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It can come on quick or gradually. It can be a gripping pain or a pain that jumps through like a lightening bolt. It can last for seconds, hours or weeks on end. The cause is usually unknown and the cure can be elusive. Facial pain is considered to be among the worst that can be experienced. Find out about three types of facial pain and if they can be helped by massage therapy.
Symptoms and Causes of Face Pain
Temperomandibular Joint Disorders (TMJ/TMD) – Aside from well-known headache disorders, such as sinus, migraine or tension pain, TMDs are perhaps the most recognized form of facial pain. These disorders occur because of problems with the articulating bones of the TMJ, the hinge joint connecting the mandible (or jaw bone) to the temporal bone of the skull, just in front of the ear. When this becomes misaligned because of injury, teeth grinding, arthritis or even stress, the result can be chronic pain, tenderness, difficulty chewing or an inability to open mouth wide or a locked jaw position. Many other symptoms have been attributed to TMD as well, such as neck aches, upper shoulder pain, earaches, dizziness and tinnitus (ringing sounds in the ears).
Trigeminal Neuralgia (tic douloureaux) – Trigeminal Neuralgia is considered to be one of the most painful disorders of all medical pathologies. Affecting the trigeminal (or 5th cranial) nerve root, which passes from an opening in the skull just over the ear, branches out into three divisions: V1, ophthalmic nerve which innervates forehead and eyes; V2, maxillary n. innervating the cheek; and, V3, mandibular n. which affects the lower face and jaw. There is no known specific cause for the intense stabbing, electrical, burning pain of this disorder, but theories include compression of the nerve root due to injury, biochemical changes in the nerve tissue or abnormalities in the blood vessels surrounding the nerve. In all cases, however, whatever the cause, the result is an excessive burst of nerve activity from some sort of damage to the nerve. The pain can be brought on by a light touch or vibration. Something as common as washing the face, shaving or brushing teeth may bring it on. Eating and chewing are also common triggers. There are several categories of trigeminal neuralgia based on the longevity as well as intensity of the pain, but all result in similar symptoms.
Cluster Headaches – Cluster headache pain is also considered to be one of the most painful types of all facial type pain. The pain comes on quickly, usually in 5-10 minutes, and lasts a half hour or more. It is a severe burning, stabbing or piercing type of pain occurring on one side of the face spreading out from the temple and eye. In some cases the eye may droop and the sufferer may have a stuffy or runny nose. Depending on the exact symptoms it can be confused with trigeminal neuralgia or even Bell’s Palsy. These headaches come in cycles – or clusters. A person can have several episodes in a day. There is no known cause of cluster headaches; neither is there a definitive cure. It is thought that certain triggers may be responsible for the onset of pain including drinking alcohol, sleep problems and allergies. While most who get them will experience one or two per year, others will have it once and never again.
Many individuals suffering from chronic face pain risk other problems as well, such as sleep deprivation, dehydration, malnutrition, irritability, anxiety and depression.
Symptoms often overlap with various facial pain pathologies and one can easily be mistaken for another. A primary care physician or perhaps a neurologist will ask questions or have the individual fill out a questionnaire regarding the pain. It is important to inform the primary care practitioner of all symptoms and answer any questions he or she may have fully. Typical information needed is the location and severity of pain, the type of pain (is it burning, achy, throbbing, stabbing, etc.), when the pain occurs (upon waking, in the evening, after eating, etc.).
Homecare for Face Pain
If the pain is mild to moderate, most physicians will advise their patients to try over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibroprofen or narproxin. Tyleonol is another choice for pain relief.
Applying alternating warm and cold packs (about ten minutes each, off and on for up to an hour) can help, both by relaxing tense muscles and numbing the pain.
Aromatherapy, whether used as an inhalant or applied topically (always dilute essential oils with a carrier oil) can be helpful in some cases. If the cause of the pain is thought to be congestion, essential oils such as eucalyptus, peppermint and ginger can be used. For more generalized pain, lavender has been shown to be helpful.
Massage for Face Pain
Any massage therapy is generally contraindicated while the condition in an acute stage, but let the client be your guide when working on someone presenting with chronic facial pain. Light touch may be painful, whereas a firm touch may ease the pain. Any massage on the face might cause more pain, but massage elsewhere on the body, such as neck and shoulders may help. Check in frequently with the client to achieve the best result.
Some massage modalities that have proven to be helpful in cases of facial pain, include:
- Cranial-Sacral Massage – Cranial sacral massage is used to restore the natural position of bones. The use of this technique can help decrease stress in the head and neck area. It can also help to reduce the feelings of pressure, which can cause facial pain.
- Acupressure/Shiatsu – Acupressure techniques, such as Shiatsu can be used once the acute phase of pain has passed. It is helpful in reducing future episodes of pain. All the elements in Traditional Chinese 5-element methods have correspondences in facial sense organs. Therefore it is important to do a thorough intake to determine the client’s history and possible origin of pain. Especially helpful are ST-3, HT-3 and TH-23 as well as points along the Bladder meridian (caution: client may find supine position uncomfortable if facial pain is still present).
- Lymphatic Drainage – Lymphatic drainage is most helpful in reducing fluid congestion that may be contributing to pain caused by pressure to nerves and muscles. It also helps to enhance the removal of toxins in the area and facilitate a return to homeostasis.
More Serious Measures
If home remedies don’t work and pain persists, a visit to the doctor may be necessary. The common recommendations range from enhanced pain medication – such as Tylenol with codeine, anticonvulsants or shots which block nerve transmission. In extreme non-responsive situations surgery may be recommended, though this is rare.
With any pain in and around the head, caution and care must be taken. Persistent facial and head pain can be indicative of something serious as can sudden onset pain and they must be ruled out. If the pain is accompanied by muscle weakness, slurring of words, dizziness, blurry vision or confusion – call 911, as these are signs of a stroke.
If your client has a history of headaches or facial pain, encourage him or her to keep a headache diary. This can be very helpful in determining the source of the pain and thus also helpful in finding relief.
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