Causes of Facial Pain

What is face pain?

Facial pain is usually harmless and temporary; however, it can be caused by various medical conditions ranging from minor to serious. Facial pain includes pain in the face, mouth or eyes and pain radiating from other parts of the body, such as the ears or head. Most facial pain is described as stabbing, aching or cramping.

Sudden and unbearable facial pain requires prompt medical care to identify the exact cause. Tests can be performed to identify the underlying cause of facial pain. Once an official diagnosis is determined, treatment can proceed.

Causes of facial pain

Causes of facial pain range from infections to nerve damage. Depending on the cause, the duration and intensity of pain differs. Sudden facial pain radiating from the chest or left arm could be a sign of a heart attack. Emergency treatment is critical. Below are other medical conditions that can cause facial pain.

Acute angle-closure glaucoma

Acute angle-closure glaucoma occurs when fluid is suddenly blocked from draining in the eye. The pressure on the optic nerve results in pain, swelling and redness of the eye. Vision changes often occur, and without treatment, vision loss is possible. A health care professional typically prescribes medication to relieve the pressure and may perform surgery to drain the blocked fluid.

Abscessed tooth

An abscessed tooth develops when bacteria invades a tooth, the surrounding gums, or the bones that connect them. The resulting infection generates pressure, which causes throbbing pain in the ear or jaw. The face and gums may become swollen, tender and red. Antibiotics are usually prescribed. A dentist can extract the tooth or perform a root canal to eradicate the abscess.

Bruxism

Bruxism is a condition that is characterized by unconsciously grinding or clenching the teeth. Oftentimes, individuals do not realize this is occurring until a different problem arises. It can happen during sleep or daytime hours. Those with sleep bruxism frequently have other sleep disorders, such as snoring or sleep apnea. Bruxism is known to present various symptoms, including facial pain, tense facial and jaw muscles, headaches, sensitive teeth, damage inside the cheek, etc.

Cluster headache

Cluster headaches are extremely painful primary headaches that occur in cyclical patterns, known as cluster periods. They typically develop suddenly and can cause severe pain on one side of the face. The pain usually starts in the area around one eye, then may spread to the forehead, temple, nose, cheek or jaw on that side of the face and neck. In rare cases, the pain may switch sides.

A cluster headache may be experienced close to the same time on a daily basis for several weeks. They normally peak within five to ten minutes. The eyes and nose often become red, inflamed and watery. Sensitivity to light, sound or smell frequently occurs. A health care professional may suggest treatment with oxygen, medications, medicated nasal sprays, or neurostimulation.

Deviated septum

A deviated septum occurs when the cartilage separating the two nasal passages becomes damaged, often from an injury or illness. Symptoms include facial pain, nosebleeds, snoring, sinus infections, stuffy nose, and difficulty breathing through one nostril. A health care professional may recommend surgery in serious cases.

Giant cell arteritis

Giant cell arteritis (GCA) can develop when arteries in the head or scalp become inflamed. This inflammation causes the arteries to narrow, which restricts blood flow to affected areas, and commonly affects the arteries in the temples of the head. GCA can cause extreme pain around the temples or on either side of the face. Jaw pain, fever, and weight loss are also common. If not treated, blurry vision or sudden and permanent vision loss can occur. Although the exact cause is unknown, individuals experiencing GCA are normally over 50 years of age. GCA is usually treated with high doses of corticosteroids.

Heart attack

Heart attacks occur when blood flowing to the heart becomes blocked. Symptoms may appear suddenly or gradually. Although chest pain is the most common symptom of a heart attack, it does not always develop. Heart attack symptoms also vary between men and women. Symptoms include pain that radiates to the shoulder, arm(s), neck and/or jaw. Immediate medical attention can make the difference between life and death. Individuals should recognize symptoms of a heart attack and get help at the first signs.

Migraine

A migraine is a debilitating type of headache that can last from a few hours to a few days. At the outset of a migraine, overactive nerve cells send impulses to the blood vessels, which triggers the release of certain hormones, such as serotonin, prostaglandins and estrogen. The release of these hormones causes the blood vessels near the nerve endings to swell, resulting in a migraine.

Migraine headaches typically cause face pain on one side of the head. Many individuals experience an aura of lights or visual blind spots prior to the pain associated with a migraine. Nausea, light sensitivity, sound sensitivity, and intolerance of certain smells may occur. A health care professional may suggest diet changes, sleep pattern adjustments, and/or medications to treat migraines.

Occipital neuralgia

Occipital neuralgia is a rare disorder that presents as a distinctive headache. Pain occurs at the base of the skull, back of the head, or behind the ear, and usually on one side. It can travel to the scalp, forehead, or behind the eye. Occipital neuralgia develops when the occipital nerves, near the base of the skull, become inflamed or injured.

Because the symptoms are similar, occipital neuralgia is often mistaken for a migraine. Occipital neuralgia pain can be sharp, shock-like, stabbing, aching, burning or throbbing. Pain may increase with neck movement, and the scalp is usually tender. A health care professional may suggest heat, massage, rest, physical therapy, or prescription medication as treatment options.

Myofascial pain syndrome

Myofascial pain syndrome is a chronic pain condition in which sensitive knots (trigger points) develop in one or more muscles. Pain is felt when pressure is applied to these trigger points. The pain associated with myofascial pain syndrome lasts longer than typical muscle soreness. Facial muscles can cause severe pain around the jaw. Treatment may include physical therapy, pain medication, and trigger point injections.

Oral cancer

Oral cancer can cause pain in the lips, gums, tongue, cheek lining, the floor of the mouth, or the roof of the mouth. Pressure, swelling and sores are symptoms of mouth cancer. Tobacco use increases the risk of developing mouth cancer. Treatment depends on the type of cancer and location. A health care professional may treat oral cancer with surgery, radiation, chemotherapy, or a combination.

Shingles

Shingles is a viral infection which presents as blisters or a rash, normally on one side of the body. Individuals who have had chickenpox are at risk for developing shingles. The chickenpox virus lays dormant in the body and can reactivate later in life. If the virus reactivates, it is referred to as shingles.

The virus travels along nerve fibers to the skin and produces painful blisters. Shingles typically develops on the abdomen, back or chest; however, it can also develop on the face. It can cause feelings of tingling, burning and itching. A health care professional may prescribe medications to ease the pain and accelerate the healing process. Shingles vaccinations are available for individuals at greater risk for developing the condition.

Postherpetic neuralgia

Postherpetic neuralgia is a painful condition that can develop as a complication of shingles. It presents as a burning pain in the nerves and skin after the rash and blisters from the shingles virus have healed. The pain associated with shingles normally ceases after the herpes zoster virus becomes dormant again; however, if pain lingers after the shingles rash disappears, postherpetic neuralgia has likely developed.

When an individual has postherpetic neuralgia, nerves that were damaged during an outbreak of shingles send faulty pain signals to the brain. If shingles appear on the face, facial pain will occur. Treatments include anticonvulsants or antidepressants for the nerve pain and topical creams, such as lidocaine.

Ramsay Hunt syndrome

Ramsay Hunt syndrome is a rare condition that can occur if the shingles virus erupts near an ear. Facial paralysis and hearing loss in the affected ear may ensue. It can also cause tinnitus, vertigo, dizziness, earaches, balance problems, and difficulty closing the eye on the affected side. Quick treatment is needed to reduce complications and permanent damage. Treatment includes antiviral medication, steroids, and pain medication.

Salivary gland infection

Sialadenitis develops when the salivary glands become infected with bacteria. Pain may occur in the cheek or chin and may be accompanied by a lump. Fever, chills, and foul-tasting pus in the mouth may follow. A health care professional is likely to prescribe antibiotic treatment.

Sinusitis

Sinusitis can cause pain in any part of the face, including the mouth and eyes. Sinus cavities are small, hollow areas near the cheekbones that can become infected. Pain and pressure is usually felt near the nose and forehead and is often accompanied by colored mucus, a stuffy or runny nose, decreased sense of smell, fever, and cheek pain. Sinusitis can become chronic if it lasts 12 weeks or longer. Chronic sinusitis may involve infection, nasal polyps, and swelling in the lining of the sinuses. Treatment typically includes rest, antibiotics, and pain medication.

Temporomandibular joint disorders

Temporomandibular joint disorder (TMJ) can be caused by trauma, grinding the teeth, or chewing too hard. The temporomandibular joint is located on each side of the head and links the skull to the lower jawbone. Symptoms of TMJ include jaw pain, pain in or around the ear(s), headaches, etc. It can result in swelling, achiness or tenderness in the face, neck or shoulder. Although it is possible for TMJ to resolve on its own, a health care professional may prescribe physical therapy, surgery, medication, night guards, or splints.

Trigeminal neuralgia

Trigeminal neuralgia (TN) is a neuropathic pain condition which develops when damage occurs to a trigeminal nerve. They are responsible for carrying the sensations of pain and touch to the brain from areas of the face including, but not limited to, the mouth, nose and cheeks. When trigeminal neuralgia occurs, even a mild sensation (washing the face, eating a snack, a slight breeze touching the face, etc.) can cause intense pain. Extreme burning or shock-like facial pain can occur and usually affects the lower face; however, the nose and eyes can also be impacted. This type of pain can be intermittent or continuous. Trigeminal neuralgia may be treated with medications or surgery.

Herpes simplex virus

Herpes simplex virus (HSV) can occur around the mouth or genitals, and in some cases, the hands or fingers. This common virus impacts over 90% of adults before they reach age 50. HSV can be asymptomatic or may cause episodes of blisters and sores. Symptoms may also include swollen lymph nodes and shooting pain at the infection site. Treatment often consists of antiviral medications.

Atypical facial pain

Facial pain with no known cause is considered atypical. This includes stabbing or burning pain on one side of the face that is constant, but may fluctuate in intensity. Numbness or tingling may also occur. Although no cure is known, tricyclic antidepressants, MAO inhibitors, and anticonvulsants are typically prescribed for treatment.

Additional sources: London Pain Clinic, U.S. Pharmacist, and Medical News Today