What Causes Facial Pain and How to Get Relief

Facial pain is common and can often be debilitating for those who experience it. Described as sharp and stabbing pain that can sometimes feel like an electric shock, simple actions like smiling, brushing teeth, or applying makeup can bring on the pain or make it worse. Other common activities like eating or drinking can be painful. Facial pain can originate from a specific area of the face, or it may radiate from another part of the head. There is no particular risk factor for developing facial pain, and facial nerve pain can affect all genders, ages and ethnicities.

If you have facial pain, it’s important to understand the causes, symptoms and available treatments to get relief.

What does facial pain feel like?

People with facial pain often describe it as intense, shooting, stabbing or electrical shock-like, or a lancing sensation. Sometimes even mild stimulation of the face from ordinary activities like hair brushing, shaving, swallowing, talking, sneezing, or touching the area can trigger severe pain. It can also be triggered by wind – even a slight breeze or air conditioning – or movement of the face or head. Sometimes the pain can happen without a trigger.

Other dynamics of facial nerve pain include:

• Pain may come on very suddenly and last for a few seconds to a few minutes
• Pain can occur in several areas including the upper neck, back of head, behind the ear, the cheek, jaw, teeth, gums, lips, eyes, and forehead
• Can affect one side of the face at a time
• Can occur with facial spasms
• Attacks may be short and relatively mild in the beginning, but over time they can last longer, are more painful and happen more often
• Bouts of multiple attacks lasting days, weeks, months or longer
• Some people have periods when they experience no pain

Facial pain causes

The nerves that affect the sensations in your face are intricate and complex. According to the Facial Pain Association, the cranial nerves are “12 pairs of nerves that can be seen on the surface of the brain. The trigeminal nerves are among these pairs, and they let you feel sensations in your face. One nerve runs down each side of your head.”

Understanding the various pain sensations and how they happen can help you have better conversations with your healthcare provider to get a diagnosis and consider different treatment options to alleviate the pain.

Facial pain can be categorized into one of several types, including:

• dental pain: problems with the teeth and gums
• nerve pain, or neuralgia: relating to conditions that affect the facial nerves
• temporomandibular pain: relating to the temporomandibular joint (TMJ) and the muscles of the jaw
• vascular pain: due to issues with blood vessels and blood flow

According to National Institutes of Health (NIH), the most common cause of facial pain is a group of conditions called temporomandibular joint and muscle disorders (TMJDs). These disorders cause recurrent or chronic pain and dysfunction in the jaw joint and its associated muscles and supporting tissues. TMJDs affect about 5 to 12% of the population and about half to two-thirds of those with TMJ disorders will seek treatment.

What are the different types of facial nerve pain?

While trigeminal neuralgia is a common facial nerve pain diagnosis, there are other nerve conditions that cause facial pain.

Different types of facial nerve pain include:

• Glossopharyngeal neuralgia: a pain condition involving the back of the throat
• Nervus intermedius: involves pain sensation deep within the ear
• Occipital neuralgia: involves the nerves that run up the spine to the scalp
• Trigeminal neuralgia: involves the 5th cranial nerve

Occipital neuralgia (ON) is another common cause of facial nerve pain. The occipital nerve is a spinal nerve that can affect the head and face. The occipital nerve begins at the C2-C3 level of the spine, then reaches up behind the ear, goes above the hairline, and then runs throughout the scalp.

Trigeminal neuralgia is a common diagnosis for facial pain—it is reported that 150,000 people are diagnosed with trigeminal neuralgia every year. It is often misdiagnosed as TMJ or a dental problem, and can be incredibly painful and stressful. However, trigeminal neuralgia can also be cured.

How do you relieve facial nerve pain?

Your doctor will diagnose your facial pain based on your description of the pain including the severity, the parts of your face that are affected by the pain, and the triggers that cause your pain. Your doctor may conduct several tests to diagnose the cause of your facial pain. A neurological examination including touching and examining parts of your face can help your doctor determine exactly where the pain is occurring. Reflex tests can help your doctor determine if your symptoms are caused by a compressed nerve or another condition. Your doctor may order an MRI (magnetic resonance imaging) scan of your head to determine if multiple sclerosis or a tumor could be causing the pain.

Your facial pain may be caused by a variety of conditions, so an accurate diagnosis is important to get the right treatment. Your doctor may order additional tests to rule out other conditions.

There are a variety of therapeutic and surgical options for facial pain based on individual patient needs which include:

• Pharmacological treatment/medications
• Procedural Treatment such as injections
• Surgical Treatment

If you have facial pain but are not sure if you have trigeminal neuralgia, take our online trigeminal neuralgia risk assessment to learn more. It involves a series of questions and after you answer all of them, you will receive recommended next steps from Baystate Medical Center based on your answers.  

If your answers suggest that you might have trigeminal neuralgia, our neurosurgery and neurology team will guide you through next steps including the advanced treatment options available at Baystate Health.