FAQ’s on Facial Pain Treatment in Las Vegas and Henderson NV

Pain of the face and head is seen commonly in the primary care setting. Patients are referred to Las Vegas pain management specialists for problems with chronic facial pain. Facial pain can occur from skull trauma, face injury, dental procedures, or sinus surgery.

How common is facial pain?

The prevalence rate of facial pain in the general population is around 25%, according to recent statistical reports. Facial pain affects females slightly more than males, and those between ages 18 and 29 have more facial pain than other age groups.

What are the most common causes of facial pain?

Facial pain often is brought on by damage to a nerve or trauma to the head and/or face. Common causes include:

  • Post-herpetic neuralgia – After a herpes zoster (shingles) infection, the affected nerve may remained hypersensitive (increased pain). The trigeminal nerve supplies the face, and it is most often affected.

 

  • Trigeminal neuralgia (TN) – This condition is the result of irritation or damage to the trigeminal nerve. Symptoms associated with TN include hypersensitivity to mild touch, spasms of pain, and electric-shock sensations on the affected side of the face.

 

  • Temporomandibular joint (TMJ) syndrome – The TMJ controls jaw movement. With this syndrome, the patient has pain with chewing gum, eating, and speaking. Pain is described as aching, burning, dull, and radiates to the side of the head and/or ear.

 

  • Cluster headaches – These headaches occur in clusters, and the pain radiates to the temples, forehead, cheek, neck, or ear on one side of the head. Associated symptoms are nasal stuffiness, eye watering, and eye redness on the affected side of the face.

 

  • Persistent idiopathic facial pain – This is pain occurs along the trigeminal nerve that is not characteristic of trigeminal neuralgia. The pain is often described as crushing, aching, and burning, and is chronic (long-term) in nature.

How does the doctor diagnose the cause of facial pain?

If you experience pain of the face and/or head, the doctor will ask you several questions regarding the onset, duration, and nature of the pain. In addition, the doctor will take a detailed medical history and perform a physical examination. Diagnostic tests are done to uncover the cause of the pain, or to rule out serious causes of facial pain. Commonly ordered tests include computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and x-rays.

What are the treatment options for facial pain?

Treatment of facial pain depends on the underlying cause. The doctor may use a combination of therapies including:

  • Trigger point injections (TPIs) – For myofascial syndrome, the doctor can inject painful trigger points (contracted muscle regions) with an anesthetic or other substance. According to recent clinical studies, TPIs are 90-98% effective, with many study participants reporting complete symptom relief.

 

  • Sphenopalatine ganglion block (SGB) – The mass of nerves below the brain and at the back of the throat are called the sphenopalatine ganglion nerves. The doctor can insert a small catheter through the nostril, position it near the nerves, and instill an anesthetic or neurolytic agent. A recent research report found that 66% of patients reported significant pain relief with this procedure.

 

  • Occipital nerve block (ONB) – For patients with pain at the posterior (back) region of the head, the doctor can perform an ONB. The doctor injects a long-acting anesthetic, with or without a corticosteroid, near the nerves to offer pain relief. Based on one clinical study, the ONB has a 100% efficacy rate for occipital neuralgia.

 

  • Medications – Many medications are used to treat facial pain. The doctor often uses a combination of agents, such as anticonvulsants, beta-blockers, antidepressants, serotonin agonists, and anti-inflammatory drugs. For severe, intractable pain, opioid analgesics are prescribed.

Resources

Dhadwal, N, Hangan, MF, Dyo, FM, Zeman, R, & Li, J (2013). Tolerability and efficacy of long-term lidocaine trigger point injections in patients with chronic myofascial pain. International Journal of Physical Medicine and Rehabilitation.

Felisati G, Arnone F, Lozza P, et al. (2006). Sphenopalatine endoscopic ganglion block: A revision of a traditional technique for cluster headache. Laryngoscope,116:1447–1450.

Jurgens, TP, Muller, P, Seedorf, H et al. (2012). Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain. Journal of Headache Pain, 13(3), 199-213. doi:  10.1007/s10194-012-0417-x

Macfarlane TV, Blinkhorn AS, Davies RM et al. (2002). Oro-facial pain in the community: prevalence and associated impact. Com Dent Oral Epidemiology, 30(1), 52-60.