Facial pain

Facial pain can have many different causes. The location alone is rarely enough to make a diagnosis; the character, duration, triggers and accompanying signs are particularly important.

• An attack lasting a few seconds to about two minutes, like an electric shock on one side of the face, suggests trigeminal neuralgia.
• A painful tooth, pain when biting, sensitivity to heat or cold, a bad taste or swelling is more suggestive of a dental problem.
• Pain and stiffness when chewing, clenching or yawning may come from the jaw joint or chewing muscles.
• Pressure in the cheek or forehead is more likely to be sinusitis only when there is also a blocked or runny nose, reduced sense of smell or discoloured mucus.
• Attacks on one side around the eye, with watering, a red eye and a strong need to move around, may suggest cluster headache; throbbing pain with nausea and sensitivity to light or sound is more suggestive of migraine.
• A newly red, very painful eye, loss of vision, loss of neurological function, a sudden exceptionally severe headache or a threatened airway is an emergency.
• New persistent facial numbness, abnormal nerve function or steadily worsening pain on one side needs prompt investigation.
• Treatment varies greatly with the cause. Do not have a tooth removed or start antibiotics or nerve pain medicines without an appropriate diagnosis.