There are many causes for why one side of your face may be hurting. Usually pain on side of the face can be caused from sinus infection with can also lead to sinus headaches. Other causes include facial cellulitis, dental complications, or trauma from an injury, Read below for more information on causes and treatment options.
Pain on one side of the face symptoms
Sensation in the face is controlled by the trigeminal nerve, the fifth and largest cranial nerve of the body, and its many branches. There are many different components of the face — from muscles and bones to arteries and glands. These can all become disrupted, damaged, or injured, and result in facial pain that can be debilitating and sometimes difficult to resolve.
Common characteristics of one-sided facial pain
Pain on one side of the face can vary in quality. Depending on the cause, your facial pain may feel:
- Sharp or dull
- Burning or aching
- Constant or intermittent
- Localized or generalized
Since the quality of facial pain can take many forms, it may be difficult to figure out what other symptoms are associated. The following are common symptoms people with one-sided facial pain also experience:
- Restricted jaw movement
- Rash on or near the face
- Light sensitivity
- Upper respiratory symptoms: This includes a runny nose, sneezing, postnasal drip, congestion, etc.
- Vision disturbances
- Skin that feels warm to the touch
- Flaking or itching
- Pain triggered by touching the face, chewing, speaking or brushing teeth
- Locking sensation: You may have difficulty opening the mouth to eat, drink or take medication.
- Shooting pains or spasms
Regardless of the combination of symptoms, one-sided facial pain often requires you to make an appointment with a physician. He or she can determine the cause and the best course of treatment.
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Pain on one side of the face causes
The causes of one-sided facial pain vary widely due to the many components of the face that can become damaged, injured, or inflamed. These include neurologic, infectious, structural, and traumatic causes.
Neurologic causes of pain on one side of the face may include the following.
- Neuropathic: The word neuropathic refers to a disruption in nerve functioning. One-sided facial pain can be caused by malfunction of the trigeminal nerve. In most cases, the exact mechanism causing the trigeminal nerve to malfunction is never diagnosed, but there are many diagnosable causes of trigeminal nerve dysfunction that this article will also discuss in depth.
- Central: Central neurologic causes are those related to lesions or dysfunction in the central nervous system. Such pain can often happen after strokes or be due to conditions such as multiple sclerosis. Causes such as headaches and migraines can also be associated with one-sided facial pain. For example, people who suffer from migraines may experience an aura (a visual or sensory warning sign) on one side of the face before a migraine or a migraine may affect only one side of the face.
Infection-related causes of pain on one side of the face may include the following.
- Bacterial: Many bacteria can affect parts of the head, such as the teeth and sinuses, and indirectly cause one-sided facial pain. For example, a bacterial infection of a tooth that results in an abscess can lead to swelling and discomfort in the face. Bacterial infection of the eye can cause pain that radiates to include the face. Furthermore, specific bacteria such as the bacteria causing Lyme disease can affect nerves of the face.
- Viral: Certain viruses are inclined to infect and attack the nerves of the face. Herpes zoster, the virus that causes shingles, can lay dormant in the trigeminal nerve and resurface to cause a painful, blistering rash of the face. Furthermore, the pain can recur even after the rash is treated and goes away in a condition known as post-herpetic neuralgia. Viruses can infect the same parts of the face that bacteria can infect, especially the sinuses and eyes.
Structural causes of pain on one side of the face may include the following.
- Musculoskeletal: Pain and dysfunction in the muscles that control chewing and movement of the jaw can result in debilitating one-sided facial pain that is easily triggered by common actions such as eating breakfast or yawning.
- Obstruction: Many conditions may obstruct or put direct pressure on the trigeminal nerve to cause pain or nerve dysfunction. For example, the presence of a salivary stone that obstructs the salivary gland may cause facial swelling that puts pressure on the trigeminal nerve causing pain.
Trauma-related causes of pain on one side of the face may include the following.
- Iatrogenic: Iatrogenic is a term that describes a problem caused by medical intervention or treatment. Direct injury to the trigeminal nerve due to surgical trauma or treatment for trigeminal neuralgia can result in a condition called Anesthesia Dolorosa (painful, post-traumatic trigeminal nerve dysfunction) that is characterized by one-sided facial or oral pain.
- Other injury: It is important to remember that one-sided facial pain can be due to direct injury to the face that may result in a fracture or bruise. Large bruises and deformities are a clear cause of any facial pain you be experiencing, but also take note of any smaller cuts or lesions on the face that could be responsible for your symptoms.
This list does not constitute medical advice and may not accurately represent what you have.
Acute bacterial sinusitis
Acute bacterial sinusitis, also called bacterial rhinosinusitis or "sinus infection," has symptoms much like viral rhinosinusitis but a different treatment.
Any sinusitis usually begins with common cold viruses. Sometimes a secondary bacterial infection takes hold. Like cold viruses, these bacteria can be inhaled after an infected person coughs or sneezes.
Anyone with viral sinusitis, upper-respiratory allergy, nasal passage abnormality, lung illness, or a weakened immune system is more prone to bacterial sinusitis.
Symptoms include thick yellowish or greenish nasal discharge; one-sided pain in the upper jaw or teeth; one-sided sinus pain and pressure; fatigue; fever; and symptoms that get worse after first improving.
See a doctor right away for severe headache, high fever, stiff neck, or vision changes. These can indicate a medical emergency.
Diagnosis is made with a simple examination in the doctor's office.
Bacterial sinusitis can be treated with antibiotics, but this is not always necessary. Often rest, fluids, and over-the-counter pain relievers and decongestants are enough.
Prevention is done through good lifestyle and hygiene to keep the immune system strong.
Top Symptoms: fatigue, headache, cough, sinusitis symptoms, muscle aches
Symptoms that always occur with acute bacterial sinusitis: sinusitis symptoms
Symptoms that never occur with acute bacterial sinusitis: clear runny nose, being severely ill
Urgency: Primary care doctor
Temporomandibular joint (tmj) dysfunction disorder
Temporomandibular Joint Dysfunction is often caused by a variety of factors, including daily habits, your teeth alignment, and even stress. It usually affects one side of the jaw, but in some people it can affect both sides. People with TMJ dysfunction will typically experience pain on one side of the face that is worse with chewing, yawning, or other movements of the jaw. With some simple changes in your daily habits and other at-home treatments, most people with TMJ dysfunction will experience relief of their symptoms within weeks.
Treatment for temporomandibular joint dysfunction usually includes avoiding eating hard foods or foods that require a lot of chewing. Good posture and relaxation techniques may help relieve tension in the muscles that connect to your temporomandibular joint. In people who clench or grind their teeth, a mouth guard worn at night (and fitted by your dentist) may also help relieve your symptoms. Pain relievers, like ibuprofen (Advil, Motrin), can also help.
Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck
Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw
Urgency: Primary care doctor
Acute viral sinusitis
Acute viral sinusitis, also called viral rhinosinusitis or "sinus infection," occurs when viruses take hold and multiply in the sinus cavities of the face.
It is most often caused by the same viruses that cause the common cold and spreads the same way, through an infected person's coughing or sneezing.
Because children have small, underdeveloped sinuses, this illness is far more common in adults.
Symptoms include clear nasal discharge (not greenish or yellowish,) fever, and pain if facial sinuses are pressed.
If there is rash, severe fatigue, or neurologic symptoms (seizures, loss of sensation, weakness, or partial paralysis,) see a medical provider to rule out more serious conditions.
Diagnosis can usually be made through history and examination alone.
Antibiotics only work against bacteria and cannot help against a viral illness. Therefore, treatment consists of rest, fluids, and fever/pain reducers such as ibuprofen. (Do not give aspirin to children.) Symptoms of viral sinusitis last for about seven to ten days. As with the common cold, the best prevention is frequent and thorough handwashing.
Top Symptoms: headache, cough, sinusitis symptoms, sore throat, congestion
Symptoms that always occur with acute viral sinusitis: sinusitis symptoms
Symptoms that never occur with acute viral sinusitis: being severely ill
Infection of the salivary duct (sialadenitis)
The ducts that create saliva can be infected by bacteria and is typically found after surgery in the mouth and in the elderly that take medications that slow saliva production.
Top Symptoms: fever, chills, swelling on one side of the face, pain on one side of the face, swollen jaw
Urgency: Hospital emergency room
Sinus headache, also called sinusitis or rhinosinusitis, is caused by either a bacterial or a viral infection of the sinuses (open spaces) behind the eyes and nose.
Symptoms include fever; thick nasal discharge which may be clear, white, greenish or yellowish; some loss of sense of smell; foul-smelling breath; and pain, congestion, and pressure over the sinus areas of the face, especially if bending forward or lying down.
A self-diagnosed "sinus headache" very often turns out to be a migraine headache with a few sinus symptoms. This requires very different treatment from an actual sinus headache, and is an important reason to see a medical provider about any sort of ongoing headaches.
Diagnosis is made through patient history, physical examination, and sometimes CT scan or MRI of the head to look for changes in the sinuses.
A true sinus headache, if caused by a bacterial infection, will be treated with antibiotics. If caused by a viral infection, the symptoms can be treated with over-the-counter pain relievers and alternating hot and cold compresses.
Top Symptoms: headache, headache that worsens when head moves, facial fullness or pressure, mucous dripping in the back of the throat, sinus pain
Symptoms that always occur with sinus headache: headache
Symptoms that never occur with sinus headache: fever, being severely ill, sore throat, muscle aches, cough, drooping eyelid, wateriness in both eyes
Myofascial pain syndrome
Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.
The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.
This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points, since they trigger pain at any stimulus.
Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.
Myofascial pain syndrome should be seen by a medical provider, since it can develop into a similar but more severe condition called fibromyalgia.
Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.
Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.
Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness
Symptoms that always occur with myofascial pain syndrome: tender muscle knot
Urgency: Primary care doctor
Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.
The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.
Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.
Symptoms arise somewhat gradually and include sore, reddened skin.
If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.
Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.
Diagnosis is made through physical examination.
Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.
Top Symptoms: fever, chills, facial redness, swollen face, face pain
Symptoms that always occur with cellulitis: facial redness, area of skin redness
Urgency: Primary care doctor
A viral throat infection is an infection of the throat, or pharynx, that is caused by viruses. Viruses are different from bacteria such as Streptococcus pyogenes (which causes "strep throat"). Viral infections are the most common cause of sore throats in children and adu..
A carotid artery dissection is a tear in a layer of the wall of a blood vessel called a carotid artery, one of two such arteries found in the neck. Blood vessel walls normally have three layers, and a tear in any of these can allow blood to flow into the result...
Bruise of the face
A bruise is an area of skin discoloration. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin.
Top Symptoms: swelling on one side of the face, head or face injury, painful face swelling, warm and red face swelling, face bruise
Symptoms that always occur with bruise of the face: head or face injury
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Pain on one side of the face treatments and relief
Treatment for your facial pain will most likely require a healthcare professional. Make an appointment with your physician in order to receive a diagnosis and get appropriate treatment. Depending on the diagnosis, your physician may recommend the following treatment options:
- Anticonvulsants: Many anticonvulsant medications, such as gabapentin (Neurontin) or carbamazepine (Tegretol), more commonly used for seizures, are also used to combat nerve pain.
- Antibiotics: If your facial pain is due to bacterial causes, your physician will prescribe the appropriate antibiotic medication to combat your symptoms. Viral causes will not resolve with antibiotics, and your physician will most likely suggest supportive remedies if that is the case.
- Surgery: There are surgical procedures that can destroy nerve fibers in the face to reduce pain symptoms, especially for the neurological causes of facial pain. Talk with your physician about this option and assess if it is the best option for you.
FAQs about pain on one side of the face
Stress can be an important and powerful trigger. In situations of high stress, some viral infections can be triggered and resurface, such as the herpes zoster virus.
Can headaches cause pain on one side of the face?
Yes, primary headaches are considered a common cause of pain on one side of the face. Many types of headaches such as migraines and cluster headaches often present initially in the face.
Why do I only have pain on one side of the face?
Your pain is focused on one side of your face because the structure — whether it is a nerve, artery, muscle, etc. — is affected, damaged or inflamed on that particular side and not the other.
Does anxiety cause pain on one side of the face?
Similarly to stress, anxiety may be a cause of one-sided facial pain for some individuals. Anxiety can quickly escalate into stress and cause similar symptoms.
What are some things I can do to help alleviate my symptoms of pain on one side of my face?
In addition to treatment approaches that your physician prescribes, there are many helpful things you can do at home in order to help with your pain. Some people find low-impact exercise, yoga, creative visualization, aromatherapy, or meditation are helpful in achieving some resolution. Some people find therapy or counseling to be helpful in managing the feelings of isolation and depression that are often associated with chronic one-sided facial pain.
Questions your doctor may ask about pain on one side of the face
- Any fever today or during the last week?
- Are you experiencing a headache?
- Do you feel a painful, tight knot or band in your muscle anywhere on the body?
- Do you have a sore throat?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Sanders RD. The Trigeminal (V) and Facial (VII) Cranial Nerves. Psychiatry (Edgmont). 2010;7(1):13-16. NCBI Link
- Trigeminal Neuralgia Fact Sheet. National Institute of Neurological Disorders and Stroke. Published June 2013. NINDS Link
- Trigeminal Neuralgia. American Association of Neurological Surgeons. AANS Link
- Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc. 2009;84(3):274-80. NCBI Link
- Tolosa Hunt Syndrome. National Organization for Rare Disorders. NORD Link