Facial Pain: Possible Causes and Treatments - Neurosurgery

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Cervicogenic headache


Hello doctor, on the morning of May 8th, I woke up with a tingling sensation on the right side of my face.
It hurts when I touch it, and there is also pain on the right side when I open my mouth.
By the evening, the pain has persisted and now I also feel pain around my right temple and eye area.
I would like to ask about the possible causes.
Thank you.

Niming, 10~19 year old female. Ask Date: 2018/05/09

Dr. Lai Zhaokang reply Neurosurgery


Hello: It is recommended that you consult a neurologist to determine if you have migraines or trigeminal neuralgia.
Wishing you well from Changhua Hospital.

Reply Date: 2018/05/09

More Info


Facial pain can be a complex issue with various underlying causes, and understanding these can help in determining the appropriate treatment. Based on your description of experiencing sharp pain on the right side of your face, particularly around the temple and eye area, there are several potential causes to consider.


Possible Causes of Facial Pain
1. Trigeminal Neuralgia: This condition is characterized by sudden, severe, and recurrent episodes of facial pain, often triggered by light touch or movement. The pain typically affects one side of the face and can be described as sharp, stabbing, or electric shock-like. It is often caused by irritation or compression of the trigeminal nerve, which can occur due to blood vessel compression or other factors.

2. Sinusitis: Inflammation of the sinuses can lead to facial pain, especially around the forehead, cheeks, and eyes. If you have had recent upper respiratory infections or allergies, sinusitis could be a contributing factor. Pain associated with sinusitis often worsens when bending forward or lying down.

3. Dental Issues: Problems such as tooth decay, abscesses, or gum disease can cause referred pain to the face. If the pain is localized to the jaw or teeth, it may be worth consulting a dentist to rule out any dental problems.

4. Temporomandibular Joint (TMJ) Disorders: TMJ disorders can lead to pain in the jaw and surrounding areas, including the temples and ears. Symptoms may include jaw clicking, difficulty chewing, and facial pain that may worsen with jaw movement.

5. Migraine or Tension Headaches: Migraines can cause unilateral facial pain, often accompanied by other symptoms such as nausea, sensitivity to light, and visual disturbances. Tension headaches can also lead to discomfort in the facial muscles and temples.

6. Nerve Damage or Inflammation: Conditions such as Bell's palsy, which affects the facial nerve, can lead to facial pain and weakness. Inflammation or irritation of the facial nerves can also result in pain.


Recommended Treatments
1. Medication: Depending on the diagnosis, various medications may be prescribed. For trigeminal neuralgia, anticonvulsants such as carbamazepine or oxcarbazepine are commonly used. For sinusitis, decongestants or nasal corticosteroids may help reduce inflammation. Pain relievers like NSAIDs (ibuprofen or naproxen) can alleviate pain associated with TMJ disorders or headaches.

2. Physical Therapy: If TMJ disorders are suspected, physical therapy focusing on jaw exercises and relaxation techniques may be beneficial. A physical therapist can also provide guidance on posture and ergonomics, especially if you spend long hours at a computer.

3. Dental Evaluation: If dental issues are a concern, a thorough evaluation by a dentist is essential. Treatments may include fillings, root canals, or other dental procedures.

4. Lifestyle Modifications: Stress management techniques, such as mindfulness, yoga, or relaxation exercises, can help reduce tension-related facial pain. Ensuring proper ergonomics while working at a computer can also prevent muscle strain.

5. Surgical Options: In severe cases of trigeminal neuralgia that do not respond to medication, surgical options may be considered to relieve pressure on the trigeminal nerve.


When to Seek Medical Attention
If your facial pain persists, worsens, or is accompanied by other concerning symptoms such as vision changes, severe headaches, or neurological deficits, it is crucial to seek medical attention promptly. A healthcare professional can conduct a thorough evaluation, including imaging studies if necessary, to determine the underlying cause of your symptoms and develop an appropriate treatment plan.

In summary, facial pain can arise from various conditions, and understanding the potential causes is vital for effective management. If you are experiencing persistent or severe pain, consulting with a healthcare provider is essential for accurate diagnosis and treatment.

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