Pain of the face can be seriously debilitating. Face pain is discomfort felt in any portion of the face. Although often caused by an injury or headache, facial pain also may be caused by a serious underlying medical disorder. While most causes of facial pain are harmless, a few can be quite serious.
What causes facial pain?
Facial pain is often caused by nerve damage of infection. Common causes of face pain include:
- Skin abscess
- Oral infections
- Facial injury
- Shingles (herpes zoster)
- Sinusitis (sinus infection)
- Trigeminal neuralgia
What are the symptoms of facial pain?
Facial pain is often described as achy, stabbing, sharp, shooting, or cramping. The pain may radiate from other body regions, such as the neck or shoulder. Headaches are often described as throbbing, aching, dull, and intense. The pain associated with sinusitis is described as pressure. Abscesses and ulcers will lead to burning pain, and injuries can cause numbness, tingling, and severe pain.
When is face pain an emergency?
If you experience facial pain that comes on suddenly and shoot from the chest to the arm, call 911 soon as possible. This could possibly be a heart attack. Face pain is not a medical emergency usually, but it can be a medical emergency. When visiting the doctor, you need to tell him:
- What part of your face hurts
- How frequent the pain occurs
- What type of pain you have
- What relieves the pain
- Any additional symptoms
How is facial pain diagnosed?
To diagnose the cause of facial pain, the doctor will take a medical history, conduct a physical examination, and order certain diagnostic imaging tests. X-rays and magnetic resonance imaging (MRI) scans are used to check the sinuses, bones, muscles, and tissues. To check for infection, the doctor may order certain laboratory tests. If you symptoms show any eye dysfunction, or if the doctor suspects heart problems, he may order additional tests.
How is eye pain assessed?
If your eyes are the cause of facial pain, the doctor will order a tonometry examination to check for glaucoma and ulcers. In addition, the doctor will check your eye for foreign bodies by placing a small strip of paper on the eyeball. A slit lamp is used to illuminate the eye and assess the cornea for tears.
Can facial pain be caused by heart problems?
The doctor will order an electrocardiogram (ECG) if he suspects cardiac (heart) problems. Angina (heart pain) often radiates to the face. The ECG test monitors the heart rhythm and is useful for diagnosing a myocardial infarction (heart attack).
How is facial pain treated?
The treatment for facial pain depends on the underlying cause. Options include:
- Botox injections – For headaches, Botox works by blocking certain chemical reactions in the nerve endings. The doctor administers several small injections to the forehead region.
- Occipital nerve block – The doctor can inject an anesthetic and/or corticosteroid agent near the occipital nerves at the back of the head. This treatment is used for cervical neck pain, occipital neuralgia, and other head pain causes. In a recent clinical study, this block was found to have an 88% success rate, with almost half of participants reporting pain relief for 1-2 years. In other studies, the rate of effectiveness ranged from 85-95%.
- Cervical epidural steroid injection – For head and neck pain due to compressed nerves, the doctor can inject a steroid with anesthetic near the spinal nerves. This is used to reduce swelling, inflammation, and pain.
- Medications – The pain management specialist may prescribe analgesics, such as nonsteroidal anti-inflammatory agents, narcotic pain relievers, and acetaminophen. In addition, tricyclic antidepressants and anticonvulsants are used for pain relief.
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