Facial Pain: Causes and Treatment

Medically reviewed by Michael Menna, DO

Not only is facial pain uncomfortable, but it can interfere with daily tasks such as talking, eating, and brushing your teeth. Facial pain can cause aching, pressure, burning, shooting, or electrical sensations. Because there are many structures in and around the face, there are many different causes of facial pain.

This article will review various facial pain causes, treatment options, and when to see a healthcare provider.

Causes of Facial Pain

There are many different structures in and around the face, including the skin, eyes, nose, mouth, sinuses, muscles, and nerves. Facial pain can result from a variety of different conditions that affect any of these structures.

Sinus Infection

The sinuses are empty cavities within the nose and middle of the face. They transport air and help drain mucus. Sinusitis, or a sinus infection, results from respiratory infections, including the common cold. This causes pressure to build up within the inflamed sinuses, causing facial pain.

Facial pain from sinus pressure has the following features:

• Throbbing

• Affecting one side of the face

• Located around the eyes, nose, cheeks, or forehead

• Occurring with nasal congestion

• Associated with fever in 50% of cases

Bell’s Palsy

Bell’s palsy results when the facial nerve on one side of the face becomes paralyzed or partially paralyzed. This results in weakness of the muscles controlled by the facial nerve, including those around the eyes, forehead, and mouth. The exact cause of Bell’s palsy is unknown, but viruses, stress, autoimmune conditions, and infections can trigger an onset.

Symptoms of Bell’s palsy include:

• Facial pain, numbness, and weakness on one side of the face

• Pain around the jaw or behind the ear

• Eye tearing and mouth drooling

Trigeminal Neuralgia

Trigeminal neuralgia is a painful condition caused by irritation to the trigeminal nerve. The trigeminal nerve arises from the pons, an area of the brain that forms part of the brainstem. From here, it travels toward the face and splits into three different branches that provide sensation to the scalp, forehead, cheeks, nose, upper and lower jaws, lips, teeth, and gums.

Trigeminal neuralgia is caused by compression of the trigeminal nerve. In 80% to 90% of all cases, compression is caused by a blood vessel, most commonly the superior cerebellar artery.

Symptoms of trigeminal neuralgia include:

• Sudden, intense pain on one side of the face

• Short bouts of pain lasting a few seconds to a few minutes

• Facial numbness or tingling

• Burning, throbbing, or aching in the face

• Recurring pain attacks

Temporomandibular Joint (TMJ) Disorders

The temporomandibular joint (TMJ) is a small joint that connects your lower jaw (mandible) to the side of your skull (temporal bone). This joint controls motion of the jaw opening, closing, and moving side to side needed for talking and eating.

The TMJ is used 1,500–2,000 times a day, and can cause significant pain if there is an issue with the joint. Facial pain from TMJ disorders can spread to the jaw, ears, temples, forehead, and neck. Tightness in the muscles that control the jaw may also become tight and tender.

The TMJ can become irritated and inflamed from poor alignment of the jaw, or poor habits like teeth grinding. Facial pain from TMJ disorders is typically:

• On one side of the face

• Dull and aching

• Worsens with moving or touching the TMJ

• Associated with limited jaw opening and clicking

Read Next: 8 Things That Make TMJ Worse

Headaches

Headaches, in addition to causing head pain, can also affect different parts of the face. Migraines are throbbing or pounding headaches that can spread pain to the neck and face. They can also cause symptoms similar to sinus infections, including pressure in the middle of the face and nasal congestion.

Cluster headache is a type of severe headache that comes on suddenly and occurs in clusters of time. It causes pain on one side of the head, forehead, and around the eye. The causes of migraine and cluster headaches are not fully understood, but certain triggers can bring them on.

Related: 4 Headache Locations and What They Mean

Wounds and Skin Conditions

Direct injury to the face can result in wounds like cuts, sores, burns, and bruises. Skin conditions, like acne, eczema, psoriasis, and allergic reactions can cause skin lesions like pimples, rashes, patches, and hives. These injuries and skin conditions can result in various uncomfortable sensations, such as facial pain, stinging, burning, or itching.

Wounds, sores, and infections affecting teeth, mouth, or gums can also cause facial pain.

Learn More: 20 Types of Skin Lesions and What They Look Like

Shingles

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. To develop shingles, you need to have had chickenpox in the past. The virus lays dormant in the body but can be triggered by an infection or stress. Shingles cause a painful skin rash, which can develop on the face.

Symptoms of shingles on the face include:

• Painful rash on one side of the face

• Burning, itching, or tingling

• Generalized fatigue, fever, chills, and body aches

Shingles can also cause a complication called postherpetic neuralgia. This condition causes nerve pain and burning in the skin that continues even after the shingles rash goes away.

Heart Attack

A heart attack is a serious condition in which blood flow to the heart is blocked. The most common symptom is severe chest pain, but pain can also be felt in the left arm, neck, or jaw. A heart attack is a medical emergency and requires immediate medical treatment.

Stroke

A stroke is a medical emergency in which blood flow to the brain is stopped, usually from a blood clot. Strokes usually affect one side of the body, and one of the first signs of a stroke is facial drooping and weakness. Strokes can cause permanent nerve damage and can result in pain in affected areas of the body, including the face.

How to Relieve Facial Pain at Home

Relieving facial pain requires treating the underlying condition causing it. While medical management is key, at home treatment methods can help alleviate discomfort. Applying ice or a cool compress to the affected part of your face can help reduce pain intensity. Over-the-counter (nonprescription) medications to reduce pain and inflammation can also be used to help with your symptoms.

Avoiding triggers for certain types of facial pain can prevent symptoms from occurring. If you frequently have migraine or cluster headaches, avoiding triggers like bright lights, loud noises, lack of sleep, and stress can help.

If you experience facial pain from a TMJ disorder, wearing a night guard to prevent teeth grinding as you sleep can ease discomfort. You may also benefit from jaw exercises and physical therapy.

Medicated Facial Pain Treatment

Various medications are used to treat facial pain depending on the underlying cause. These include:

• Prescription painkillers

• Anticonvulsant medication to decrease nerve activity, such as carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine, and valproic acid

• Antidepressants to decrease pain signals released from nerve endings

• Antibacterial or antiviral medications to treat infections

• Blood thinners, blood pressure drugs, and cardiac medications to prevent blood clots, reduce heart rate, and lower blood pressure

For many cases of trigeminal neuralgia, medication provides only short-term relief, and surgery is often needed to reduce compression of the trigeminal nerve. Several surgical procedures can be performed to treat trigeminal neuralgia. These include:

• A rhizotomy to selectively destroy nerve fibers to block pain while preserving the fibers that control sensation. Techniques include balloon compression, glycerol rhizotomy, or radiofrequency thermocoagulation

• Microvascular decompression to surgically insert a small soft cushion between the trigeminal nerve and the blood vessel that is compressing it

• A neurectomy to cut and remove a portion of the trigeminal nerve

Seeing a Provider to Diagnose Facial Pain

Facial pain usually isn’t a medical emergency, but it still requires attention from a healthcare provider to address your symptoms. See your healthcare provider if you experience facial pain that does not improve after one week.

If you have any signs of infection, skin irritation, or loss of sensation, see your healthcare provider sooner. These symptoms require more urgent treatment.

Takeaway

Heart attacks and strokes are medical emergencies and require immediate medical attention. Call 911 if you experience severe chest pain, pain radiating down the arm, upper back, or jaw, shortness of breath, nausea, vomiting, dizziness, headache, confusion, difficulty speaking, or sudden numbness or weakness.

Managing Chronic Facial Pain

It can be difficult to find relief from chronic facial pain. While there is not strong evidence for the effectiveness of complementary treatments for treating facial pain, some options may provide you pain relief. Complementary treatment options include:

• Acupuncture

• Massage

• Nutrition therapy

• Botox injections

• Aromatherapy

• Meditation

Summary

Facial pain can result from a variety of different conditions that affect the various structures of the face. Causes include sinus infections, wounds and skin conditions, headaches, temporomandibular joint (TMJ) disorders, shingles, Bell’s palsy, trigeminal neuralgia, heart attack, and stroke.

Medications to treat these conditions include pain medication, medication to decrease nerve activity, medication to treat infections, and medication that control the activity of your heart and blood vessels.

While medication is used to manage most of these conditions, surgery may be needed if you have trigeminal neuralgia to relieve nerve compression causing unpleasant facial pain. If your facial pain lasts more than one week, talk with your healthcare provider to determine what may be causing it and what treatment options are available.

Read the original article on Verywell Health.