Facial pain is a common symptom of headaches and injuries, but it may also indicate an underlying condition. It’s important to get diagnosed and treated properly to ensure the cause of your symptoms doesn’t get worse.
The face has many nerves, muscles, bones, teeth and tissues that connect in a tight space. This makes it difficult to pinpoint the root cause of your facial pain.
A diagnosis of facial pain usually begins with a medical history and physical exam. During this examination, your doctor will ask questions about the symptoms you’re experiencing, how often they occur and what seems to trigger them. They’ll touch your face to determine if you have any abnormalities in the nerves or other structures that could be causing the symptoms.
Some facial pain is a result of the way your body works, like temporomandibular joint disorder (TMJ) or ear problems. Depending on the underlying cause, your treatment may include medications, exercises, or surgery.
Trigeminal neuralgia is a common disorder that causes a sudden tingling, shooting or stabbing pain in one side of your face. The pain is triggered by touch, cold, heat or even an emotional stressor.
It’s most common in middle-aged and older men and women. This condition is often caused by a blood vessel pressing on the trigeminal nerve. Other times, a tumor or multiple sclerosis can cause the protective sheath of the nerve to deteriorate and send abnormal signals to the brain.
Other causes of facial pain can be bacterial or viral. Bacteria can infect your mouth, sinuses and eyes, and viruses can attack your nerves. Infected cells can swell and become inflamed, which can then affect the nerves of your face.
Viral causes are less common, but they can also be painful. Herpes zoster, the virus that causes shingles, can lay dormant in your nerves and resurface to produce a painful rash. It can also be triggered by certain dental procedures or injuries.
Another type of pain, called atypical trigeminal neuralgia, is more rare and is caused by the deterioration of the protective sheath of your trigeminal nerve. This deterioration is believed to send abnormal signals to your brain and trigger your symptoms.
In atypical trigeminal neuralgia, the symptoms can vary from an electric shock-like pain to a constant burning or aching sensation in the face that lasts for hours or days. Patients describe it as a pins and needles sensation, or as a sharp, stinging pain.
The most effective treatments for atypical trigeminal neuralgia involve drugs. Some are anticonvulsants, others block the nerve’s ability to send pain messages. Your doctor will work with you to find the right combination of these medicines to control your pain and reduce any side effects.
Your doctor will also discuss with you how to manage your symptoms at home, such as by reducing the stress in your life. For some people, relaxation techniques such as meditation and deep breathing can be helpful.
Your doctor can refer you to a specialist for an expert evaluation of your facial pain. This specialist will do a thorough examination of your face, including examining your eyes, ears and nose. If needed, they may perform tests such as X-rays and an MRI to identify the underlying cause of your facial pain.
