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Face Pain

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Understand your face pain symptoms with Buoy, including 10 causes and common questions concerning your face pain.

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Face pain symptoms

Sensation to the face is controlled by specific nerves and arteries. Damage to these nerves and arteries can result in debilitating facial pain that is often very challenging to resolve.

Common characteristics of face pain

The quality of facial pain symptoms can be everything from:

  • Sharp to dull
  • Burning to aching
  • Constant to intermittent
  • Localized to generalized

Since the quality and severity of facial pain can take many forms, it may also be difficult to characterize symptoms that may be associated with the pain as well.

Common accompanying symptoms of face pain

People with facial pain may also experience:

  • Restricted jaw movement
  • Rash on or near the face
  • Light sensitivity
  • Noises from the joints of the jaw
  • Upper respiratory symptoms: Runny nose, sneezing, and post-nasal drip
  • Vision disturbances
  • Skin that feels warm to the touch
  • Flaking or itching
  • Pain triggered by touching the face, chewing, speaking, or brushing teeth

Regardless of the combination of symptoms, facial pain is often debilitating and resistant to normal home remedies. Therefore, make an appointment with your doctor in order to properly treat and diagnose your face pain symptoms.

Face pain causes

The causes of facial pain are varied because the arteries and nerves of the face are susceptible to damage by various sources.

Neurologic causes

Neurologic causes of face pain include the following.

  • Neuropathic: The word neuropathic refers to disruption in nerve functioning. Facial pain can be caused by malfunction of the trigeminal nerve the nerve that provides sensation to the face and scalp. In most cases, the exact mechanism causing the trigeminal nerve to malfunction is never diagnosed. Trigeminal neuralgia is a chronic facial pain syndrome that is quite uncomfortable even after such activities as teeth brushing or applying facial makeup.
  • Central: Central neurologic causes such as headaches and migraines can also be associated with facial pain symptoms.

Infectious causes

Infectious causes of face pain include the following.

  • Bacterial: Many bacterial viruses can affect parts of the head such as the teeth and sinuses and indirectly cause facial pain symptoms. For example, a bacterial infection of a tooth causing an abscess can result in swelling and discomfort in the face. Bacterial infection of the eye can cause pain that radiates to surrounding areas of the face. Furthermore, specific bacteria such as the bacteria causing Lyme disease can affect nerves of the face resulting in pain.
  • Viral: Certain viruses have a propensity for infecting and attacking 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 addition, the same parts of the face that bacteria can infect, especially the sinuses and eyes, viruses can also infect.

Structural causes

Structural causes of face pain include the following.

  • Musculoskeletal: Pain and dysfunction in the muscles that control chewing and movement of the jaw can result in debilitating facial pain that is easily triggered by common actions such as eating breakfast or yawning.
  • Obstruction: Presence of a salivary stone that obstructs the salivary gland may cause facial swelling that puts pressure on the trigeminal nerve causing pain.

Vascular causes

Some autoimmune diseases can cause inflammation of the blood vessels in your head leading to facial pain. One such condition is called Giant Cell/Temporal Arteritis [3].

Injury-related causes

Finally, a direct blow to the face is an obvious trigger for facial pain. 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 face pain symptoms.

This list does not constitute medical advice and may not accurately represent what you have.

Chronic sinusitis

Chronic sinusitis is also called chronic rhinosinusitis. It is an inflammation of the sinuses, or open spaces of the skull, above and below the eyes. "Chronic," in this case, means the condition has persisted for weeks in spite of treatment and has probably followed several cases of acute sinusitis.

The condition may start with a viral, bacterial, or fungal upper respiratory tract infection; asthma; allergies; or nasal polyps.

Symptoms include facial pain, swelling, and nasal congestion. There is often fatigue; greenish or yellowish nasal discharge; loss of sense of smell; ear pain; cough; and sore throat.

Chronic sinusitis should be seen by a medical provider, especially if symptoms worsen. The condition interferes with quality of life and the ongoing infection can become serious.

Diagnosis is made through patient history; physical examination; sinus cultures; skin tests for allergies; CT scan of the head; and nasal endoscopy (rhinoscopy.)

Treatment may involve saline nasal irrigation; nasal spray corticosteroids; oral corticosteroids; antibiotics for bacterial infection; immunotherapy for allergies; and, in some cases, surgery to remove polyps or other obstructions.

Rarity: Common

Top Symptoms: fatigue, headache, trouble sleeping, congestion, runny nose

Symptoms that always occur with chronic sinusitis: chronic sinusitis symptoms

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.

Rarity: Common

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

Urgency: Self-treatment

Common cold

The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.

The common cold is, of course, very common..

Viral throat infection

A sore throat is most often caused by the same viruses that cause influenza and the common cold. The illness spreads when an infected person coughs or sneezes, and then someone else inhales the airborne virus or touches a surface where it has landed.

Those most at risk for viral sore throat are children, smokers, those who work indoors with others, and anyone with a weakened immune system.

Symptoms include throat irritation; pain when swallowing or talking; red, swollen tonsils; fever; body aches; and cold-like symptoms of cough, sneezing, and runny nose.

If symptoms do not clear up within 24 hours – especially in children – a medical provider should be seen. A persistent sore throat can be a symptom of serious illness such as mononucleosis, measles, chickenpox, or croup.

Diagnosis is made through physical examination and throat swab.

Treatment involves rest, fluids, and over-the-counter pain relievers. Do not give aspirin to children. Antibiotics only work against bacteria and cannot help against a viral illness.

The best prevention is frequent and thorough handwashing.

Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

  • Pain or discomfort in the muscles controlling the TMJ.
  • Dislocation or injury to the jawbone.
  • Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Rarity: Common

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

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Rarity: Common

Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash

Symptoms that always occur with skin abscess: rash with bumps or blisters

Urgency: Primary care doctor

Sinus headache

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 , 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.

Rarity: Common

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, sore throat, cough, drooping eyelid, headache resulting from a head injury, severe headache, unexplained limb pain

Urgency: Self-treatment

Cellulitis

Crohn's disease is an inflammation of the bowel. It is caused by a faulty immune system response which makes the body attack the lining of the intestines.

The disease usually appears before age thirty and can affect anyone. Those with a family history may be most susceptible. Smoking is a known risk factor.

Aggravating factors include stress, poor diet, and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin.

Early symptoms usually develop gradually, but can appear suddenly. These include fatigue, loss of appetite, fever, mouth sores, diarrhea, abdominal pain, and blood in stool.

Untreated Crohn's disease can cause ulcers throughout the digestive tract as well as bowel obstruction, malnutrition, and deteriorating general health.

Diagnosis is made through blood test and stool sample test. Colonoscopy, CT scan, MRI, endoscopy, and/or enteroscopy may also be used.

Crohn's disease cannot be cured, but can be managed through reducing the inflammation. Antibiotics, corticosteroids, and immune system suppressors may be tried. Excellent nutrition, vitamin supplements, smoking cessation, and reduction in stress can be helpful.

Rarity: Uncommon

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

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.

Rarity: Common

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

Condition causing facial weakness

Facial weakness may be the sign of a stroke or bell's palsy & requires immediate medical attention.

Rarity: Uncommon

Top Symptoms: face weakness

Urgency: Hospital emergency room

Face pain treatments and relief

When to see a doctor for face pain

Treatment for your facial pain will most likely not resolve via home remedies. You should make an appointment with your doctor. Depending on the diagnosis, your doctor may recommend the following treatment options:

  • Anticonvulsants: Do not be alarmed, your facial pain is most likely not the result of seizures. Many anticonvulsant medications are also used to combat nerve pain and your doctor may prescribe medications such as gabapentin (Neurontin) or carbamazepine (Tegretol).
  • Antibiotics: If your facial pain is due to bacterial causes, your doctor will prescribe antibiotics. Viral causes will not resolve with antibiotics, and your doctor 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 doctor about this option and assess if it is the best option for you.

When face pain is an emergency

Seek medical attention immediately if you experience sudden onset scalp pain accompanied by fever or visual symptoms. These could be signs of Temporal Arteritis which must be treated quickly to prevent visual loss.

Questions your doctor may ask about face pain

  • Any fever today or during the last week?
  • Do you feel a painful, tight knot or band in your muscle anywhere on the body?
  • Do you have a runny nose?
  • 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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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Vorvick LJ. Face Pain. U.S. National Library of Medicine: MedlinePlus. Updated December 3, 2018. MedlinePlus Link
  2. Trigeminal Neuralgia Fact Sheet. National Institute of Neurological Disorders and Stroke. Updated July 6, 2018. NINDS Link
  3. Giant Cell Arteritis (Temporal Arteritis). Vasculitis Foundation. Updated September 2012. Vasculitis Foundation Link
  4. Blahd Jr WH, Husney A, Romito K, eds. Facial Problems, Noninjury. University of Michigan: Michigan Medicine. Updated September 23, 2018. UofM Health Link
  5. Zakrzewska JM. Facial Pain: Neurological and Non-Neurological. Journal of Neurology, Neurosurgery & Psychiatry. 2002;72(Suppl 2):ii27-ii32. JNNP Link