Face pain is a general term covering any pain that is felt in the mouth, jaws, eyes, and face. In the United States, it is estimated one in five people suffer from some form of facial pain at any one time, often resulting from dental problems (e.g., a toothache or dental abscess).
Facial pain is abnormal pain felt in any part of the face, including the mouth and eyes. The pain can be present on just one side of the face or both. The pain can be intermittent, but is typically present every day.
Face pain, sometimes called “orofacial pain,” occurs in an area that includes the region above the neck to the top of the eyes, and from the ears forward. Facial pain can also include pain within the mouth, which includes dental pain and temporomandibular disorders (i.e., problems opening the mouth, the jaw becomes ‘stuck’ or ‘locked’ either open or closed).
What Causes Face Pain?
The cause of facial pain can be due to anything from an infection to nerve damage in the face. The most likely cause of face pain is an injury to any of the various branches of the sensory nerves of the face. The injury can result in scarring around the nerve (entrapment) or scarring of the internal nerve itself (neuroma).
Some of the more common causes of facial pain include:
An oral infection, such as a salivary gland or duct infection.
TMJ (Temporomandibular Joint) Disorder, which causes problems with the joints and muscles that connect the lower jaw to the skull.
Oral Cancer is an uncontrollable growth of cells that damages the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, or pharynx (throat).
A Deviated Septum can cause other health complications.
Temporal Arteritis, an inflammation or damage to the arteries that supply blood to the head and brain.
Mumps, a contagious disease caused by a virus that passes from person to person through saliva and nasal secretions.
Glaucoma, an eye condition that damages the optic nerve.
Multiple Sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.
Acoustic Neuroma, a benign tumor growing on the nerve connecting the brain and ear.
Polymyalgia Rheumatica, an inflammatory disorder that causes muscle pain and stiffness.
Fibromyalgia, a syndrome characterized by fatigue and chronic pain in the muscles and tissues surrounding the joints.
Hypoparathyroidism, a rare condition that causes the parathyroid glands to not produce enough parathyroid hormone (PTH).
Surgery to remove a tumor from the face or jaw, or after a facelift.
In some cases, the actual source of pain is from other areas of the body (ears or head) that spread (radiate) to the face.
What are the Symptoms of Face Pain?
Patients often describe face pain as feeling like a cramp. The pain can be dull and throbbing, or an intense, stabbing discomfort in the face, lips, gums, cheek, or chin.
The exact type of pain depends on the cause.
A dull, throbbing pain on one side of the face or around the mouth is generally due to problems in the mouth, such as a toothache, cavity, or abscess.
The pain associated with sinusitis feels like pressure or an aching pain across the front of the cheekbones and underneath the eyes.
Abscesses and ulcers will often throb at the site of the sore.
Headaches and injuries can feel like a stabbing sensation or can throb and ache.
Disorders of the facial muscles often cause spasms or sudden muscle contractions on one side of the face. Limited motion may also be experienced.
How is Face Pain Diagnosed?
The diagnosis of face pain begins with a complete medical history and physical exam, including a review of the symptoms.
It is important to tell the doctor everything about the pain, which includes:
What part of the face hurts.
How often the pain occurs.
Exactly where the pain seems to originate.
The type of pain being felt.
How long the pain lasts.
What helps relieve the pain.
Any other symptoms experienced.
Additional tests may be necessary, depending on what the doctor learns during the medical history and physical exam. These tests include:
ECG, if heart problems are suspected.
Tonometry, if glaucoma is suspected.
X-rays of the sinuses.
Neurological tests, if nerve damage is suspected.
Blood tests, if an infection is suspected.
Depending on the findings, it may be necessary to refer the patient to another medical professional (such as a dentist, if a tooth problem is suspected).
How is Face Pain Treated?
The treatment options for face pain are based on the cause of the pain. The list below outlines the basic treatments for different types of facial pain.
Nerve (Neuropathic) facial pain is treated by a nerve block. In most cases, the block is managed with electrical stimulation (neuromodulation), such as a spinal cord stimulator or a peripheral nerve stimulator. Also, medications such as anti-inflammatories, anticonvulsants, antidepressants, and occasionally opioids and opioid-like medications are used when treatment begins.
Infection (Sinusitis) facial pain generally clears up after using antibiotics or allowing the infection to heal on its own.
Headache (cluster and migraine) facial pain is treated with over-the-counter (OTC) and prescription pain medication.
Oral Condition facial pain is treated by a dentist with antibiotics or by performing a tooth extraction or other dental procedure.
For patients who do not obtain relief from a non-surgical technique, surgery may be beneficial. Patients are selected for surgery based on their medical history, age, symptoms, diagnosis, and the underlying cause or origin of the pain and initial treatments.
Support for Face Pain Sufferers
The Facial Pain Association is a leading resource for information and healthcare guidance for anyone suffering from neuropathic (nerve) facial pain. Both patients and medical professionals can benefit from its educational programs, personal support, and research work.
Novus Spine & Pain Center is in Lakeland, Florida, and specializes in treating face pain. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.