Face pain

Definition
Face pain may be dull and throbbing or intense and stabbing discomfort in one or both sides of the face or forehead.

Considerations

Pain that originates in the face may be caused by a nerve disorder, an injury, or an infection in a structure of the face. Face pain may also begin elsewhere in the body.

Sometimes face pain occurs for no known reason.

Common Causes

• Injury to the face
  
• Abscessed tooth (continuous throbbing pain on one side of the lower face aggravated by eating or touching)
  
• Sinusitis or sinus infection (dull pain and tenderness around the eyes and cheekbones that worsens when bending forward)
  
• Tic douloureux
  
• Trigeminal neuralgia
  
• Herpes zoster (shingles) or simplex (cold sores) infection
  
• Cluster headache
  
• Migraine

Follow prescribed therapy for treating the underlying cause.

Painkillers may provide temporary relief, but if the pain is severe and/or persistent, consult your primary health care provider or dentist.

Call your health care provider if

• Face pain is accompanied by chest, shoulder, neck, or arm pain. This could mean a heart attack. Call your local emergency number (such as 911).
  
• Pain is throbbing, worse on one side of the face, and aggravated by eating. Call a dentist.
  
• Pain is persistent, unexplained, or accompanied by other unexplained symptoms. Call your primary health care provider.

In emergency situations (such as a possible heart attack), the patient will be stabilized first. Then, a medical history will be obtained and a physical examination performed. For tooth problems, expect a referral to a dentist or an orthodontist.

Medical history questions documenting face pain in detail may include the following:

• Location
  o What part of the face is in pain?
  o Is it on both sides?
  o If only one side, which one?
  o Is the pain over a sinus (forehead, cheekbones, etc.)?
  
• Time pattern
  o Did the pain begin suddenly?
  o Is face pain occurring repeatedly (recurrent)?
  o How long have the episodes of face pain lasted (for how many months)?
  o How long does each episode of pain last (how many seconds)?
  
• Aggravating factors
  o Is the pain worse when speaking, chewing, swallowing?
  o Does the pain develop when touching a specific part of the face (trigger point)?
  
• Other
  o Did face pain occur prior to developing a brain or nervous system loss (weakness, speech loss, etc.)?
  o What other symptoms are also present?

• ECG (if heart problems are suspected)
  
• Tonometry (if glaucoma is suspected)
  
• X-rays of the sinuses
  
• Dental X-rays (if a tooth problem is suspected)

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