Facial Pain Causes and Diagnosis

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.

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

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 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.

FAQ

• 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.