Facial pain refers to pain felt in any region of the face and may or may not include more specific areas like the sinuses or areas inside the mouth, such as the gums, inner cheeks, tongue, and/or jaw. This pain may develop suddenly or gradually, ranging anywhere from dull aches to sharp jabs or burning sensations.

There are many possible causes of pain in the face, such as those conditions affecting nerves, blood vessels, muscles, or dental tissues. This article discusses several common causes of facial pain.

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Trigeminal Neuralgia

Trigeminal neuralgia, also called tic douloureux, is a disorder affecting the trigeminal nerve—the nerve responsible for sensation of pain in the face. Common characteristics of trigeminal neuralgia include severely debilitating facial pain with one or more of the following:

  • Severe electric-shock like pain in different areas of the face, following a cyclic pattern that lasts for seconds or minutes and returns again after few hours—the cycle continues for months or even years.
  • One sided pain that usually does not cross over the midline of the face.
  • Pain triggers such as light touch (or even breeze), talking, eating, and yawning can instantly cause severe pain to occur.

The cause of trigeminal neuralgia is speculated to be due to compression from blood vessels, multiple sclerosis, aging, degeneration of the nerve, tumors, and/or cysts.

Temporomandibular Joint (TMJ) Pain

TMJ pain or TMJ pain dysfunction syndrome (TMJPDS) typically causes pain in one or both temporomandibular joints, soreness in the muscles around the jaw, pain in the temples, pain above the eyes, and may even affect the neck and shoulders. Pain is aggravated by chewing or talking. There may be trouble moving the jaw or opening the mouth wide, usually accompanied by a clicking or popping sound.

TMJ pain mostly results from bruxism (clenching and grinding of teeth), trauma to the mouth, a displaced articular disc, arthritis, a poorly aligned bite, muscle tension, or anxiety, stress, and depression.

Occipital Neuralgia

An injury to the occipital nerve results in a condition called occipital neuralgia. Occipital neuralgia can cause sharp jabs, constant burning, or a continuous ache superimposed with come-and-go sharp pains often occurring on the back of the head. The pain attacks may last for a few seconds or minutes. The pain radiates in the distribution of the occipital nerve from the back of the head to the top of the head and behind the ears.

This condition is caused due to impinging of the occipital nerve from blood vessels or tumors, injuries such as whiplash, muscle spasm, or arthritis in the upper cervical spine (neck).

Burning Mouth Syndrome

Burning mouth syndrome is a condition that causes severe burning sensation in the mouth commonly affecting the tongue, although the entire mouth may be affected. The pain may appear suddenly or develop overtime; may come-and-go or be continuous. The sensation is typically described as a scalding feeling. A dry mouth with altered taste sensations such as metallic or bitter taste may be experienced. The symptoms are usually worse in the evenings.

Burning mouth syndrome has no known causes and most commonly affects post-menopausal women.1 Some possible underlying conditions speculated to cause burning mouth syndrome include fungal infections, allergies, nerve damage, nutritional deficiencies, stress, and psychological factors.

Eagle’s Syndrome

Pain from Eagle's syndrome occurs when the styloid process is elongated and pushes into nearby structures, such as nerves and blood vessels.

Eagle’s syndrome also known as stylohyoid process syndrome refers to symptoms caused due to an elongation of the styloid process with or without calcification of the stylohyoid ligament. Common symptoms of Eagle’s syndrome include pain in the ears, jaw, neck, face, throat; accompanied by ringing in the ears and a foreign body sensation in the throat. Pain is triggered by chewing or moving the head/tongue.

Read more about Neck Pain from Eagle Syndrome on Spine-health.com

This condition is typically seen after a tonsillectomy surgery (removal of tonsils), though it may also be seen after pharyngeal surgeries (surgeries involving part of the digestive tract connecting the mouth and esophagus).

Other Causes of Facial Pain

Other uncommon causes of facial pain include conditions resulting from bacterial causes such as maxillary sinusitis, salivary gland disease; fungal infections, such as candidiasis; or neurological problems, such as neck-tongue syndrome, optic neuritis, or shingles (herpes zoster) with or without subsequent development of post-herpetic neuralgia. Conditions such as atypical odontalgia, atypical facial pain, facial arthromyalgia, and cranial arteritis result from unknown causes and may also cause facial pain. In rare instances, cervical spine pathology including intervertebral disc disease, facet joint, and ligamentous pathology, can manifest with pain symptoms radiating to the face.

When to See a Doctor for Facial Pain

In general, it is advised to visit a doctor for facial pain if it:

  • Is accompanied by fever, chills, nausea, and/or vomiting
  • Causes numbness in any part of the face, neck, and/or arm
  • Causes ringing in the ears and/or loss of balance
  • Does not go away on its own
  • Interferes with daily activities, such as the ability to concentrate or sleep

These symptoms could signal a serious medical condition and should be immediately evaluated by a doctor.

References:

  1. Jimson S, Rajesh E, Krupaa RJ, Kasthuri M. Burning mouth syndrome. J Pharm Bioallied Sci. 2015;7(Suppl 1):S194-6.
Further Reading: Acute vs. Chronic Pain