Facial Pain

What is facial pain?

Facial pain (sometimes called orofacial pain) is a symptom of several health conditions. It can occur anywhere on your face, including your eyes and mouth. Face pain has many possible causes, including injuries, infections and nerve disorders.

Facial pain may be short-term (acute) or long-term (chronic). It can affect one side of your face or both. You might describe the pain as tingling, stabbing, shooting, dull, aching or throbbing.

Most of the time, face pain isn’t an emergency. But it could mean there’s something else going on. It’s important to tell a healthcare provider if you have unexplained or persistent facial pain that doesn’t go away.

Types of facial pain

Facial pain is a broad term used to describe pain that occurs anywhere on your face. There are different types of face pain, depending on where the pain originates:

• Toothaches from conditions like cavities or abscesses
• Jaw pain due to temporomandibular joint (TMJ) disorders or jaw fractures
• Nerve pain from disorders like trigeminal neuralgia (TN)
• Vascular pain due to conditions like migraines or vasculitis
• Atypical facial pain (AFP), which occurs for no apparent reason

Atypical facial pain

People with AFP have pain in their face every day for at least three months. Heat, cold or touch may trigger the pain. Some people also report that the pain gets worse if they’re tired or stressed.

The pain may be on the left or right side of your face, often near your jaw or ear. It might feel contained to one small area, or it might spread over your whole face. It doesn’t follow the path of a nerve.

Someone with AFP may describe the pain as:

• Burning
• Deep
• Dull or aching, but with periods of a sharp, stabbing sensation
• Pounding or throbbing
• Tingling, or having a pins-and-needles feeling

What are the most common causes of facial pain?

Many things can cause face pain, including:

• Headaches, including migraines
• Herpes simplex (cold sores) or herpes zoster (chicken pox or shingles)
• Myofascial pain syndrome
• Sinus infections
• Sialadenitis (swollen salivary gland)
• TMJ disorders
• Tooth abscesses
• Trigeminal neuralgia

How is face pain treated?

Facial pain treatment depends on the underlying cause. Healthcare providers usually try nonsurgical procedures first. If your symptoms don’t improve, you might need surgery.

Nonsurgical procedures

Healthcare providers use several nonsurgical methods to treat facial pain, including:

• OnabotulinumtoxinA (Botox^®) injections. These injections temporarily paralyze targeted muscles. This reduces contractions that cause facial pain.
• Complementary therapy. Many people benefit from therapies like facial massage and acupuncture. You can try sinus massage if congestion causes face pain.
• Nerve blocks. These nerve injections can temporarily relieve facial pain.
• Medications. Healthcare providers may prescribe antiseizure medications, antidepressants, or muscle relaxers to ease facial pain. Even though scientists didn’t design these medications for pain relief, studies show they have a positive effect.

Surgical procedures

Surgeries to relieve facial pain include:

• Peripheral nerve stimulation (PNS). This procedure uses a small needle and a mild electrical current to calm overactive facial nerves, making them less sensitive to pain.
• Microvascular decompression (MVD). When a blood vessel or artery presses on a nerve, it can cause pain in your face. With MVD, a surgeon makes a small opening in your skull (craniotomy) and places a surgical pad between the nerve and vessel to stop pain signals.
• Stereotactic radiosurgery. This procedure uses a Gamma Knife® to deliver radiation to nerves that cause facial pain. The Gamma Knife is as precise as a surgical blade, so it minimizes damage to surrounding tissues.

Are there home remedies for facial pain?

You might be able to treat mild facial pain at home. Here are some recommendations:

• Apply an ice pack to the affected area. Wrap the ice pack in a towel. Leave it on the affected area for 20 minutes, take a 20-minute break, then repeat as needed.
• Elevate your head. Use pillows to prop yourself up when sleeping.
• Massage the affected area with gentle pressure.
• Take over-the-counter pain relievers like acetaminophen (Tylenol®), ibuprofen (Advil^® or Motrin®) or naproxen (Aleve^®).
• Use a heat pack to soothe sore facial muscles.
• Wear a mouth guard if you have TMJ disorder or grind your teeth.

What are the possible risks of not treating facial pain?

While facial pain itself isn’t dangerous, it could point to something more serious. In rare cases, face pain can be a symptom of head and neck cancers, including oral cancers and cancers of the nose, sinuses or salivary glands.

If you develop facial pain, the best rule of thumb is to tell your healthcare provider. They can help you determine the cause and tell you whether you need treatment.

Can facial pain be prevented?

You can’t always prevent it. But understanding the cause can help you reduce your risk. If you know certain things make your facial pain flare, you can try avoiding those triggers.

For example, if you get migraines that cause facial pain, avoid loud noises and bright lights. If you grind your teeth at night, wearing a night guard can reduce your risk of uncomfortable symptoms.

Talk to your healthcare provider about ways to minimize your risk.

When should face pain be treated by a doctor or healthcare provider?

You should tell your healthcare provider if you have facial pain that:

• Doesn’t go away
• Goes away and comes back
• Has no known cause
• Occurs alongside other symptoms like shortness of breath, dizziness or vision problems

When should I go to the ER?

Call 911 (or your local emergency services number) or head to your local emergency room if you have face pain along with:

• Heart attack symptoms like pain in your arm, chest, shoulder or neck
• Stroke symptoms like tingling, numbness, muscle weakness or loss of movement