates may be coming into contact with the nasal septum and causing the pain. Have any of you heard of this Dr. Behin? Do you think this type of surgery may help?

Thanks
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replied June 1st, 2011
ds_pain:

Yes, amitriptyline helps tremendously. I'm currently on 50 to 75 mg per day.

Is your pain on the surface of your nose, like near the skin? Or is it deeper inside, like a throbbing pain back behind the nose?

My understanding is that there is a syndrome in which the external nasal nerves are involved. Is your pain aggravated by pinching or putting external pressure on the bridge of your nose?

But there is also a different condition where the pain originates deeper inside. This could be the result of a nasal contact point. Your average ENT doctor will not be able to diagnose this, or even accept it as a valid medical condition. I saw about 6 different ENTs before going to see Dr. Behin, who was able to spot a contact point on my scan. After he saw it on the scan, he anesthetized the area and the pain went away almost instantly. (But only momentarily...it was just a diagnostic test.) I am planning to have surgery by Dr. Behin, but I haven't done it yet.

Please let us know some more about your pain and what it feels like exactly. Is it a dull, throbbing pain back behind the nose? That's how mine feels. (And it also radiates to the temples.)
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replied June 1st, 2011
I should mention that I also had a badly deviated septum, and I had the surgery to have it fixed in 2009. It did nothing to help this pain. The doctor did not address the area where my "contact point" is located.
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replied June 1st, 2011
Hi eo,

Thanks for your quick reply. I've tried amitriptyline briefly, but had a very bad reaction to only 12.5 mg. The pain I experience is not superficial, it is deeper behind my nose. For the first 5.5 years, it was worst at the bridge of my nose. A deep pain that was dull and sometimes throbbing. This pain would radiate to my temples if I didn't chew gum. Is your pain helped at all by chewing?

For whatever reason, the pain has slowly migrated the past 1.5 years and is now worse at my temples but still bad at the bridge of my nose. Still, the same deep sort of pain it's always been. At no time has my pain been aggravated by any pressure applied externally. If anything, pressure applied externally helps the pain, but only for a short time.

I do have a contact point between my right superior turbinate and septum. I recently convinced my ENT to anesthetize this contact point with a cotton ball soaked in lidocaine. This seemed to help the pain at the bridge of my nose but not the pain at my temples.

Eo, where was the location of the contact point that Dr. Behin found? Was it superior or middle turbinates? When he applied the anesthetic, did it help the pain at the bridge of your nose as well as the pain at your temples?

Thanks
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replied June 1st, 2011
ds:
It sounds like we definitely have the same condition. I'm sorry you can't tolerate amitriptyline.

If you post an email address I can send you an image of my contact point. I don't know the name of the specific location, but I have the image.

As I recall, when Dr. Behin anesthetized mine, the pain in my temples also subsided. The nose pain and temple pain are definitely related and caused by the same thing, if that's what you're wondering.

Any chance you can visit Dr. Behin? I am all the way across the country from him, which is why I haven't had the surgery yet.
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replied June 1st, 2011
Eo:
You can reach me. I'd be really curious to see an image. I'm in Minnesota, so seeing him in New Jersey is a bit of a challenge. I'm seeing an ENT down at Mayo in a few weeks. If I can't find any help from that ENT, I think I'll find a way to see Dr. Behin.

Also, I know I've asked this a couple of times so sorry to be a pest, but does chewing help your pain at all??? The fact that chewing helps me tremendously is such a weird symptom. I have no idea why chewing would help and no doctor has been able to tell me why it might be the case.
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replied July 27th, 2011
Facial Migraine pain at bridge of nose, and dizzyness
Hi
I have been having pain at the bridge of my nose for over a year, it also gives me pain around and under my right eye i get dizzyness with it also, I have been to see ent consultant who did a scan put sinus was clear, I have also had an MRI scan which showed nothing sinister (the consultants words) I have been to see a neurologist who sugested facial migraine, he has put me on pregabalin, I am uping the dose slowly as my body does not seem to tolerate drugs, currently on 75mg at night and 25mg in the morning, slight improvement, but I still get the pain every day, just sometimes I go through longer periods without it, any suggestions or advice would be very welcome, you all seem very technical with your anatomy of the nose, so please no complicated replies, the dizzyness is the worst thing for me, almost getting used to the pain. Has anyone tried accupuncture or had botox injections? Thanks Tracy
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replied January 4th, 2013
I have tried both acupuncture and Botox. Neither helped. (Nor did diet change, or off-label use of antidepressants which I could not tolerate.)
Good luck to us all for a solution to this in 2013!
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replied July 27th, 2011
Yes, I have tried both acupuncture and botox for this. Neither had any effect.

I get the dizziness as well. (I would call mine more of a lightheadedness.) It's arguably even more of a distressing symptom than the pain itself. Cymbalta seems to help with it.
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replied July 27th, 2011
Facial Migraine pain at bridge of nose, and dizzyness
Hi
I have been having pain at the bridge of my nose for over a year, it also gives me pain around and under my right eye i get dizzyness with it also, I have been to see ent consultant who did a scan put sinus was clear, I have also had an MRI scan which showed nothing sinister (the consultants words) I have been to see a neurologist who sugested facial migraine, he has put me on pregabalin, I am uping the dose slowly as my body does not seem to tolerate drugs, currently on 75mg at night and 25mg in the morning, slight improvement, but I still get the pain every day, just sometimes I go through longer periods without it, any suggestions or advice would be very welcome, you all seem very technical with your anatomy of the nose, so please no complicated replies, the dizzyness is the worst thing for me, almost getting used to the pain. Has anyone tried accupuncture or had botox injections? Thanks Tracy
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replied February 22nd, 2012
Tracy,
I forgot to mention something . . . have you tried cutting out artificial sweeteners? This made a huge difference for me.
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replied July 27th, 2011
Yes, I have tried both acupuncture and botox for this. Neither had any effect.

I get the dizziness as well. (I would call mine more of a lightheadedness.) It's arguably even more of a distressing symptom than the pain itself. Cymbalta seems to help with it.

And by the way, mine has never responded to migraine medications either. But amitriptyline has worked pretty well for me.
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replied July 27th, 2011
Thank you so much for your responce, I tried amitriptyline but it made one side of my face swell up.
Will keep trying the pregabaline one of the drugs suggested was gabapentine but i did not choose if after looking up the side effects, but if pregabaline does not work thats my next choice.
Thank you again
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replied July 27th, 2011
Gabapentin didn't work for me either. Sorry, I am not trying to be discouraging -- hopefully it will work for you!

You might want to research "nasal contact points." I don't know if that is really the answer, but it's worth looking into.
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replied January 30th, 2012
I can relate
Hello,

This is interesting to see that there are others dealing with similar pain. I have had this for the past two years. The only way I can explain it is it hurts when I breathe through my nose. I have a burning sensation in my nose and there is constant pain. Sometimes it gets so bad I feel it in my jaw. All of the doctors I have seen say its sinusitis or the reaction of allergies. However, this is my only symptom. There is no nasal drip, watery eyes, mucus etc. I have tried numerous allergy medications from nasal sprays, antihistamines, nasal irrigation, etc. I have also purchased several humidifiers and air flitters for my house, to no avail. I too, was prescribed amitriptyline, which does help with decreasing the pain just enough for me to sleep at night. However, it does make me drowsy so I am unable to use this medication in the day. Therefore, for daytime relief I use a variation of anti-inflammatory medications, which helps however, I have noticed recently that I have needed to increase my dosage that makes me scared of the long term stomach issues.

I will schedule to meet with a neurologist in the next couple of weeks to see if they may have a better solution. My goal is to get to the root of the problem and take whatever measures to alleviate the problem so I am not dependent on medication for relief.
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replied January 30th, 2012
mseducationkje,
Sorry about your pain. If you find anything useful or helpful, please post it here. Just FYI, I have been on amitriptyline for many months now, and over time my body has gotten used to it so I am not drowsy at all anymore. I take 2-3 right before bedtime.
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replied January 30th, 2012
mseducationkje,
Also, is your pain deep inside the nose or is it more on the outer surface?
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replied January 30th, 2012
More inside the nose. Sometimes, my coworkers say they can see the ridge of my nose swollen, when it's at it's worst.
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replied February 22nd, 2012
Do any of you have pressure above your teeth. I also have pressure around the bridge of my nose. Chewing makes it go away for about a minute then it comes back. Anyone of you ever thought about tmj??
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