Facial pain is common, and can be felt in the forehead, behind the eyes, across the cheeks or in the jaw. It can sometimes be associated with headache. Many patients with facial pain will experience pain every day (chronic facial pain).
Causes of facial pain
Facial pain can sometimes be due to sinus infections, and occasionally due to chronic sinus disease (chronic rhinosinusitis).
However quite frequently, there may be no sinus disease, and the pain may be a neurological (nerve-related) symptom, like a headache. This can be a form of migraine or a variant of tension-type headache known as mid-facial segment pain.
The most important question to answer is whether the pain could be due to sinus disease - this is why seeing an expert in sinus disease is valuable. The first step in managing facial pain is asking a careful and thorough set of questions about the patient's pain, to find out whether it is more likely to be a sinus problem or a neurological problem.
Following this you may require a nasendoscopy (examining the nasal cavity with a fine fiberoptic camera), and sometimes a scan to examine the contents of the sinuses.
The best treatment for you depends on the cause of your pain. Pain due to sinus problems should respond to treatment of the underlying sinus disease (with medication and sometimes surgery). If the pain is due to a form of migraine or tension-type headache, you will be offered a trial of a low-dose medication, as well as lifestyle advice, to improve the pain. It can be helpful to see a neurologist about the pain - we can organise a referral to an expert colleague if needed.