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Facial Pain Causes and Diagnosis

Scott Loeb DO
Medically reviewed by Dr. Loeb
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Scott Loeb DO
Medically reviewed by Dr. Loeb

The medical term prosopalgia commonly refers to facial pain. It is a syndrome that is not a separate disease but a single term for all types of facial pain. Prosopalgia can occur due to many reasons. They make it not always possible to make an accurate diagnosis quickly and correctly. Doctors can misdiagnose facial pain in about 45% of cases. The possible facial pain causes occur due to:

  • the complex anatomical and functional organization of facial structures;
  • the nervous system of this area.

It determines the variety of diseases that cause painful symptomatology. It is a clinical term for all pain syndromes localized in the facial area. Prosopalgia can be:

  • neurogenic;
  • vascular;
  • symptomatic;
  • myogenic;
  • psychogenic and atypical character. 

During diagnosis, doctors can determine the type of prosopalgia. To identify its cause, doctors conduct the following examinations:

  • ophthalmologic;
  • otolaryngologic;
  • neurologic;
  • dental, and psychological.

Depending on the type and etiology of prosopalgia, they use:

  • anti-inflammatories;
  • antihistamines;
  • corticosteroids;
  • sedatives and psychotropic pharmaceuticals. 

Read further information about pain in the face  in our article.

facial pain causes

What Can Cause Facial Pain? 

An inflammatory response can be a factor in facial pain. Prosopalgia of inflammatory genesis most often occurs in sinusitis. Doctors observe it in otitis media, ophthalmologic diseases. Facial pain can occur with inflammatory lesions of the facial vessels. The pain of pharyngeal and laryngeal neuralgia often has an inflammatory etiology. 

On the other hand, facial neuralgia may have a compression genesis. It may be due to the compression of nerve trunks or nodes. It occurs due to:

  • changes in the relative location of anatomical structures of the facial area;
  • narrowing of bone and intermuscular nerve channels;
  • development of tumor formations, etc. 

Facial pain of psychogenic origin often occurs in hypersensitive people because of:

  • overwork;
  • chronic psychoemotional discomfort;
  • an acute stressful situation. 

One of the causes of neurogenic facial pain can be damage to the nerve structures. It often happens during operations in the facial area. People can also experience facial pain with headaches. Also, several facial pains do not have a precisely defined etiology. For example, bundle headache, atypical prosopalgia, and chronic paroxysmal hemicrania. Read more about some of the facial pain causes below.

Neuralgia of the trigeminal nerve

Trigeminal neuralgia manifests as intense pain more often in the upper or lower jaw. There are many triggers that provoke it, including:

  • hypothermia;
  • speech;
  • food intake. 

You can also have accompanying vegetative manifestations:

  • stuffy nose;
  • lacrimation;
  • facial hyperemia. 

The pain in the face is often based on the compression of the trigeminal nerve fibers. Most often, it is one of the cerebellar arteries. Often “trigger zones” are present. A doctor has to perform neurosurgical treatment to relieve the patient. 

Neuralgia of the lingual pharyngeal nerve

Established causes include:

  • tumors and osteophytes of the jugular foramen;
  • scarring of the nerve root;
  • aneurysms. 

Clinically, the disease manifests by:

  • acute shooting;
  • twitching pain in the area of the root of the tongue;
  • tonsil;
  • palatine sinus.

Paroxysms may be usually accompanied by abnormal heart rhythm and loss of consciousness.

Dental problems

Dental problems commonly cause facial pressure and pain, particularly in the jaw and cheek areas. Tooth decay, gum disease, and an abscessed tooth can all cause pain in the face.

When tooth decay or gum disease is untreated, it can lead to an abscessed tooth. It is a bacterial infection that can cause severe pain and swelling. People can feel pain in the affected tooth and the surrounding areas of the face.

Tooth decayб gum disease, and other dental problems that can be facial pain causes include:

  • Impacted Wisdom Teeth. When wisdom teeth do not have enough space to emerge, they can become impacted. And it causes pain and swelling in the surrounding areas.
  • Temporomandibular Joint (TMJ) Disorder. It is a disorder that affects the jaw joint and can cause pain in the jaw and ear area.
  • Bruxism. Grinding or clenching the teeth can cause pain in the jaw and surrounding facial areas.

If you are experiencing facial pain, it’s important to see a dentist. Especially if the pain is in the jaw and cheek areas, a doctor can determine if dental problems are the cause.


Sinusitis can cause pain in the face. As the inflammation and swelling of the sinuses can put pressure on the surrounding:

  • tissues;
  • nerves;
  • bones of the face. 

The sinuses are air-filled cavities located within the skull’s bones. And they are tightly connected to the nasal passages. When they become inflamed or infected, they can fill up with mucus, which can cause pressure to build up.

The facial pain caused by sinusitis is often described as deep, aching pain. It has a location in the affected sinus. People can feel it in the forehead, cheeks, nose, and around the eyes. It may also go with tenderness and swelling in the affected area.

Besides facial neuralgia, sinusitis can cause other symptoms such as:

  • nasal congestion;
  • headache;
  • fatigue;
  • fever. 

These symptoms can be uncomfortable and affect a person’s daily life.

Cluster headaches

This type is often characterized by severe pain localized to one side of the head. The location of facial pain with headache is usually around the eye or temple. The pain can be excruciating, typically described as a stabbing or piercing sensation. Cluster headaches, also known as “bundle headaches,” can cause facial pain as they affect the trigeminal nerve, which is a nerve that supplies sensation to the face.

Besides the head pain, cluster headaches can also cause pain and discomfort in the face. The pain occurs in the cheek, jaw, or temple areas, and a sensation of pressure or fullness may go with it.

Facial pain with headache is also associated with other symptoms, including:

  • nasal congestion;
  • tearing or redness of the eye on the affected side;
  • a drooping or swollen eyelid. 

These symptoms can make the facial pain associated with cluster headaches even worse.

Narrowing of bone

Narrowing bones in the face, such as in the nasal passages or the jaw, can cause facial pressure. As it can lead to facial bone stenosis. Stenosis refers to the narrowing of a passage or opening in the body. And when it occurs in the bones of the face, it can cause compression of nerves and blood vessels in the area. As a result, a human has pain and discomfort.

Facial bone stenosis can occur due to various factors, including:

  • injury;
  • inflammation;
  • infection;
  • congenital abnormalities. 

When the bones narrow, they can pressure the surrounding tissues. These are the nasal passages or the nerves that supply sensation to the face. 

Narrowing of the jawbone can cause:

  • pain and discomfort in the jaw joint;
  • difficulty opening the mouth;
  • even ear pain. The location and severity of the facial pain will depend on:
  • the affected bone;
  • the size of the occurred narrowing.

For example, the narrowing of the nasal passages can cause:

  • facial neuralgia and pressure;
  • difficulty breathing;
  • a decreased sense of smell.

When is facial pain an emergency?

Facial pain can be a symptom of many conditions, some of which may require emergency medical attention. Here are some situations where pain in the face may be an emergency:

  • Severe and sudden onset of facial pain. It may be an emergency if you experience sudden, severe, and debilitating facial pain. Particularly if it goes with other symptoms such as fever, headache, or loss of consciousness. It will need immediate medical attention.
  • Trauma to the face. If you experience facial pain due to a head injury or trauma to the face, it may be an emergency and require immediate medical attention.
  • Vision changes. Suppose you have facial pain or changes in vision, such as double or blurred vision. In that case, it may be a sign of a serious condition and require emergency medical attention.
  • Difficulty breathing. Consider turning to the doctor if you experience facial pain with difficulty breathing.
  • Swelling or redness. Your facial pressure can go with swelling, redness, or other signs of inflammation. So it may be a sign of an infection or other serious condition requiring medical attention.

facial neuralgia diagnosis

Facial Neuralgia Diagnosis

Facial pain is not a diagnosis but a syndrome. Therefore, it is important to identify the underlying disease that causes prosopalgia. During diagnosis, a neurologist-algologist must:

  • examine various characteristics of the pain phenomenon;
  • palpate the facial muscles;
  • identify trigger points. 

Exclusion or confirmation of the symptomatic nature of pain in the face is performed with the participation of an ophthalmologist, dentist, and otolaryngologist.

If necessary, they may perform:

  • a dental X-ray;
  • orthopantomogram;
  • X-ray of paranasal sinuses and temporomandibular joints;
  • otoscopy and pharyngoscopy;
  • intraocular pressure measurement;
  • examination of eye structures, etc. 

Clinical blood tests are prescribed to detect inflammatory changes in facial pain with headaches.

Lone Star Neurology is a leading neurology practice that offers expert diagnosis and treatment for a range of neurological conditions, including facial pain. Our highly trained and experienced neurologists use state-of-the-art diagnostic tools and techniques to accurately identify the underlying facial pain causes and develop personalized treatment plans to help relieve your pain and improve your quality of life. Whether you are experiencing mild or severe facial pain, we are here to help. Contact Lone Star Neurology today to schedule a consultation and get the relief you need.


  • What is the most common cause of facial pain?

The most common cause of facial pain is dental problems, such as tooth decay or a dental abscess. So we recommend choosing your dentist carefully.

  • Can face pain be a stroke?

Facial pain can be a symptom of a stroke, but it is not typically the only or primary symptom. Other symptoms of a stroke may include sudden weakness or numbness on one side of the face or body, confusion, or trouble speaking,

  • What does neuralgia in the face feel like?

Neuralgia is a type of pain that occurs when a nerve is damaged, irritated, or inflamed. When neuralgia affects the face. The pain is often described as a sudden, sharp, shooting, or stabbing pain.

  • How to treat facial pain?

Hirudotherapy and acupuncture, biofeedback therapy, and botulinum therapy are effective in treating facial pain.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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