Facial Nerve Pain: Diagnosis and Treatment

There are several types of facial pain. However, the most common is Trigeminal Neuralgia. In severe cased, you may need the help of an oral medicine specialist.

What is Trigeminal Neuralgia?

Trigeminal neuralgia (TN), also called tic douloureux, is a chronic facial nerve pain condition that causes extreme, sporadic, sudden burning, or shock-like face pain.  The pain seldom lasts more than a few seconds or a minute or two per episode. The intensity of pain can be physically and mentally incapacitating. TN pain is typically felt on one side of the jaw or cheek and has different symptoms from tension and cluster headaches.

Episodes can last for days, weeks, or months at a time and then disappear for months or years. In the days before an episode begins, some patients may experience a tingling or numbing sensation or a somewhat constant and aching pain. The attacks often worsen over time, with fewer and shorter pain-free periods before they recur. The intense flashes of pain can be triggered by vibration or contact with the cheek (such as when shaving, washing the face, or applying makeup), brushing teeth, eating, drinking, talking, or being exposed to the wind. TN occurs most often in people over age 50, but it can occur at any age, and is more common in women than in men. 

There is some evidence that the disorder runs in families, perhaps because of an inherited pattern of blood vessel formation. Although sometimes debilitating, the disorder is not life-threatening. The presumed cause of TN is a blood vessel pressing on the trigeminal nerve in the head as it exits the brainstem. TN may be part of the normal aging process but in some cases, it is associated with another disorder or painful condition, such as multiple sclerosis or other disorders characterized by damage to the myelin sheath that covers certain nerves.

Other causes of facial pain include:

• Persistent clenching teeth.
• Head injury from an car or sports accident.
• Postherpetic trigeminal neuralgia: Caused by acute herpes zoster.
• Dental pain: Including abscessed teeth.
• Temporomandibular joint syndrome (TMJ): This affects the jaw joint.
• Glossopharyngeal neuralgia: Involves the back of the throat.
• Arthritis in the temporomandibular joint (TMJ) can cause aching facial pain.
• Nervus intermedius: pain sensation steaming from within the ear.
• Burning mouth syndrome.
• Occipital neuralgia: Involves the nerves that run up the spine to the scalp.
• Mental and emotional issues

A medical history review and physical examination can help differentiate TN from other causes of facial pain.

Persistant Facial Nerve Pain

Is there any treatment?

A neurologist or oral-facial pain specialist is the best person to seek consultation from for the correct/proper diagnosis of trigeminal neuralgia. Because there are a large number of conditions that can cause facial pain, TN can be difficult to diagnose. But finding the cause of the pain is important as the treatments for different types of pain may differ.

Treatment options include medicines such as anticonvulsants and tricyclic antidepressants, surgery, and complementary approaches. Typical analgesics and opioids are not usually helpful in the treatment of the sharp, recurring pain caused by TN. If medication fails to relieve pain or produces intolerable side effects such as excess fatigue, surgical treatment may be recommended. Several neurosurgical procedures are available. Rest assured, the Minnesota Head & Neck pain clinic has a high success rate with our medication management plans.

Some are done on an outpatient basis, while others are more complex and require hospitalization. Some patients choose to manage TN using complementary techniques, usually in combination with drug treatment. These techniques include acupuncture, biofeedback, vitamin therapy, nutritional therapy, and electrical stimulation of the nerves. How a person responds to chronic pain may be quite different from how another individual does.

Conservative Treatments that Can be Helpful for Facial Nerve Pain

• Educating yourself about facial nerve pain and how to manage it.
• Exercise — Low-impact exercises like walking, swimming, or cycling can increase blood flow to the brain and release endorphins, which can help relieve pain. Neck exercises help loosen muscles and relieve facial pain.
• Relaxation techniques to help ease your pain.
• Ensure that you are consistently getting a good night’s sleep.
• Psychological treatments to reduce distress and anxiety and improve your mood.
• Physical therapy to help you control of your pain severity levels.
• Trigger point injections can block pain receptors within the nerves surrounding the muscle, and, in turn, reduce the pain signals sent to the brain.

Give yourself enough time to find the strategies that work best for you. If you have chronic pain, find and attend a multidisciplinary pain clinic, where orofacial health professionals can prepare you a personalized pain management plan. Your primary care doctor or dentist can refer you to a pain clinic. Facial nerve pain commonly lasts anywhere from a few seconds to as long as two minutes per episode.

These attacks can occur in quick succession, sometimes in volleys lasting as long as two hours. Don’t delay professional diagnosis and pain management for yourself or someone who knows who is facing this medical condition. Get help. Our clinic provides treatment for multiple types of pain disorders. Check out our helpful information for patients.

Living with trigeminal neuralgia can be very challenging. It may have a huge impact on a person’s quality of life, resulting in problems such as weight loss, isolation and depression that can trigger chronic pain.

What is the prognosis for someone with facial nerve pain?

The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. Trigeminal neuralgia is not fatal and is a unique diagnoses from hidden TMJ problems.

Your prognosis will be determined, in part, by the cause of your pain. For example, Facial nerve pain (tic douloureux) is common in MS and more challenging to overcome due to complications with having MS.

However, we do fint that patients overcome face pain better when they understand their head and jaw anatomy.

We’ll let you know how our pain specialist can help. Call 763-577-2484 or click the “Request Appointment” button to Schedule an Appointment Today!