Pain in the Face – Causes, Treatment & Prevention

Pain in the cheeks, jaw, temples, ears, eyes, nose and mouth, as well as in the muscles and skin of the face is referred to as facial pain. Depending on the underlying disease, facial pain can affect only one or both halves of the face, run along certain nerves or only occur in individual areas around the eyes, mouth or nose.

Neck , shoulder or back pain sometimes develops in this context . The most common forms of facial pain include trigeminal neuralgia and persistent idiopathic facial pain. Trigeminal neuralgia is a term used to describe sudden, extremely severe and stabbing nerve pain that usually only lasts a few seconds.

Idiopathic facial pain occurs irregularly at first, then every day, does not have the characteristics of neuralgia and cannot be attributed to other diseases. The burning, piercing pain indicates an acute inflammation , without any pathological changes to the face, jaw and teeth being detectable. Sometimes, despite numerous examinations, no physical source can be identified for the facial pain: Doctors refer to this form as idiopathic facial pain.

causes

One of the most important triggers of facial pain are disorders of the nerves (neuralgia). The very intense pain, which is due to damage to the fifth cranial nerve – the trigeminal nerve – can be triggered by closely adjacent blood vessels pressing on the nerve (classic trigeminal neuralgia).But other diseases such as multiple sclerosis, which lead to inflammation of the nerve, or nerve tumors can also cause the extreme facial pain (symptomatic trigeminal neuralgia). The areas of the face supplied by the trigeminal nerve are affected: after exiting the base of the skull, the nerve node branches into three main branches, of which the first branch conveys sensations from the forehead, frontal sinus and eyes, the second branch those from the upper jaw (including the teeth ) and cheek and the third branch which transmits the mandibular region to the brain.

A further cause of acute or chronic facial pain is a shingles or facial rose. The virus remains in the nerve nodes even after the herpes infection has been overcome and can trigger postherpetic zoster neuralgia. Misaligned teeth or jaws, deep dental caries and inflammation of the gums or tooth root can also be the cause of facial pain.

If no underlying diseases or other causes can be identified for persistent facial pain, psychological or psychosomatic disorders can be considered. The persistent idiopathic facial pain can also be a late consequence of an injury or surgery in the face that has already healed.

Diseases

• Multiple Sclerosis

• shingles

• brain tumor

• face rose

• jaw misalignment

• gingivitis

• caries

• Tooth root inflammation

• maxillary sinusitis

• sinus infection

• psychosomatic disorder

• migraine

When to the doctor?

Facial pain can occur for many different reasons. Not all causes require a doctor to be consulted. The pain in the face often occurs with scratches or pimples and heals relatively quickly. If the pain occurs due to abrasions or bruises after an accident, a doctor should be consulted. Consequential damage and wounds can thus be avoided. There is also a risk of infection with bleeding wounds, which must be avoided at all costs.

Likewise, the pain in the face can occur due to toothache or pain in the jaw. In any case, this should be treated by a doctor. In most cases, this pain does not go away on its own and must be treated with either medication or surgery.

Herpes can also cause facial pain. A doctor only has to be consulted if the herpes does not go away on its own and lasts for several days. In most cases, however, it heals relatively quickly and leaves no wounds. A doctor must also be consulted if normal everyday life is no longer possible due to the pain in the face. This can be a serious illness.

diagnosis and course

In order to find out the cause of the pain in the face and to initiate successful therapy, a detailed anamnesis is required, in which the type, location and duration of the symptoms are described in detail. Further examinations are then usually carried out by specialists.

To determine trigeminal neuralgia, an MRI or computed tomography is performed to detect any tumors and injuries that may be present. Blood tests and, if necessary, an examination of the cerebrospinal fluid provide information about possible nerve damage.

If the description of the facial pain indicates a malfunction in the tooth or jaw area, further dental or orthodontic examinations are required. The jaw area is usually x-rayed to confirm the diagnosis. If idiopathic facial pain is suspected, all other possible causes of the painful sensations in the face must be ruled out.

Since surgical interventions would increase the idiopathic facial pain, thorough non-invasive examinations are necessary: ​​In addition to a dental and orthodontic check-up, the ear, nose and throat area is also thoroughly checked. X-rays of the face and jaw as well as computer or magnetic resonance imaging of the skull show whether abnormalities indicate an underlying disease or not.

complications

Of course, facial pain can occur for many different reasons. For this reason, the different complications are just as varied. If the pain in the face was caused by an external force, various complications can occur. Headaches often occur in this context, which in the worst case can even indicate a concussion . Of course, bone fractures can also occur in the face, which must be treated by a doctor.

If there is a sinus infection, this is also expressed by pain in the face. The pain mainly occurs in the nasal area, which at the same time causes an uncomfortable feeling of pressure.

Toothache is also a common cause of facial pain. This can lead to various complications, such as bleeding gums, severe headaches or even balance disorders .

If the cause is a misalignment of the teeth, this can lead to complications when eating. This in turn can lead to weight loss, so a visit to a dentist or oral surgeon is essential. In principle, further complications can occur in connection with pain in the face. However, the range in this context is so wide that individual clinical pictures can only be dealt with to a limited extent.

treatment and therapy

The treatment of facial pain depends very much on the underlying cause. If there are organic diseases such as tooth root inflammation, eye or sinus inflammation or brain tumors, the treatment consists of combating the cause of the pain.Trigeminal neuralgia is initially treated with medication. Since classic pain therapy with analgesics , which only develop their effect after about 30 minutes, is not effective, antiepileptics are used in particular, which effectively prevent pain attacks. Surgical interventions are performed less frequently, in which either the irritated nerve is relieved or the pain conduction at the nerve node is switched off. In this procedure, radiation energy is shot precisely at the tissue with a gamma knife or a cyber knife.

Possible consequences can be sensory and hearing disorders or vision problems . Once diagnosed with persistent idiopathic facial pain, tricyclic antidepressants can help relieve pain and improve mood. Acupuncture or electrical stimulation of the nerves sometimes has a positive effect on facial pain.

Since a permanent cure is usually not possible, neurologists recommend behavioral therapy to those affected, in which they learn to deal with the pain and reduce fears . Strategies for stress management and relaxation will also be shown to you there.

prevention

There are no surefire ways to prevent facial pain. It is advisable to avoid stress and relax your muscles regularly. A healthy lifestyle with lots of physical exercise, a balanced diet and little alcohol has a positive effect on body and soul.

In order to identify possible illnesses at an early stage, check-ups should be carried out at least once a year. If there is already facial pain, medication can relieve the symptoms. In addition, those affected can learn to deal with facial pain in behavioral therapy.