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Pain in the head and neck is controlled by afferent fibers in the nervus intermedius, trigeminal nerve, vagus nerve, and glossopharyngeal nerve, as well as the occipital nerves. Any dysfunction or lesions of these nerves can produce pain of the face.

The four most common causes of facial pain and the associated symptoms are:

. Temporomandibular joint and muscle disorders (TMJDs) - These conditions cause pain related to the muscle and joint between the temple and mandible. The pain is often worse with facial movement and produces an aching, dull pain that results in soreness of the associated tissues.
. Trigeminal (TN) - The main symptom of TN is agonizing, pain of the face, which is most always on one side (unilateral).
. Post-herpetic neuralgia (PHN) - Caused by a herpes zoster infection, the pain of PHN usually is unilateral and burning in nature.
. Persistent idiopathic facial pain - Known also as atypical facial pain, this pain is often brought on by trauma or surgery to the face, gums, or teeth. The pain is continuous, dull, and aching, with intermittent severe episodes that spare the jaws.

The treatment of facial pain depends on the underlying cause. Common treatment modalities include:

Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs) and tricyclic antidepressants are used to relieve the pain of TMD. For TN, pain can be controlled with carbamazepine, Baclofen, gabapentin, and topiramate. Antidepressants and anticonvulsants are used to treat PHN, and topical agents show varying degrees of success (Capsaicin, lidocaine, and menthol).

Trigger point injections (TPIs) - To reduce the pain associated with myofascial syndrome, the doctor can inject an anesthetic into the trigger point to relieve contraction and pain. Clinical research reports show that TPIs are 90-98% effective, with around two-thirds of patients reporting complete pain relief.

Occipital nerve block (ONB) - Used for various types of head pain, the doctor injects a long-acting anesthetic, with or without a corticosteroid, into the back of the head. One recent clinical study of patients with face pain showed a 75% success rate for this block for reducing pain, and some patients reported complete symptom relief.

Sphenopalatine ganglion block - With this procedure, a numbing gel is instilled into the nostril. After the mucosa is numb, a tiny catheter is inserted through the nose to reach the nerves beneath the brain at the back of the throat. The doctor injects a long-acting anesthetic near the nerves. One clinical study showed that around two-thirds of patients reported facial pain relief within one week of this block.