Facial Pain

Introduction

Pain in the facial region including orofacial pain and craniofacial pain is broadly referred to as facial pain. The pain may be dull, throbbing or intense, stabbing discomfort on one or both sides of the face or forehead.

Facial pain, often described as burning aching or cramping, pinching and pulling can also occur on one side of the face, often in the region of the trigeminal nerve and can extend into the upper neck or back pf the scalp.

Facial pain is a constant symptom for patients of Atypical Facial Pain (ATFP), which is a syndrome encompassing a wider group of facial pain problems.

Causes of Facial Pain

Common causes of facial pain include infection and conditions that affect the skin of the face and other diseases. Here we list the main factors, which can lead to facial pain:

1) Infections

• Bacterial infections, such as impetigo, cellulites

• Viral infections, such as shingles

• Infection in salivary gland

• Lyme disease

2) Skin Conditions

• Rosacea, causing redness on cheeks, nose, chin or forehead.

• Acne, mostly in teenagers and young adults

• Seborrheic dermatitis, causing, red itchy patches around eyebrows, nose and mouth

3) Miscellaneous

• Sinusitis

• Injury to the face

• Dental problems

• Teporomandibular joint problem (TMJ)

• Migraines or cluster headaches

• Trigeminal Neuralgia

• Bell’s palsy

• Multiple sclerosis

• Myasthenia gravis

• Abscessed tooth

• Herpes Zoster

Diagnosis and Treatment

Apart from the usual examination of medical history, certain diagnostic tests might also be carried out. The most common ones include:

• ECG (especially if heart problems are suspected)

• Tonometry (if glaucoma is suspected)

• X-rays of the sinuses

• Neurological testing

• Dental x-rays

The treatment plan for facial pain has to be devised in accordance with the specific cause and symptoms.

Medication is generally the first course of treatment, while surgical treatments such as microvascular decompression are normally not successful with patients of facial pain.

The most common drugs prescribed for relief from facial pain include:

• Amitriptyline (Triptyl, Elavil)

• Gabapentin (Neurontin)

• Pamelor

• Capsaican

Other pain relief strategies are also applied for relief from facial pain. These include:

• Hot and cold compresses

• Acupuncture

• Biofeedback

• Dental Splint

When to seek help?

Though facial pain is common, and mostly has obvious causes, the patient should seek immediate medical help if any one of the below is experienced:

• Face pain accompanied by chest, shoulder, and neck or arm pain. This could imply a heart attack.

• Pain is throbbing, worse on one side of the face and aggravates by eating. This could be dental problem.

• Pain is persistent, unexplained or accompanied by other unexplained symptoms.