A throbbing and dull or stabbing and intensely uncomfortable sensation on one or both sides of the face is referred to as facial pain. There are two basic types of facial pain: orofacial pain which stems from the sensory and motor parts of the trigeminal nerve system; and trigeminal neuralgia (TN) facial nerve pain. TN is also referred to as ‘tic doloreaux’.
What are the common symptoms of facial pain?
There are different kinds of facial pain. In some instances, it is sudden and shock-like; pain of this nature is most often felt near the ears, eyes, lips and nose. Other types of facial pain cause dull, constant, boring, or burning sensations interspersed with sharp stabs of discomfort. Tingling and numbness may also be part of a facial pain episode.
What is the cause of facial pain?
There are numerous causes of facial pain. Among these are cluster headaches, an abscessed tooth, herpes zoster, sinusitis, a migraine, jaw disorders, and trigeminal neuralgia (TN). It’s not uncommon for facial pain to occur following dental or sinus surgery, and facial or skull trauma.
How is facial pain diagnosed?
Several factors must be taken into consideration in order to diagnose facial pain accurately. Age is significant because facial pain rarely occurs in children. The patient’s gender, the location of the pain, its frequency and duration must also be noted. Identifying the stimuli which trigger the pain, including shaving, speaking, a light touch, or brushing teeth, will offer important clues.
In order to diagnose your facial pain accurately, your doctor may also request a complete eye exam; an evaluation of your ear, nose, throat and neck; an assessment of the muscles you use for chewing, your cranial nerves and your sensory and motor capabilities.
In some instances, imaging technology, including MRIs and X-rays are employed. If glaucoma is considered a possible cause, tonometry will be used to measure fluid pressure in the eyes. An EKG might help uncover suspected heart problems that may be causing your facial pain.
How is facial pain treated?
Facial pain treatment must be tailored to its specific cause.
Trigeminal neuralgia and presses (TN) is generally considered to be one of the most painful experiences known. This stabbing recurrent facial pain comes on suddenly and is excruciating, so much so that the patient’s mood, overall health, and ability to sleep or work is seriously threatened; in some instances, it is so severe it can lead to suicide.
Formerly referred to as ‘tic doloreaux’, TN is a chronic condition that affects one of the largest nerves in the head, and is believed to be caused by a blood vessel which presses upon it. The trigeminal nerve has three branches that control the communication of sensation from all across the face and inside the mouth to the brain. More than one of these branches can be affected by trigeminal nerve pain.
Treatment of TN includes medicines, surgical procedures, and a variety of other approaches. Anticonvulsant and antidepressant medications are often prescribed. There are several neurosurgical options to help TN patients with facial pain. Choosing the right one will depend upon the patient’s preferences, past surgeries, physical condition, and the area of the trigeminal nerve involved. Some are outpatient procedures, while others are more complex and require general anesthesia.
One procedure, a rhizotomy, involves the elimination of certain nerve fibers to block pain. Microvascular decompression, the most invasive of all the surgeries which treat trigeminal nerve pain, has the best chance of eliminating the facial pain. This procedure involves entering the skull to access the trigeminal nerve and inserting a cushioning material between the nerve and the blood vessel which was pressing upon it.
If an abscessed tooth is the cause of facial pain, antibiotics and a root canal may prove useful in both eliminating the pain and saving the tooth. Pain killers, antihistamines, and antibiotics are among the medicines frequently prescribed to help manage and eliminate facial pain due to headaches, migraine, a sinus infection or herpes zoster.
Electrical stimulation, radiation therapy and heat or chemical treatments have proven effective in treating some patients.
Jaw disorders can be very painful. Basic treatments include: the application of cold packs and moist heat; a temporary diet of soft foods; medications; low-level laser therapy; wearing a night guard or splint; corrective dental treatments; and the practice of relaxation techniques
In addition, there are several complementary treatments that are often used in combination with medication to manage and eliminate facial pain. These include: chiropractic adjustment, acupuncture, self hypnosis and meditation, vitamins, biofeedback, and nutrition therapy.