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Facial pain

Facial pain may be dull and throbbing or an intense, stabbing discomfort on one or both sides of the face or forehead. Pain that starts anywhere in the face may be caused by a nerve disorder, an injury or an infection in a structure of the face. Face pain may also begin elsewhere in the body.

Common causes are:

  • An abscessed tooth
  • Cluster headache
  • Shingles (herpes zoster)
  • Injury to the face
  • Migraine
  • Myofacial pain syndrome
  • Sinusitis
  • Trigeminal neuralgia
  • Temporomandibular joint dysfunction syndrome


Dial 911 when face pain is accompanied by pain in the chest, shoulder, neck or arm. If pain is persistent, unexplained or accompanied by other unexplained symptoms, call your primary care provider.

Common Symptoms

  • Dull, throbbing pain on one or both sides of the face or forehead
  • An intense, stabbing discomfort on one or both sides of the face or forehead


Diagnosis

Your doctor will ask you a series of questions, including:

  • What part of your face is in pain?
  • Is the pain on both sides?
  • Did the pain begin suddenly?
  • Is face pain occurring repeatedly?
  • How long have the episodes of pain been occurring?
  • How long does each episode last?
  • Is the pain worse when speaking, chewing or swallowing?
  • Did face pain occur before the start of a brain or nervous system problem such as weakness or speech loss?


Diagnostic tests may include:

  • Dental x-rays if a tooth problem is suspected
  • ECG if heart problems are suspected
  • Tonometry if glaucoma is suspected
  • X-rays of the sinuses
  • MRI if a tumor or trigeminal neuralgia is suspected
  • Neurological tests if nerve damage is suspected
  • Magnetic resonance angiogram (MRA) if a vascular problem is suspected
  • CT scan


Treatment

We offer a variety of treatments depending on the cause of your facial pain.

  • Medical management with medications such as carbamazepine
  • Interventional management including nerve blocks, radiofrequency ablation
  • Neurosurgical referral for vascular decompression or stereotactic radiosurgery



Source: National Institutes of Health

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