Facial pain may come as a result of an infection in some structure of the face, an injury, or a nerve disorder such as trigeminal neuralgia, and in some cases it may occur for no apparent reason.
This is a short list of common causes of facial pain (see also the overview by the AANS):
- Inflammation of the sinuses (sinusitis)
- Abscessed tooth (a condition in which a tooth is surrounded by pus and inflammation)
- Facial injury
- Temporomandibular joint disorders or TMJ disorders
- Trigeminal neuralgia
Trigeminal Neuralgia
Trigeminal neuralgia, or TN, is also known as tic douloureux. This condition is usually recognized by its typical symptom: a sudden, shooting pain in the facial area.
The condition affects the trigeminal nerve, which is one of the biggest nerves in the head. This nerve carries sensations of pain, touch, temperature, and pressure to the brain from the face, gums, jaw, the area around the eyes, and the forehead.
What Leads to Trigeminal Neuralgia?
One of the most common causes of trigeminal neuralgia is pressure from a blood vessel on the nerve close to the brain stem. Over time, changes in the blood vessels of the brain can lead to a vessel rubbing against the root of the trigeminal nerve.
This continuous rubbing, which happens with every heartbeat, wears away the insulating membrane around the nerve, and this leads to nerve irritation.
What Are the Common Symptoms of Trigeminal Neuralgia?
Trigeminal neuralgia leads to unexpected, acute, stabbing pain that usually goes away after several seconds. The pain can be felt on the face and near the lips, nose, forehead, scalp, and eyes.
The attacks are often triggered when people brush their teeth, touch their face, put on makeup, swallow, or even feel a light breeze.
Trigeminal neuralgia is considered to be one of the most painful health problems. The pain is typically felt on one side of the cheek or jaw, although some people have felt it on both sides. It can happen several times a day, and the episodes can go on for weeks or months.
There are situations when the pain is gone for years and then suddenly returns. The condition is more frequent in women, and most of the people affected are older than 50.
How Is Trigeminal Neuralgia Diagnosed?
Doctors may use magnetic resonance imaging, or MRI, to check whether the pain comes from multiple sclerosis or from a growth that is irritating the trigeminal nerve. Other than that, there is no single test that can precisely confirm trigeminal neuralgia.
However, certain tests can help rule out other causes of facial pain. Trigeminal neuralgia is usually diagnosed on the basis of the patient’s description of the signs and symptoms.
How Is Trigeminal Neuralgia Treated?
Trigeminal neuralgia is most often managed with prescription anti-seizure drugs such as Tegretol (carbamazepine) or Neurontin (gabapentin). In some cases, doctors also prescribe medications like Depakote (divalproex sodium) and Klonopin (clonazepam).
They are often used in combination with other drugs in order to reduce pain. Certain antidepressant drugs may also be prescribed to ease the pain.
If these medications don’t provide enough relief or they cause serious side effects, doctors may suggest neurosurgical procedures that aim to relieve the pressure on the nerve or reduce its sensitivity.
Some patients also report that complementary approaches such as chiropractic adjustment, acupuncture, yoga, and meditation help them cope with the pain. These can be discussed with a doctor as an addition to, not a replacement for, medical treatment.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to your doctor about any health concern.