Facial pain is a common symptom that can be associated with a host of medical conditions. While some causes are trivial and benign, some may need immediate medical attention. In some cases, facial pain on one side or nerve pain in face may be experienced. Face pain with trigeminal neuralgia or pain in face associated with sinus, eye, nose, jaw, teeth, etc are common.
The character of pain in face may be dull, sharp, constant or intermittent and may vary depending on the cause. As the possible causes are spread over a wide spectrum, proper medical history, clinical examination and thorough assessment can help in detecting the precise cause. Appropriate investigations help in diagnosing the underlying condition, which can direct towards relevant treatment options.
The Causes Of Facial Pain Can Be Classified As:
Facial Pain from Nasal Problems - Conditions like respiratory infections, nasal polyps, nasal trauma and impacted foreign body can result in pain in face associated with other relevant symptoms. Respiratory infections causing inflammation and excessive nasal secretion can cause pain in face around the nasal region. Injury to the internal or external part of the nose can affect the nasal bones, cartilage, and other tissues surrounding the nose causing pain. Impacted foreign body in the nose can cause pain, injury or infection inside the nose and cause facial pain.
Facial Pain Due To Nasal Vestibulitis – Infection of the tissues around nasal vestibule near the nasal opening can result after folliculitis, dermatitis, viral infections or running nose. It can cause severe facial pain around the nasal region.
Facial Pain from Sinus – Inflammation of sinuses can occur when these areas get filled with bacteria or fluid, which progresses after a common cold or flu. Conditions like blocked nose, sinusitis, injury to the sinuses or carcinoma can contribute to facial pain and pain in the area of cheeks or above the eyebrows.
Facial Pain Due to Ear Problems – Conditions like excessive ear wax, ear injury, swimmer's ear or ear infections, otitis media, otitis externa can commonly cause pain in ear and jaw region along with headache.
Facial Pain due to Eye Problems – Conditions like inflammation of eyes, corneal abrasion or ulcer, orbital cellulitis, glaucoma, infections, foreign body or injury. Facial nerve involvement in certain eye related conditions may result in related symptoms.
Facial Pain from Jaw Problems – Pain in face can result from problems with upper and lower jaw, mastoid, or jaw joint (temporomandibular joint). Any injury to the jaw, temporomandibular dysfunction (TMD), arthritis of the jaw, injuries or disorders of muscles and ligaments of the temporomandibular joint can cause face pain. Depending on the side affected, facial pain on one side may be seen.
Pain in Face from Glands – Parotid gland, salivary and submandibular glands are located in the region of face and conditions affecting these glands can cause facial pain. Inflammation of parotid gland (parotitis), viral infections, mumps or bacterial infection can affect these glands causing pain in face.
Facial Pain Caused by Neurological Origin - Conditions affecting the nerves of the face can cause symptoms like pain, burning sensation with other neurological findings. Common causes include Trigeminal Neuralgia (TN), in which sudden sharp pains may be felt in the face around lips and the nose region. Nerve pain in face can also result from nerve injury, nerve compression or viral infections like herpes zoster. Other conditions like occipital neuralgia or post traumatic neuropathy can also contribute to facial pain.
Facial Pain from Tumor and Cancer – Benign tumors and malignant conditions of brain and facial structures can cause facial pain.
Facial Pain from Headaches – Headaches of various types, of different origins can cause pain in face around forehead, eyes, jaws or ears. Tension headaches, cluster headaches, migraines and other forms are commonly seen along with other complaints.
Pain from Injury to Face – Facial pain can result from an injury to the face and the facial structures. A whiplash injury can affect jaw joint and ear region along with the neck, a fall or blow to the face can cause facial trauma and pain.
Facial Pain from Dental Issues – Dental causes of face pain are commonly seen. Tooth abscesses, dental extraction, wisdom tooth, dental trauma, infection and other dental or oral causes can lead to facial pain especially along the jaws, cheeks and may extend to ears.
Face Pain from Skin and Soft Tissue Problems – Skin and soft tissue infections, injuries or other disorders can cause facial pain, when the skin and tissue of the face is involved. Severe acne or pimples, soft tissue infection, cellulitis, erysipelas, etc. can cause facial pain in the surrounding area.
Face Pain from Vascular Origin – Conditions affecting the blood vessels can cause pain in face. In some conditions, inflammation, infection, injury or compression of the blood vessels can occur. For example, temporal arteritis, in which the arteries to the brain get damaged or when eyes or nose get affected from Raynaud's disease.
Face Pain Originating from Bone – Pain originating from the bone or bone disorders like osteitis, cysts in the facial bones can cause pain in face.
Atypical Facial Pain – This is also called chronic idiopathic facial pain or psychogenic facial pain, which does not present with any obvious signs or abnormality and most investigations are negative. It may be more commonly seen in elderly persons and females. Anxiety, depression or emotional disturbances may be contributing to the existing pain.