Facial pain can take many forms—sharp, dull, sudden, or persistent. It may appear around the eyes, nose, jaw, or forehead, and it can disrupt your daily life in ways that are hard to explain. At Stanford’s Division of Pain Medicine, we understand how complex facial pain can be. In this blog, we’ll walk through common causes, how our pain clinicians diagnose the condition, and what treatment options are available.
What causes facial pain?
Facial pain can be caused by a variety of health issues, ranging from temporary problems to long-term conditions. Common sources of facial pain include:
- Nerve problems, like trigeminal neuralgia or postherpetic neuralgia
- Jaw disorders, such as temporomandibular joint dysfunction (TMJ or TMD)
- Infections, including sinus infections or dental abscesses
- Headaches or migraines
- Trauma from an injury or surgery
Sometimes, facial pain may occur even without a clear cause, which can make it even more frustrating.
Meet the Trigeminal Nerve – The Highway of Facial Sensation
The trigeminal nerve is one of the body’s most important nerves for facial function. It’s a large nerve that splits into three main branches, each responsible for carrying sensory messages—like pain, temperature, and touch—from different parts of your face to your brain. It also helps control the muscles you use for chewing.
Because the trigeminal nerve covers so much ground, it’s especially vulnerable to problems. If it gets compressed by a blood vessel, irritated by an infection, or injured through trauma or surgery, you may feel pain, numbness, or tingling across your face. When this nerve misfires, conditions like trigeminal neuralgia can arise—causing sharp, electric-shock-like pain that’s often difficult to manage without expert care.
How is facial pain diagnosed?
At Stanford Division of Pain Medicine, diagnosing facial pain starts with a deep conversation about your symptoms and medical history. Your doctor may ask:
- Where exactly is the pain located?
- What triggers it—touch, chewing, cold air?
- Is it constant or does it come and go?
Next, your care team may order imaging tests like MRI or CT scans to rule out structural issues, tumors, or vascular compression. Sometimes, nerve blocks are used during the diagnostic process to help identify which nerves might be involved.
Get to Know Our Team: Dr. Meredith Barad
Dr. Barad is a neurologist and pain doctor who specializes in facial pain and headaches. She co-leads Stanford’s Orofacial Pain Program and helps patients find answers and relief through a whole-person approach to care.
She also leads clinical research focused on expanding treatment options for patients with few proven choices. Right now, she’s running a study on the use of Botox to treat chronic facial pain that develops after surgery or trauma—such as dental procedures, facial fractures, or cosmetic surgery. These types of injuries can lead to long-term nerve pain that’s notoriously difficult to treat.
The study uses targeted Botox injections to try to calm overactive nerves and reduce pain signals in the face. It’s one of the only clinical trials in the country focused on this exact group of patients, and it could help establish Botox as a safe, effective treatment for a condition that currently has limited evidence-based options.
Common conditions we treat
Here are some of the most common causes of facial pain that our team sees and treats:
Trigeminal Neuralgia
This is a nerve disorder involving the trigeminal nerve. Patients experience sudden, severe facial pain, often on one side. Triggers can be as simple as brushing your teeth or feeling a breeze.
Postherpetic Neuralgia
A complication of shingles, this condition can cause lasting nerve pain after the rash disappears. If shingles affects the face, the trigeminal nerve may be involved.
Temporomandibular Joint Dysfunction (TMJ)
Problems with the jaw joint can lead to pain that radiates across the cheeks, temples, and ears. TMJ may be worsened by stress, clenching, or arthritis.
Atypical Facial Pain (Persistent Idiopathic Facial Pain)
Sometimes facial pain doesn’t fit neatly into any category. This type of pain may not follow a nerve path and may not respond to typical treatments, requiring a personalized approach.
What are the treatment options?
There’s no one-size-fits-all treatment for facial pain. Your care plan may include:
- Medications, including anticonvulsants, antidepressants, or anti-inflammatories
- Physical therapy for jaw alignment or muscle tension
- Nerve blocks or injections to calm irritated nerves
- Surgical options if a blood vessel is compressing a nerve
- Psychological support to manage stress and pain-related anxiety
Our team uses a whole-person approach, meaning we consider your physical, emotional, and social needs. We work closely with other Stanford specialists in neurology, neurosurgery, oral medicine, and mental health to create a comprehensive plan for you.
When to seek help
If you’ve been living with facial pain and haven’t found relief, you’re not alone—and it’s not all in your head. Getting the right diagnosis is the first step. Early intervention can prevent symptoms from worsening and help you regain control of your life.
