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Triggers and therapy for painful cheeks
Cheek pain can have a variety of causes. They are often due to irritation or inflammation of the facial nerves (neuralgia). The trigeminal neuralgia, in which the pain originates from the fifth cranial nerve, the trigeminal nerve, occurs most frequently in the area of the face. It runs in three main branches on the face and can cause very severe pain.
Often, however, the chewing muscles, the temporomandibular joint, or inflammation in the teeth also trigger pain on the cheek. There are also fractures and bruises that can be attributed to accidents. In order to be able to start targeted therapy, it is first necessary to find the exact cause of the symptoms.
Definition
Pain in the face below the eye socket, between the cheekbone and lower jaw is called cheek pain. The complaints can occur selectively or over a large area, acute or chronic. Facial pain in the cheek area, which can be attributed to trigeminal neuralgia, is one of the most severe pain experiences.
Cheek pain in neuralgia
Cheek pain can occur at certain points regardless of movement and position, but also in small areas depending on movements of the temporomandibular joint, so that the discomfort when opening or closing the mouth can be felt. They can also make themselves felt in front of the temporomandibular joint or along the zygomatic bone.
Some nerves and muscles run in the area of the cheeks, which can cause severe pain due to irritation and inflammation. The medical term for nerve pain is neuralgia. This includes pain that is felt in the supply area of one or more nerves and is caused by damage to these peripheral nerves.
Trigeminal neuralgia is one of the most common neuralgias. The facial nerve, the trigeminal nerve, which runs in three main branches on the face, triggers the pain. One of these nerve branches (maxillary nerve) runs into the cheek area. Even more precisely, the pain trigger is the infraorbital nerve. It supplies the teeth of the upper jaw and the skin of the front and upper face and emerges through a hole in the upper jaw (foramen infraorbitale) about three millimeters below the eye.
The trigeminal nerve provides the individual facial areas with sensitivity, but is also responsible for the activity of the chewing and temple muscles. Irritation of this nerve can occur, for example, if an adjacent blood vessel in the lower brain section changes or other sections of the trigeminal nerve are disconnected. Sometimes the cause cannot be fully clarified. In other cases, another underlying disease can trigger the pain, such as multiple sclerosis or a tumor. Head injuries from accidents can also lead to nerve pain.
Symptoms of trigeminal neuralgia include sudden, stabbing pain, especially on the surface of the cheek and chin, which can also trigger toothache. The pain attacks often only last for a few seconds and are repeated at short intervals. Usually there is a phase without seizures until the pain starts again.
Another cause of cheek discomfort can be a herpes zoster. A weakened immune system in older people, for example, is often the reason that the chickenpox virus breaks out again and causes acute and chronic symptoms. The extremely uncomfortable neuralgia is called postherpetic zoster neuralgia.
Cheek pain in craniomandibular dysfunction
Craniomandibular dysfunction is a disorder of the muscles of the jaw and the temporomandibular joint. The pain that occurs is often localized in the cheek area or radiates there. Most of the time, the muscles that close the mouth are tight and can cause pain.
According to recent studies, these muscles have a changed pH value and increased values for pain substances, which could be partly responsible for the development of pain. In addition, clenching or grinding your teeth during the day or grinding your teeth at night could contribute to muscle hardening. Asymmetry of the temporomandibular joint, which is caused, for example, by misaligned teeth or tooth growth, leads to an uneven strain on the muscles and could cause one-sided complaints. In addition, the teeth themselves can cause discomfort, as with inflammation centers.
Pain on the cheek with underlying diseases
Pain in the cheek sometimes occurs as a result of other illnesses. For example, a sinus infection, tooth and jaw complaints, problems with the cervical spine and muscle tension in the shoulder and neck area come into question. In most cases, other specific symptoms appear superficially. Then cheek pain is only a side effect.
In addition, there are numerous diseases that affect the head or the inside of the skull. Strokes and brain tumors are among them. Even with migraines, the pain radiates partly to the cheeks. In diseases that affect the central nervous system, such as multiple sclerosis, cheek symptoms can also appear along with other symptoms.
The causes mentioned here are only a selection and are not suitable for self-diagnosis. For cheek pain that appears suddenly and violently, continuously or recurrently or after accidents, a doctor should be consulted.
Diagnosis
In order to track down the cause of the symptoms, the doctor will first clarify when and where exactly they occur. Other symptoms can also indicate an underlying illness. If the pain in the cheek in flare-ups occurs suddenly or as a result of a certain stimulus such as brushing your teeth or stressful situations, this can indicate trigeminal neuralgia. If the affected person feels the discomfort especially when chewing, it is suspected that it is a problem of the teeth or the temporomandibular joint.
In addition to scanning the cheek area, further examinations such as X-rays and MRI may be necessary. Depending on the cause, doctors from various specialties such as dentists, orthodontists, ear, nose and throat doctors, orthopedists, neurologists and internists are consulted.
Treatment options for cheek pain
Therapy for cheek pain depends on its cause. In the case of a malfunction in the temporomandibular joint (CMD), a special bite splint or small corrections of the bite position in connection with a corresponding connection with appropriate exercises are often sufficient to alleviate the symptoms. More complex interventions are usually only carried out if all other measures have been exhausted or only such an intervention can remedy the dysfunction.
When muscle tension triggers, physiotherapy, manual therapy, and muscle relaxation procedures can provide relief. There is also the possibility of electrical nerve stimulation through the skin to relax the muscles.
For nerve pain such as trigeminal neuralgia, medication is usually used if there is no underlying disease. Since pain relievers are not effective in relapsing pain attacks, those affected often receive so-called anti-epileptics, which are used primarily in the treatment of epilepsy and prevent attacks of pain by influencing the excitability and conductivity of the nerve pathways. In severe cases, an operation can be useful in which the focus is on relieving the irritated or pressurized nerve or interrupting the pain pathway.
Surgery may also be necessary for tumors, fractures, or sometimes multiple sclerosis.
Naturopathic treatment for cheek pain
The treatment concept of osteopathy, which was founded by the American doctor Arthur Taylor Still, includes other factors and relationships in the diagnosis that can have an impact on the cheek area, but are often ignored in conventional medicine. As part of the initial examination, complaints such as neck tension, temple pain, forehead pain or hip pain are included and treated if necessary. This makes sense because they affect the overall statics of the body.
Depending on the cause, natural remedies can also be used, which are either used as a supplement or as an alternative to conventional medicine. For example, cloves have been used as a proven home remedy for toothache for centuries, as their ingredients have an analgesic effect. In addition, they are said to have an antiviral effect and in particular to combat herpes viruses.
If the cheek pain is due to an inflammation in the mouth, you can gargle with chamomile or sage, since both are said to have anti-inflammatory effects. (no, last updated on March 7th, 2018)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese
Swell:
- Daniel R. Reissmann: Therapy of craniomandibular dysfunctions, dentistry up2date 2017; 11 (02): 179-202, DOI: 10.1055 / s-0042-116618, Georg Thieme Verlag, (accessed 28.08.2019), thieme
- Kenneth M. Kaye: Herpes Zoster (shingles; acute posterior ganglionitis), MSD Manual, (accessed August 28, 2019), MSD
- Thomas Lenarz, Hans-Georg Boenninghaus: ENT, Springer-Verlag, 14th edition 2012
