Neurology and Neurosurgery

Why does my face hurt? Understanding facial pain and how to treat it

A young woman wearing a fuzzy red sweater stretches her arms up and face to the blue skin. She is happy and smiling because she is managing her facial pain well.

09/30/2024

When you’re faced with facial pain, you want relief fast. Here are the common causes of face pain — from migraines and nerve problems — and treatments for relief.

 

By Hida Nierenburg, MD, Neurology and Headache Medicine, Nuvance Health

 

A dull ache or sharp, shooting sensation in your face can make simple tasks like talking or chewing difficult. Facial pain can also make it hard to concentrate, enjoy meals or sleep. It is common and can affect your eyes, nose, mouth, cheeks and forehead. Finding the underlying cause is key to relieving your discomfort and pain.

 

Find out what can cause pain in your face and what to do about it.

 

 

What is facial pain?

 

Facial pain is discomfort in regions of the face, including the eyes, nose, mouth, cheeks and forehead. It can be a mild, dull ache or an intense, sharp, shooting pain that affects everyday activities like blowing your nose or applying sunscreen. Facial pain can come and go or be persistent, depending on what is causing it.

 

Facial pain is not only a physical issue; it can take an emotional toll as well. Chronic sufferers often experience frustration, anxiety and depression as they struggle with the unpredictability of their condition.

 

What causes face pain?

 

Facial pain is often a symptom of a condition affecting the nerves, sinuses or blood vessels in your face. In some cases, it could signal a more serious issue such as a neurological disorder. Facial pain can happen from a variety of underlying causes. It may be a symptom of an acute infection, like sinusitis, or a chronic neurological disorder, like migraine, trigeminal neuralgia or cluster headache, or a sign of stress or anxiety. 

 

 

Common conditions associated with facial pain

 

Tension-type headaches, migraines and sinus problems are some of the common conditions that can cause discomfort in the face. Identifying the root cause of your facial pain is crucial for effective treatment. 

 

Here are common reasons for face pain:

 

Headaches: Cluster, migraine and tension headaches can put pressure on the trigeminal nerve, the largest cranial nerve that sends sensations from your face to your brain.

 

Migraines: A migraine is not just a bad headache — it is a neurological disorder that can cause radiating pain in your face, especially around your eyes and temples. Migraine-induced facial pain can be sharp, throbbing or pressure-like. It is usually accompanied by sensitivity to light and sound, along with nausea and possibly vomiting.

 

 

Sinusitis: If you have ever had a sinus infection, you are likely familiar with the pressure it creates in the face. Sinusitis occurs when the sinuses become inflamed, leading to facial pain around the forehead, nose and cheekbones. The pain is often worse when you bend over, sending pressure to your head. You may also have tenderness when you touch your sinuses. Sinusitis can also cause congestion, fever or thick nasal discharge. There must be evidence of sinus disease in a CT scan to be diagnosed with sinusitis.

 

Allergies: Allergies can trigger headaches, migraines and sinus problems! Controlling allergies through medications or avoiding allergens can alleviate facial pain caused by these common conditions.

 

 

Dental problems: Temporomandibular joint (TMJ) disorders affect the jaw joint and chewing muscles and can cause pain in the face, neck, shoulders or back.

 

Anxiety and stress: Like allergies, anxiety and stress can trigger other conditions that can cause facial pain in people who have a genetic predisposition to get headaches or migraines. Feeling anxious or worried can lead to headaches, migraines and jaw pain from clenching your teeth, which then sends a signal through the trigeminal nerve to cause pain.

 

 

Trigeminal neuralgia: Trigeminal neuralgia (TN) causes sudden, severe facial pain. It is more common in the middle cheek or lower jaw. It primarily affects older adults and is more common in women. Light touches or even a cold breeze across the face can trigger TN.

 

What neurological disorders cause facial pain?

 

Trigeminal neuralgia: Nerve pain in the face that comes and goes

 

The most notable neurological condition linked to facial pain is trigeminal neuralgia. The trigeminal nerve sends sensations from your face to your brain. When the nerve is compressed or irritated, it can cause an intense, stabbing pain in your face that comes and goes. It can happen from compression of the nerve by arteries inside the brain but can also happen on its own.

 

Some people describe TN pain as an “electric shock” to the face. Simple daily activities, like applying makeup, brushing teeth or chewing gum can trigger an attack. Headaches, migraines and sinus problems can also trigger trigeminal nerve pain. 

 

Facial pain from multiple sclerosis or stroke

 

Other neurological conditions that may cause facial pain include multiple sclerosis (MS) and stroke. These conditions can cause damage to the nerves responsible for facial sensation. MS affects the central nervous system and can trigger episodes of facial pain, especially trigeminal neuralgia. Strokes that affect certain parts of the brain can lead to facial pain or numbness, often accompanied by other serious symptoms like difficulty speaking or moving.

 

Treating the underlying cause can help alleviate trigeminal nerve pain. If facial trauma or a stroke damages the trigeminal nerve, speak with your doctor about effective pain management options.

 

 

How do you relieve facial pain?

 

As you now know, there are many possible reasons why you might have facial pain! Speaking with your doctor is a great first step to alleviating pain in your face. Together, you can determine the cause and discuss the best possible treatment. Whether your pain is due to migraine, cluster headache, trigeminal neuralgia, sinusitis or anxiety-related tension, there are several approaches to finding relief.

 

 

Conservative approaches for managing facial pain

 

For many people, simple remedies can bring relief. For instance, if sinusitis is causing your facial pain, over-the-counter pain relievers like ibuprofen or acetaminophen may help; but ultimately, the sinus infection must be treated. A warm compress placed on the affected area can also reduce discomfort and inflammation. Gentle massage, especially around the jaw or temples, can alleviate tension and stress-related facial pain.

 

 

If you suffer from migraines or TMJ disorders, lifestyle changes can help relieve symptoms. Common triggers for both migraines and TMJ are lack of sleep, dehydration, certain foods and stress. Avoiding triggers, practicing stress-relief techniques and maintaining good posture to reduce strain on your head and neck can help. Working with your doctor on maintenance and rescue medications can also help.

 

If facial pain occurs more than four days per month, you may need preventive medications to help decrease the frequency and intensity.

 

 

Medications and therapies for facial pain relief

 

If your facial pain stems from chronic conditions, like headaches, migraines or trigeminal neuralgia, your doctor may prescribe treatments. 

 

There are many treatments for headaches and migraine, depending on the type and individual. Treatments could include oral medications, injections, infusions or wearable neuromodulator devices to calm nerve activity. 

 

If migraines cause face pain, your headache specialist may recommend specific medications for acute treatment and prevention.

 

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Treatments for trigeminal neuralgia may include anticonvulsants or muscle relaxants to block nerve activity.

 

For some people, antidepressants can also be effective in treating chronic facial pain, particularly if anxiety or depression is involved. 

 

Alternative treatments for facial pain relief

 

In addition to medications, therapies such as physical therapy, acupuncture or cognitive-behavioral therapy (CBT) can help manage the symptoms of chronic facial pain, especially when stress is a contributing factor.

 

Surgical interventions for facial pain relief

 

For severe cases of trigeminal neuralgia that do not respond to medication, surgical options are available. These include procedures like microvascular decompression (relieving pressure on the trigeminal nerve) or gamma knife radiosurgery (targeting the nerve with focused radiation).

 

Managing anxiety to relieve facial pain

 

When you are anxious or stressed, your body can hold tension in certain areas, especially around the jaw, neck and shoulders. This tension can lead to jaw clenching, teeth grinding and even muscle spasms, all of which can contribute to facial pain.

 

If you notice a connection between stress and your facial discomfort, it may be worth exploring relaxation techniques or speaking with a mental health professional. Stress management techniques, like deep breathing and mindfulness meditation, can help reduce anxiety and alleviate facial pain.

 

What are the red flags for facial pain?

 

While facial pain is often due to less serious conditions like sinusitis or TMJ disorders, certain symptoms may indicate a more urgent problem. Red flags to watch for include:

 

  • Sudden, severe facial pain that peaks within minutes that does not improve with rest or over-the-counter medications.

 

  • Facial pain accompanied by stroke symptoms, including numbness, weakness, confusion or paralysis on one side of the face; vision changes such as blurred vision or double vision; difficulty speaking, swallowing or moving parts of your face.

 

If you experience any of these symptoms, seek medical attention immediately.

 

 

The bottom line: Facial pain can range from a mild inconvenience to a debilitating condition that significantly affects your quality of life. The causes vary from sinus infections, cluster headaches and migraines to trigeminal neuralgia. It is important to visit your doctor for a proper diagnosis and treatment plan.

 

Depending on the cause, treatments range from home remedies like warm compresses to more advanced therapies such as medications. Pay attention to red flags and seek immediate medical advice if your pain is severe, persistent or accompanied by other worrying symptoms. With the right care, facial pain can often be managed effectively, helping you get back to living life comfortably.