Which Specialist Should I See for My Persistent Facial Pain?

I'm not sure which specialty to see?

Hello, doctor.
My situation is as follows: the symptoms occur occasionally, but recently they have been happening frequently.
For the past three to four days, I have experienced multiple episodes of pain in a single day.
Initially, there was some pain around the periphery of my eye, which I can feel slightly when I press on it, but it extends to the area below the eye (the area where dark circles appear).
Then, the pain spreads to my cheek (near the nose), and it only affects the left side of my face.
The pain can be intense enough to reach my teeth (which I suppose counts as tooth pain).
Even blinking causes discomfort, but the pain is mostly localized to my cheek.
The recent pain has made it difficult for me to sleep; once it starts, I feel quite weak overall.
Which specialist should I see for this issue? I apologize for the trouble!

Mei, 20~29 year old female. Ask Date: 2006/10/15

Dr. Cai Jueren reply Family Medicine

Hello, your symptoms appear to be quite similar to trigeminal neuralgia.
Of course, a detailed examination is necessary for confirmation.
I recommend that you first visit the neurology outpatient clinic for an initial assessment.
Please rest assured that this is not a serious condition.
Thank you for your inquiry, and I hope the above information helps alleviate your concerns.
Hualien Hospital, Dr.
Tsai Jue-Ren.

Reply Date: 2006/10/15

More Info

I'm sorry to hear about the persistent facial pain you're experiencing. Based on the symptoms you've described, it sounds like you may be dealing with a complex issue that could involve several different medical specialties. Here’s a breakdown of your symptoms and the appropriate specialists you might consider consulting.

Symptoms Overview
1. Pain around the eyes and cheeks: This could indicate issues related to the sinuses, dental problems, or even nerve-related pain.

2. Pain extending to the teeth: This is particularly concerning for dental issues or referred pain from the jaw or facial nerves.

3. Pain with eye movement: This could suggest an ocular issue or inflammation in the surrounding tissues.

4. Difficulty sleeping due to pain: This indicates that the pain is significant enough to affect your quality of life.

Recommended Specialists
1. Otolaryngologist (ENT): Given that your pain is around the eyes and cheeks, an ENT specialist can evaluate for sinusitis or other sinus-related issues. They can perform imaging studies like a CT scan to check for sinus blockages or infections that could be causing referred pain to your facial area.

2. Dentist or Oral Surgeon: Since you mentioned that the pain extends to your teeth, it would be wise to consult a dentist. They can rule out dental issues such as cavities, gum disease, or even temporomandibular joint (TMJ) disorders, which can cause significant facial pain.

3. Neurologist: If the pain is severe and persistent, a neurologist can evaluate for conditions such as trigeminal neuralgia, which is characterized by sudden, severe facial pain. They can also assess for other neurological conditions that might be contributing to your symptoms.

4. Pain Management Specialist: If your pain is chronic and significantly affecting your daily life, a pain management specialist can help develop a comprehensive treatment plan that may include medication, physical therapy, or other interventions.

Additional Considerations
- Imaging Studies: Depending on the findings from your initial consultations, your doctors may recommend imaging studies such as X-rays, CT scans, or MRIs to get a clearer picture of what might be causing your pain.

- Symptom Diary: Keeping a diary of your symptoms, including when they occur, their intensity, and any potential triggers, can be very helpful for your healthcare providers in diagnosing the issue.

- Referral: Don’t hesitate to ask your primary care physician for a referral to any of these specialists if you’re unsure where to start.

Conclusion
Given the complexity of your symptoms, it might be beneficial to start with an ENT specialist to rule out sinus issues, followed by a visit to a dentist to address any dental concerns. If those evaluations do not yield answers, a neurologist would be the next logical step. Remember, it’s important to communicate all your symptoms clearly to each specialist to ensure a thorough evaluation.
I hope you find relief soon and that your symptoms improve with the right care!

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