Trigeminal neuralgia – This is inflammation of the trigeminal nerve, which leads to muscles spasms and severe pain. This syndrome is associated with electric shock-like pain that occurs without warning and is triggered by touch, wind, or chewing. This condition is caused by damage to the trigeminal nerve, which supplies the face.
Post-trauma and post-surgical face pain – This occurs after injury or surgery to the face. Whether it’s a serious car accident, a fall, or a direct blow, any trauma to the face can result in this condition.
Glossopharyngeal neuralgia – This condition involves repeated episodes of severe pain of the throat, ears, tonsils, and tongue. The pain can last from seconds to a few minutes. Experts believe this condition is related to irritation of the glossopharyngeal nerve, which supplies the affected areas. Symptoms being around age 40, for most patients, and the source of irritation is often unknown.
Post-herpetic neuralgia – This condition is a complication of shingles, which is caused by the same virus (herpes zoster) that brings on chickenpox. If this virus affects nerves of the face, it can produce nerve inflammation and prolonged pain. The risk of post-herpetic neuralgia increases with age, and mainly affects persons 60 years old and older.
Temporomandibular disorder – Also called temporomandibular joint (TMJ) disorder, this condition affects the jaw joint and muscles that control jaw mobility. For some patients, TMJ is associated with arthritis or injury. Many people with TMJ disorder also grind their teeth or clench their teeth a lot.
Myofascial pain syndrome – With this painful chronic disorder, the trigger points of the muscles are painful when pressure is applied. This condition arises after a muscle has been contracted repeatedly.
Hemifacial spasm – This condition is the result of muscle spasms on one side of the face. The spasms are not life-threatening, and are related to a nerve disorder.
Occipital nerve block (ONB) – This procedure involves injecting the back of the head (occipital region) with a long-acting anesthetic. Used for headaches, occipital neuralgia, and other pain, this block was found to be 75-100% effective for conditions related to facial pain.
Sphenopalatine ganglion neurolysis (SPN) – This procedure involves injecting the sphenopalatine ganglion nerves with a long-acting anesthetic and a neurolytic agent, such as absolute alcohol or phenol. In a recent clinical study, around two-thirds (67%) of patients reported effective pain relief with this procedure.
Medications – Certain medicines are prescribe for headaches and facial pain (Imitrex, Maxalt, Ergotamines). For post-herpetic neuralgia, the doctor can offer an antiviral agent, such as acyclovir or valcyclovir. Neuropathic facial pain is treated with antidepressants (amitriptyline, Cymbalta, Savella), anticonvusants (carbamazepine, gabapentin), and narcotic analgesics (tramadol, hydrocodone, oxycodone).
Trigger point injections (TPIs) – With an efficacy rate of 90-98%. TPIs are used for myofascial syndrome and other conditions. The doctor injects a numbing agent into certain trigger points associated with neck and head discomfort.