Pain of the face is seriously debilitating. Facial pain is any discomfort felt in all or any portion of the face. Facial pain can be caused by a headache, injury, or serious underlying medical condition. However, most causes of facial pain are harmless.
What causes facial pain?
The most common cause of facial pain is a group of disorders called temporomandibular joint and muscle disorders (TMJDs). These conditions cause intermittent, recurrent, and/or chronic pain and dysfunction of the jaw joint and associated tissues and muscles. Other causes of facial pain are nerve damage, infection, skin abscess, headache, tooth decay, trigeminal neuralgia, herpes zoster (shingles), and sinusitis (sinus infection).
How common is facial pain?
Around 5-12% of the U.S. population has some type of facial pain. TMJDs are the second most commonly occurring musculoskeletal disorders that result in pain and disability.
What symptoms are associated with facial pain?
Pain of the face can be stabbing, achy, shooting, sharp, dull, and/or cramping. The pain can radiate to or from other body regions, such as the shoulder or neck. Headaches can cause pain at the top or back of the skull, which radiates over the head to the face. The pain associated with the sinuses is described as pressure, whereas ulcers and abscesses cause burning or searing pain. Some facial injuries result in tingling, numbness, and electric-shock sensations of the face.
When is face pain an emergency?
If you feel pain in your chest or arm, and it radiates up to your jaw and face, this could possibly indicate a heart attack. Facial pain could also be indicative of an impending stroke. If you experience loss of facial sensation or pain coming from the chest upward, call 911 or get to an emergency department soon.
How is facial pain diagnosed?
To diagnose facial pain, the doctor will ask questions about your symptoms, take a medical history, and conduct a physical examination. Certain diagnostic tests are used to assess facial bones, sinuses, tissues, and muscles. These include x-rays, magnetic resonance imaging (MRI) scans, and computed tomography (CT) scans. The doctor may order additional eye-specific tests if symptoms indicate the need for this.
How is facial pain treated?
The treatment of facial pain is aimed at curing the underlying cause. When no cure exists, the goal of treatment is control of symptoms. Treatment options include:
- Botox injections – For certain types of headaches and facial pain, the doctor can administer Botox injections. Botox works by blocking chemical reactions in nerve endings. In a recent study for myofascial pain syndrome, Botox was injected into areas of the neck and shoulders of study participants. Researchers verified effectiveness and safety of this treatment modality.
- Occipital nerve block – For occipital neuralgia, cervical (neck) pain, and other pain at the posterior region of the head, and nerve block can be done. This involves injecting an anesthetic with or without a corticosteroid agent onto the occipital nerves. This block has an 88% efficacy rate with pain relief lasting for up to 2 years.
- Cervical epidural steroid injection – For neck and head pain related to nerve compression, an ESI can be done. This procedure involves injecting a corticosteroid and anesthetic into the epidural space surrounding the spinal cord. This treatment is effective for reducing inflammation and swelling. Based on research reports, this procedure has a 75% success rate, with most participants reporting more than 70% pain relief.
- Medications – Certain pain relievers and other medications are used to treat facial pain. Tricyclic antidepressants and anticonvulsants are useful for pain relief associated with nerve pain, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used for inflammation and swelling. For sinus infections, antibiotics are used, along with salt water nose sprays.
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