Facial Pain
Signs and Symptoms:
Facial pain commonly results from temporomandibular joint (TMJ) disorder. There are various sub-diagnoses (e.g. myofascial pain, temporomandibular joint inflammation). TMJ disorder is an umbrella term covering acute or chronic pain, especially in the muscles of mastication, or inflammation of the temporomandibular joint. The temporomandibular joint is susceptible to many of the conditions that affect other joints in the body, including ankylosis, arthritis, trauma, dislocations, developmental anomalies, neoplasia and reactive lesions.
Symptoms usually involve more than one of the numerous TMJ components: muscles, nerves, tendons, ligaments, bones, connective tissue, and the teeth. Symptoms can include;
- Difficulty in biting or chewing
- Jaw pain or tenderness of the jaw
- Clicking, popping, or grating sound when opening or closing the mouth
- Reduced ability to open or close the mouth
- A dull, aching pain in the face
- Dizziness
- Headache or migraine (particularly in the morning)
- Neck and shoulder pain
- Blinking
- Ear pain,
- Hearing loss and tinnitus.
Is Facial Pain Common?
Around 33% of the population has at least one temperomandibular symptom and 3.6% to 7% of the population has TMJ disorder with sufficient severity to cause them to seek treatment (Wright 2009). The disorder is common and most often occurs in people aged between 20 and 40 years (NICE 2009).
Standard Care:
Treatment of a patient with chronic facial pain includes analgesics, NSAIDs, an occlusal splint (bite guard), cognitive behavioural therapy, physiotherapy and surgery (Al-Jundi 2008).
Your treatment plan
After a thorough medical history and examination procedure treatment needs to address the underlying causes and any exacerbating factors.
Acupuncture
Acupuncture is commonly recognised as an aid to pain relief. Certain acupuncture points have been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety (1). Acupuncture may help in the management of facial pain by:
- Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (2).
- Increasing the release of adenosine, which has antinociceptive properties (3).
- Inducing antinociception by activating the opioid pathway (4) or the L-arg/NO/cGMP pathway (5).
- Exciting or inhibiting the anterior temporalis muscle via reflex pathways and thus smoothing jaw opening and closing (6).
Massage - A combination of bodywork such as tui na, acupressure, massage, reflexology, relaxation, breathing and mindful awareness exercises are also a core strategy that has proven helpful for many people.
Other Lifestyle factors - Creating restful sleep patterns, making sure you have the right diet, nutrients and nourishing eating habits are also key, as well as addressing any emotional issues that may be involved.
British Acupuncture Research Fact Sheets - For further information please take a look at the related issues section on the right hand-side of the screen.
- Wu MT et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain-- preliminary experience. Radiology 1999; 212: 133-41.
- Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.
- Goldman N et al. Adenosine A1 receptors mediate local anti- nociceptive effects of acupuncture. Nat Neurosci 2010; May 30.
- Almeida RT, Duarte ID. Nitric oxide/cGMP pathway mediates orofacial antinociception induced by electroacupuncture at the St36 acupoint. Brain Res. 2008b;1188:54- 60.
- Almeida RT et al. Opioidergic orofacial antinociception induced by electroacupuncture at acupoint St36. Braz J Med Biol Res. 2008a;41(7):621- 6.
- Wang M et al. Electromyographic responses from the stimulation of the temporalis muscle through facial acupuncture points. J Chiropr Med. 2007;6(4):146-52.