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Q: recurrant severe facial pain
asked by: milsochilso on March 13th, 2008
New User
I am going to the doctor about this tomorrow (finally!), but I am interested to hear other people's perspectives and anyone who has experienced anything similar.

I had never had any facial pain or ear pain prior to December 2001 when I was in my final year at college and I contracted a severe virus, which affected my ears and face.

Since then, I have had recurring episodes of extremely severe facial pain - to the point where I have wanted to take my own life. It is really starting to affect my life... work is very difficult due to either the unpredictable pain or lack of sleep and I cannot make plans to go places because I never know when a fresh wave of attacks is going to happen.

I have been to the doctor twice - they suggested sinusitis and sent me away with antibiotics. When another attack started I began to visit my dentist as a large proportion of the pain was focused on my right upper molars and I thought something was wrong with them or I might have an abscess. Anyway, my dentist gave me more antibiotics because he could not find anything.

The latest attack began about a month ago. I woke up in the early hours of the morning with this feeling of intense pressure in my right cheek and a heavy feeling in that side of the face. The pressure was replaced with the most excrutiating pain, which continued on and off for days. It feels like an aching feeling combined with sharp shooting pains. I thought maybe I was getting a cold or something so I waited 5 days, taking massive doses of painkillers, but nothing seemed to hit the pain. I would want to cry with pain, but couldn't even manage that. During an attack I cannot do anything. I cannot lie down as it makes it worse. I find eating very difficult as well as speaking/using a telephone or even concentrating on anything. The muscles in the right side of my face feel very tense during an attack, almost like they are cramping. The attacks usually last for a few hours at a time. They seem to occur at certain times of the day more than others. The late afternoon/evening and night are worse... from about 2 or 3 AM onwards is not too bad.

I booked in to see the emergency dentist who took X-rays of my teeth/cheek area and tapped the teeth, made me bite on things, blew air all around the teeth - NOTHING.

Anyway, he gave me 2 doses of antibiotics to take side by side and said to continue on the painkillers. I do not think the dentists understand the meaning of the pain I am experiencing!! I came back to my regular dentist a week later and he examined me - lots of tapping, air blowing, X-ray examining... he said: there's nothing wrong with the teeth and I am not going to do a root canal or extraction on a tooth which I can see nothing wrong with. He told me to go away and come back if the tooth hurt when I touched it with my finger or bit on something.

I have not gone back to the dentist because although I feel pain in the teeth area - I do not feel pain on application of pressure or touch.

So... I continued. After years of this, I think I have got this kind of resignation and high tolerance of pain. I find it hard to take the time off work to go see the dentist or doctor so I have been trying to cope as best I can.

Now I have got to the end of my tether finally. The pain has become less localised in the upper right back teeth and has now become more generalised. It seems to focus from around my jaw hinge on the one side and spread down to my lower jaw and my upper teeth, then up towards my eye and back towards my ear. The pain is still extreme aching pain topped with sharp stabbing pulsations. Teeth feel fine to touch. No feeling of pressure in my face. My eye hurts if I press against it (like if my eyelid is closed). I feel a numbness when touching my cheek/jaw area and pins and needles/prickling sensation - to the point where touching my face made me feel physically sick.

If I go to bed at night - an attack starts about 11:30 and goes on until 2 or 3 in the morning. I finally get to sleep then have to get up for work at 6:45 a.m. Sometimes a further attack starts around 7:30 a.m. otherwise I can continue to maybe lunchtime before another one threatens. The worst time is around 5 p.m. onwards.

I have taken at times, in addition to painkillers, anti-allergy tablets, sudafed, beconese, used neilmed sinus rinse, homeopathic sinusitis tablets, luffa complex. Nothing has made any inroads to resolving the situation.

I am sorry this is so long and I hope that it makes sense.
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Replies(14)
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MandMs
replied on March 21st, 2008
Extremely eHealthy
Hi!
Reading your post, I started to suspect about two possible conditions.
For all these years, have you been having several headaches a day for weeks, sometimes months, usually interrupted by a pain-free period of variable length or this is everyday pain without pain-free period?
Have you experienced a beginning of headache as a burning sensation on the side of your nose or deep in your eye?
Do these headaches usually come on just after you go to sleep?
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milsochilso
replied on March 24th, 2008
New User
Thank you for your reply.

It's not a really what I would class a headache - it's facial pain in the right hand side.

It seems to come for periods of time and then disappear. These periods of time could be several days or several weeks. When it is gone... I am pain-free and take no painkillers.
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milsochilso
replied on March 24th, 2008
New User
I forgot to say - usually it starts when I am asleep... or when I wake up I notice it is there. Then it goes on for weeks... with several long episodes a day rather than a continuous pain.

I have never had a burning sensation. It is more of a throbbing or gnawing feeling with sharp stabbing pulsations over the top of the baseline pain.
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MandMs
replied on March 27th, 2008
Extremely eHealthy
Is this facial pain, usually, triggered by a light touch of the face or mouth?
Do you often find yourself afraid to talk, eat, or move during periods of attacks?
Do you wince involuntarily when you feel the intense facial pain?
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milsochilso
replied on March 27th, 2008
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I have not noticed that it is triggered by anything in particular, but I am afraid to talk, eat and move during the periods of attacks as these seem to make it a lot worse. It is so bad that it is more than wincing, it is the most gripping and terrifying pain I have ever experienced. It has made me feel extremely desperate.
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antigone
replied on March 28th, 2008
Extremely eHealthy
I am a neuro RN. This sounds like it could be trigeminal neuralgia. A viral infection can trigger the neuralgia. If you do not get any help with your doctor consider seeing a neurologist. There are treatments available. This can be an excruciating condition. I hope this helps. Let us know how you do with the doctor.
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MandMs
replied on March 28th, 2008
Extremely eHealthy
This severe, stabbing pain that you feel on one side of your face, that is one of the most painful conditions and makes wince involuntarily (hence the term tic) is known as tic douloureux or trigeminal neuralgia. These painful attacks can be spontaneous, but they may also be provoked by even mild stimulation of your face. Acctually, is a neuropathic disorder of the trigeminal nerve (it is responsible for sensation in the face) and the pain you feel is in areas innervated by this nerve, that has three main branches.
The first branch is ophthalmic nerve, responsible for sensory information from the scalp and forehead, the upper eyelid, the eye, the nose, the nasal mucosa, the frontal sinuses, and parts of the meninges (the dura and blood vessels).
The second branch is maxillary nerve, carries sensory information mainly from the lower eyelid and cheek, upper lip, the upper teeth and gums, the nasal mucosa.
The third branch mandibular nerve, carries sensory information from the lower lip, the lower teeth and gums, the floor of the mouth, the tongue, the chin and jaw, parts of the external ear.

The exact cause of this painful condition is not known, but, there are several theories for its etiology.
As you said in your first post, you noticed this after having an infection.
One of the theories states the same that some infection can cause the nerve damage. But, don't get this as a final answer.
In most of the cases it is due to contact between a normal artery or vein and the trigeminal nerve at the base of the brain, placing pressure on the nerve. This is some kind of genetic and runs in families.
Other reasons to have this conditions can be due to bone abnormalities, trauma or multiple sclerosis.
You should visit neurologist as soon as possible, because remission is less common the longer you have trigeminal neuralgia.
This pain can be treated with medications (anticonvulsants, antidepressants, nerve blocks with anesthetics) or surgery.

Best wishes!
Marija
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cherokee4444
replied on February 21st, 2009
New User
Same experience
I have a very similar condition that's lasted about 10 days. So far I've had one suspect tooth pulled, but after it was pulled, they found no indication of infection and the pain continues. By the description of the tregeminal neuralgia-third branch mandibular nerve describes my periodic waves of pain perfectly. Right now they suspect virus in the gums near where my tooth was pulled...maybe that's causing the nerve trauma? The only thing that's eliminated the pain is novocaine.
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grad12
replied on March 6th, 2009
New User
Same for me
I walked out my dentist's office yesterday because he wanted to pull to teeth that are not infected. I spent last Saturday afternoon in the emergency room. I have seen my primary physician also. I have been on several different pain killers and antibiotics over the last 8 days. I am now trying gabapentin, which is also used for symptoms of fibromyalgia. Could there be a link between the fibromyalgia and my severe, unrelenting facial pain?
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vivthor
replied on June 20th, 2009
New User
Facial Pain and Fibromyalgia
I have just looked at th eprevious posts because I am having severe facial pain for the past 2 months, my doctor is trearing me for sinusitis/ allergic rhinitis and I have had on top on the usual antibiotics/ ant- allergics, painkillers, Steroid injections and oral steroids - all to no avail. I have a diagnosis of fibromyalgia for the past 2 years and am on gabapentin. The more I read and experience of this pain, I believe it is related to fibro, I hate it !!
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DHB
replied on July 15th, 2009
New User
chronic facial pain
Hi, I have been suffering with bilateral facial pain for 1and a half yrs. All scans and MRIs are normal. TMJ function is normal. The pain is bilateral and is often sharp in nature although the pain is most often a constant gripping pain in my lower jaw. The pain also goes into my neck and shoulder. I have seen 15 drs with no concrete diagnosis. I have been told that I do not have trigeminal neuralgia or neuropathy or TMD. I am so frustrated. Any advice would be a great help!
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monieq
replied on August 5th, 2009
New User
I to have all the same pain it is the worst pain I have ever had I am on the oxycodone 10mg and I take tegretol 200mg 2times a day.I am seeing a neurologist who thinks that it may be trigeminal neuralgia today I had a brain MRI.During the nuro exam he put this steel thing that made a high piched sound to my ear that brought me toalmost hit him, it was so painful. I think that who eer is having this pain should find a good nerologist to start the road to some relief.
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irenesiunz
replied on August 24th, 2009
New User
My chinese doctor fixed my facial nerve pain
I have started having this facial nerve pain on the right side on my face (it was near my ear) 4 years ago (it just suddenly came). every episode is just a few seconds, but it was really painful that i had to scream and kneel down on the floor when it happened. and then the pain will be gone. at first it was 1-2 times a day (talking and chewing would trigger it), and then it became 5 times a day. and then after a week, it would go away for weeks before it started again. After 2 years, by chance i found this chinese doctor (i live in new zealand now) who is expert in spine. I went to him for acupunture for something else, and he checked my back and found that my spine is not straight (it was crooked at 2 places), and so i told him my nerve problem, he immediately checked my neck (the spine at the neck area) and it was painful when he pressed it, and it was crooked. So he straightened my spine and neck (by a simple twist on my waist, took merely one minute) and my spine was fixed and straightened. He told me that my spine was not straight, and it would affect my posture and my neck bone will be affected, and it would affect the nerves around the neck/face area (and also the blood circulation will be bad. each vertebra of our spine is connected to different organs in our body, so if any part of the spine is crooked, it would affect the organs and causing poor blood circulation). i went home after one session and I could not believe it, the nerve pain disappeared as well. it came back after 3 months and i went back to get my neck/back again (when our spine is not straight, it can be easily straightened, but it can get crooked again easily because it takes time for the tendon and muscle to grow back, and if we were not careful, e.g carry heavy things, then it get crooked again. so it takes a bit of time). so it has been 2 years since i first started seeing this chinese doctor, and the last time i had an attack was half a year ago (it only happened 1- 2 times and i would go to my chinese doc immediately to get it fixed). i recently twisted my lower back (by carrying a 100kg wood table with my husband) and had terrible back pain for a week (for some reason i forgot to go to my chinese doc immediately, as i don't see him that often), and when i finally went to see him, he fixed my back in a few minutes. He is amazing. but unfortunately it is very hard to find anyone who is specialised in spine/back (he started doing that in chinese since he was 13), even the doctor told me he has back problem and he can't find anyone to fix him (as in new zealand no other person does what he does). I just wanted to share this, as it was a miracle that my nerve pain problem was fixed in 1 minute, and i would never have thought of the problem is the back/neck being crooked. So maybe you should ask around to find a specialist who is specialised in spine alignment to see whether that could be the problem.
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irenesiunz
replied on August 24th, 2009
New User
i forgot to mention, during my treatment with the chinese doctor, he also did acupuncture on my neck (just one needle) and on my back, just to help to relax the muscle and improve circulation. so straightening the spine/neck and a little bit of acupuncture might help. it definitely healed me.
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