FAQs of Facial Pain

Facial pain refers to any pain that occurs to the front region of the head. This pain can occur from numerous different causes. Facial pain can be dull, throbbing, sharp, shooting, achy, constant, and/or intermittent. When a person has pain of the face, it is often related to a nerve condition, an infection, or a recent injury. However, pain that arises from the neck or shoulder region can radiate to the face.

What are the common causes of facial pain?

  • Trigeminal neuralgia (TN) – This is a chronic disorder that involves the trigeminal nerve. With TN, there is an intense pain in one region of the face, or discomfort can be perceived all over the head and face. The pain is trigger by mild stimulation, such as chewing or a slight touch.
  • Abscessed tooth – An infected tooth can cause throbbing pain on one side of the lower face. The pain associated with an abscess often worsens with chewing or jaw movement.
  • Migraine headache – This type of pain occurs around the eye, but can be perceived all over the head. Patients who experience a migraine often have associated symptoms of nausea, vomiting, and visual disturbances.
  • Cluster headache – Occurring in clusters, this type of headache is more common for men than women. The pain is often on one side of the head, and is often accompanied by a droopy eyelid, runny/blocked nose, and/or redness of the eye.
  • Sinusitis – Also called a sinus infection, sinusitis causes facial pain of the forehead, nasal bridge region, or cheeks. It can occur on one side only (unilateral) or both sides (bilateral) of the face.
  • Myofascial pain syndrome – This is a chronic condition that involves pressure on sensitive points of the muscles (trigger points). The pressure leads to pain and is caused by repetitive motions and muscle contractions.
  • Temporomandibular joint (TMJ) dysfunction – The TMJ connects the mandible (lower jaw bone) to the skull. With this disorder, the joint is injured or inflamed, which causes the jaw to move abnormally and be tender. Pain is often localized to the jaw, but can radiate up the face.
  • Temporal arteritis – The temporal arteries deliver blood to the head and brain. With these vessels become damaged or inflamed, pain can occur on the side of the head (temple region).

What can I expect at the doctor visit?

If you have recurrent, severe, or persistent facial pain, you should be evaluated by a medical professional. To determine the source of your pain, the doctor will conduct a physical examination and do some blood work and diagnostic imaging tests.

  • Dental x-rays – If a serious abscess is suspected, the doctor will refer you to a dentist for dental x-rays and an evaluation.
  • Sinus x-rays – To diagnose sinusitis, the doctor may order x-rays of the sinuses.
  • Electrocardiogram (ECG) – Because a heart attack can cause facial pain that radiates from the chest to the face and jaw, the doctor may do an ECG to assess your heart rhythm.

How is facial pain treated?

The treatment of facial pain is directed at the actual cause of the discomfort. Depending on the underlying condition, treatment options include:

  • Occipital nerve block (ONB) – Used for cluster and migraine headache, this procedure involves the injection of an anesthetic, with or without a steroid, into the posterior region of the head (occipital nerves). In a clinical study of patients with face pain, participants reported a 75% reduction of pain after the block. Patients with occipital neuralgia reported 100% pain relief.
  • Sphenopalatine ganglion block (SPGB) – This procedure involves numbing the nostril with an anesthetic gel. Once numb, a tiny catheter is inserted through the nose to reach the nerves at the back of the throat. A long-acting anesthetic agent is injected near the nerves. In a clinical study, approximately two-thirds of patients reported pain relief within 7 days following the block.
  • Trigger point injection (TPI) – Done to reduce pain of myofascial syndrome and other conditions, the trigger point is injected with an anesthetic agent. Studies show that TPIs relieve pain in 90-98% of patients, with almost two-thirds reporting complete symptom relief.