Facial Pain: Possible Causes and Relief Strategies - Neurology

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The left side of the face seems to be experiencing continuous muscle spasms?


Hello Doctor, this past Monday night I suddenly experienced severe pain in my upper and lower jaws (even affecting the bones around my nose).
Therefore, I went to see a dentist on Tuesday afternoon (initially thinking it might be periodontal disease, as I have never had such symptoms and didn't know which specialist to consult).
After the dentist's examination, no issues were found, and I was given a dental cleaning.
However, the pain recurred yesterday, this time only on the left side of my cheek, feeling like a continuous mild cramp (even the muscles used for speaking hurt).
Should I buy pain relievers, or are there any methods to alleviate the pain?

Wu Ying-Hsuan, 10~19 year old female. Ask Date: 2016/04/21

Dr. Jiang Junyi reply Neurology


According to the diagnostic criteria for headache classification, if a headache is persistent, one should consider: Hemicrania continua.
Description: A persistent unilateral headache responsive to indomethacin.
Diagnostic criteria: A.
Headache lasting at least three months and meeting criteria B-D.
B.
All of the following: 1.
Fixed unilateral pain 2.
Continuous daily pain without interruption 3.
Moderate to severe intensity C.
During severe pain, at least one of the following autonomic symptoms on the affected side: 1.
Conjunctival injection and/or tearing 2.
Nasal congestion and/or rhinorrhea 3.
Ptosis and/or miosis D.
Absolute response to indomethacin E.
Not attributable to another disorder.
Additionally, symptoms caused by trigeminal nerve inflammation should also be considered.
It is recommended that you consult a neurologist for evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2016/04/21

More Info


Facial pain can be a complex issue, as it may arise from various underlying causes, including dental problems, nerve issues, or even muscle tension. Given your recent experience with sudden and severe pain in your upper and lower jaw, which radiated to your nasal area, it’s understandable that you initially sought help from a dentist. However, since the pain has persisted and localized to the left side of your face, it’s crucial to consider a broader range of potential causes and treatment options.


Possible Causes of Facial Pain
1. Dental Issues: While your dentist did not find any significant problems, dental issues such as temporomandibular joint (TMJ) disorders, tooth abscesses, or gum disease can cause facial pain. TMJ disorders, in particular, can lead to pain in the jaw, face, and even the neck.

2. Nerve Pain: Conditions like trigeminal neuralgia can cause severe, shooting pain in the face. This condition is often triggered by touch or movement and can be mistaken for dental pain.
3. Muscle Tension: Prolonged stress or poor posture, especially if you spend long hours at a computer, can lead to muscle tension in the jaw and face, resulting in pain that feels like cramping or soreness.

4. Sinusitis: Inflammation of the sinuses can lead to facial pain, particularly around the cheeks and forehead. This might be relevant given your mention of pain affecting the nasal area.

5. Other Causes: Other potential causes include infections, migraines, or even referred pain from other areas of the body.


Relief Strategies
1. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain. However, it’s essential to follow the recommended dosages and consult a healthcare provider if the pain persists.

2. Heat Therapy: Applying a warm compress to the affected area can help relax tense muscles and improve blood circulation, potentially reducing pain.

3. Relaxation Techniques: If muscle tension is a contributing factor, practicing relaxation techniques such as deep breathing, meditation, or gentle stretching exercises may help relieve discomfort.

4. Dental Evaluation: Since dental issues can often be overlooked, consider returning to your dentist or seeking a second opinion. A dental specialist may be able to assess for TMJ disorders or other dental-related causes more thoroughly.

5. Neurological Assessment: If the pain continues or worsens, it may be beneficial to consult a neurologist. They can evaluate for conditions like trigeminal neuralgia or other nerve-related issues.

6. Physical Therapy: If muscle tension is a significant factor, physical therapy may provide exercises and techniques to strengthen and relax the facial muscles.

7. Avoiding Triggers: If you notice that certain activities or positions exacerbate your pain, try to modify those behaviors. For example, if clenching your jaw is a problem, being mindful of your jaw position throughout the day can help.


Conclusion
Facial pain can stem from various sources, and identifying the underlying cause is crucial for effective treatment. While over-the-counter pain relief can provide temporary relief, it’s essential to seek further evaluation if the pain persists or worsens. A comprehensive approach that includes dental evaluation, potential neurological assessment, and lifestyle modifications may be necessary to address your symptoms effectively. If you continue to experience discomfort, don’t hesitate to reach out to a healthcare professional for further guidance.

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