Might facial pain be a symptom of another condition?

Chronic facial pain can either be experienced in the form of aching, burning, and/or a stabbing pain. In this article, mightily experienced consultant in anaesthetics and pain medicine, Dr Roshan Thawale, explains in further detail what facial pain is, and reveals if it may be a symptom of another medical condition.

What is chronic facial pain?

Chronic facial pain is any pain in the oral-facial region which has not subsided even with medical or surgical treatment after a certain period of time in which it is expected to settle down. Classically, this period is defined as three months.

Trigeminal neuralgia, which is one of the most notorious of chronic facial pain conditions, can feel like a quick shock, or it may last a few minutes or a few days. It typically affects one side of the face or the other, but sometimes both. Some describe it as a stabbing pain, while others experience it as aching or burning.

What may facial pain a symptom of?

It can either be a symptom of nerves of the face going into overdrive (neuropathic pain), a structural issue, a developmental anomaly, or trauma to the teeth, soft tissue, bones, sinuses, or joints.

It is very important that any facial pain which is of nerve origin (neuropathic) is being thoroughly investigated to rule out conditions such as multiple sclerosis, tumours, or aneurysm.

What causes conditions that cause chronic facial pain?

There are many causes of chronic facial pain. The most common ones include the following:

• tooth pain
• oral infection
• headaches and migraines
• neck pain
• temporomandibular joint (TMJ) problems
• facial trauma or injuries
• skin conditions
• sinus problems
• complex facial nerve pain (trigeminal neuralgia)
• tumour, stroke, or multiple sclerosis

How is chronic facial pain diagnosed?

Usually, your neurologist or pain physician will perform a quick examination. This will typically be followed by a few sets of blood and imaging investigations.

How do you treat chronic facial pain?

The first line of treatment for chronic facial pain is medication. If medications aren’t effective, a pain medicine specialist may offer you a targeted nerve block, which is an injection of an anaesthetic under live-image guidance. It bathes your nerves with medication, and immediately stops the transmission of pain signals from your nerves to your brain, giving you relief.

Thankfully, there are procedures that can provide long-lasting relief for facial pain. Once the nerve block identifies the nerve or nerves causing your pain, your pain specialist can turn off the nerves’ ability to send painful signals into the facial nerves with radiofrequency ablation or rhizotomy. This is usually performed in a pulsed manner to preserve crucial facial structures during the procedure.

If an MRI scan or other imaging suggest or show a surgically correctable cause, then referral to a specialist neurosurgical service can also be made by your neurologist, pain medicine specialist, or your primary care physician (GP).

Dr Roshan Thawale is a highly proficient and revered consultant in anaesthetics and pain medicine. Consult with him today to book an appointment if you are experiencing facial pain at present.