Facial Pain: Symptoms, Causes, and Treatment Options

Understanding Your Facial Pain

The first step to ending your facial pain is determining its cause. There are some types of pain that start in one place but are felt in other places, making the exact source difficult to pinpoint. This is particularly true within the face and head. Considering all the complex structures that exist above the neck, from nerves to muscles to teeth, tracking down the origin of your facial pain can take some time.

You may be wondering where to even start. Taking note of your symptoms and qualities of your facial pain will help provide clues as to its source. This can help you decide your next steps, such as a visit to a neurologist. Three common causes of facial pain are outlined below to assist you:

  • Sinus pain
  • Tooth pain
  • Trigeminal neuralgia

Compare your experience to the following information to help you decide what to do next and what type of specialist if any, you should consider visiting.

Sinus Pain

There are hollow areas within the skull called sinuses. These spaces are lined with a membrane and are typically filled with air. Sinusitis occurs when these membranes become inflamed, leading to mucus production and uncomfortable pressure. Causes of sinusitis include allergies, bacteria and swelling of the nose or other nasal issues.

Sinus pain can be classified as acute or chronic. Sometimes taking a nasal decongestant can provide relief. If you find that your facial pain lessens after taking a decongestant, then you may be experiencing sinus pain in the face. If your facial pain is linked to sinus inflammation, you may also find that the quality of your pain changes when lying down versus standing up. You may feel pressure when tapping on the forehead or cheekbones, areas overlying the sinuses. You may also experience nasal congestion or a runny nose. Sinus pain may also be felt as:

  • Pain in the face under the eye
  • Pain in the cheekbone and teeth
  • Left- or right-side face pain

Tooth Pain

Sometimes it’s obvious when pain is coming from a tooth. However, it can sometimes be hard to pinpoint a dental origin for your facial pain. Dental pain may feel like:

  • Toothache
  • Sinus pain
  • Pain under the eye
  • Pain in cheekbone
  • Jaw pain

A toothache can be severe enough that the whole side of your face hurts. Tooth pain tends to be throbbing and worsens when lying down. It may even wake you up at night. If facial swelling accompanies tooth pain, this indicates a severe infection, which can be dangerous and requires immediate attention.

Trigeminal Neuralgia

Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition that can cause pain that may be mistaken for sinus or tooth pain. It is characterized by severe pain in response to activities that should not cause any discomfort at all, such as brushing your teeth, smiling and speaking. Characteristics of trigeminal neuralgia include:

  • Intense pain on the entire side of the face in response to light touch or movement
  • Pain characterized as electric or stabbing
  • Pain lasts for seconds to minutes
  • Frequency of attacks may increase for a period, then subside
  • Some patients experience numbness, tingling or dull aching before an attack

Trigeminal neuralgia used to be difficult to diagnose and treat. However, it is now understood that the underlying cause is typically some structure that is impinging on the trigeminal nerve, which is responsible for sensory information from the mouth and face. The most common culprit is a blood vessel within the brain that is irritating the nerve. Treatment options include surgery and Gamma Knife radiosurgery.

Your Next Steps

To begin to diagnose and treat your facial pain, you will need to work with the appropriate medical specialist within northern NJ. Take a moment to consider your own facial pain and compare your experience to the conditions listed above. This will help you determine where to begin.

  • If you suspect you have sinus pain, you should schedule an appointment with your primary care physician. He or she may recommend diagnostic imaging to visualize the sinuses to diagnose or rule out sinusitis.
  • If you suspect you have tooth pain, a visit to your dentist is in order. When patients experience dental pain with no obvious cause, trigeminal neuralgia may be the cause. Interestingly, dentists are often the first practitioners to suspect trigeminal neuralgia when facial pain is present.
  • If you suspect you have trigeminal neuralgia, it will be important to work with an experienced neurologist within the tri-state area. Diagnosis is based on your symptoms, so keeping a diary of your symptoms can be very helpful. Log the time you experience facial pain, what you were doing and what it felt like. The more information you can provide, the better.

Putting an End to Your Pain

It is important to remember that the information provided above is designed to guide your next steps, not definitively diagnose your condition. The trigeminal nerve is responsible for transmitting facial pain in sinusitis, toothaches and trigeminal neuralgia, and there can be overlap in symptoms. This is why it is important to visit a specialist within NJ who can correctly diagnose the origin of your facial pain, ensuring you receive the appropriate treatment and put an end to your facial pain.

(Disclaimer: There are several other causes of facial pain. This list of three potential facial pain causes is not meant to be all inclusive and serves only as a highlight of potential causes, not as a diagnostic guide. For specific information regarding your unique condition, speak to a doctor to learn more.)

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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