There are many causes of chronic pain affecting the face but by far the most common is Trigeminal Neuralgia. We have two trigeminal nerves – one each supplying sensation to the right and left side of the face. The trigeminal nerve has 3 branches, supplying sensation to the forehead, cheek and jaw. Trigeminal neuralgia typically causes pain affecting one side of the face. It is often described as ‘burning/stabbing/electric or shooting’ pain. For most it is mild but for some, it can be excruciating pain. Patients often have trigger points on the skin which when touched can cause a violent spasm of pain. Pain can also be felt in the teeth. It is twice as common in females as males and seems to afflict the right side of the face more.
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Other causes of facial pain are:
Glossopharyngeal neuralgia - this usually causes pain at the base of the tongue, back of the throat and ear.
Post-herpetic neuralgia is a form of chronic facial pain which follows an attack of shingles on the face. Shingles is caused by the chicken pox virus/herpes zoster virus. It begins with a dull pain in the skin over the face, followed by an eruption of a weeping rash. However, it is the chronic pain lasting from this viral infection that can cause the post-herpetic burning, aching or throbbing nature.
Temporo-mandibular joint dysfunction can cause pain in the form of a dull ache around the jaw and muscles over the side of the face. It can also cause clicking of the jaw joint and difficulty in opening the mouth due to spasm of the jaw muscles.
Toothache can sometimes be so painful that is causes facial pain too.
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