Pain in cheekbone under eye: Causes, Diagnosis, Treatment & More

17.08.202310.06.2023 by alexxlab

Causes, Diagnosis, Treatment & More

Face Pain: Causes, Diagnosis, Treatment & More

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Medically reviewed by J. Keith Fisher, MD — By April Kahn — Updated on August 6, 2019

Overview

Facial pain is pain felt in any part of the face, including the mouth and eyes. Although it’s normally due to an injury or a headache, facial pain may also be the result of a serious medical condition.

Most causes of facial pain are harmless. However, if you have facial pain that seems to come without any known cause, call your doctor for an evaluation.

Facial pain can be due to anything from an infection to nerve damage in the face. Common causes of facial pain include:

an oral infection
an ulcer, or open sore
an abscess, such as a collection of pus under the surface tissue in the mouth
a skin abscess, which is a collection of pus under the skin
a headache
a facial injury
a toothache

More serious causes of facial pain include:

herpes zoster, or shingles
a migraine
sinusitis (sinus infection)
a nerve disorder
herpes simplex virus 1 (HSV-1), which causes cold sores

People often describe facial pain as cramp-like, stabbing, or achy. Pain from other areas in the body, such as the ears or head, may radiate or spread to your face.

The exact type of pain you feel will depend on the cause. A dull, throbbing pain on one side of your face or around your mouth is generally due to problems within the mouth, such as a toothache, cavity, or abscess. If you experience this type of pain, contact your dentist.

The pain associated with sinusitis feels like pressure or an aching pain across the front of the cheekbones and underneath the eyes. Abscesses and ulcers will often throb at the site of the sore. Headaches and injuries can feel like a stabbing sensation or can throb and ache.

Because there are many causes of facial pain, talk to your doctor if you experience pain that’s unexplainable or unbearable.

If you experience facial pain that appears suddenly and radiates from the chest or the left arm, call 911 or your local emergency services immediately. This may be the sign of an impending heart attack.

Facial pain usually isn’t a medical emergency, and you can often receive treatment at a regularly scheduled doctor’s appointment.

When visiting your doctor, make sure that you tell them:

what part of your face is hurting
how often you feel pain
exactly where the pain is coming from
what kind of pain you feel
how long the pain lasts
what relieves the pain
any other symptoms experienced

Your doctor may order an imaging test, such as an X-ray or MRI scan to make a diagnosis. These imaging tests are useful in diagnosing problems within the bones, muscles, and tissue. Your doctor can also use an X-ray to check the sinuses.

Your doctor may take a blood sample to test for certain infections. This is a procedure with minimal pain that involves drawing blood from your arm.

If your symptoms reveal a possible eye condition or if your doctor is concerned you may be having heart problems, they’ll order additional tests.

If an eye condition is the cause of your facial pain, your doctor will refer you to an eye doctor who’ll give you a tonometry examination.

For this exam, your doctor will apply a numbing drop to each eye. Then, they’ll place a small strip of paper containing an orange dye against your eyeball. Your eye doctor will use a slit lamp that illuminates your eye to check your cornea and other parts of your eye for damage.

This test is effective in diagnosing ulcers and glaucoma.

An electrocardiogram (ECG) may be necessary to see if your heart is causing the issues.

For this test, small, painless electrode monitors are placed on your chest, arms, and legs. These monitors are connected to an ECG machine, which takes a reading of your heart’s electrical activity.

This test is helpful in diagnosing a heart attack or abnormal heart rhythms.

Facial pain generally goes away once you receive a diagnosis and begin a treatment plan. Your doctor will determine treatment options for your facial pain based on the cause.

Pain caused by an infection such as sinusitis generally clears up after using antibiotics or allowing the infection to heal on its own.

Facial pain caused by a viral infection such as shingles may be associated with a rash. In some cases, the pain goes away without treatment within a few days to a few weeks. In other cases, nerve pain may persist for multiple months.

Prescription antiviral medications like acyclovir (Zovirax) and valacyclovir (Valtrex) may shorten the duration of the rash, but your doctor may use other medications to address any persistent nerve pain specifically.

If the facial pain is due to an oral condition, your dentist can treat it by prescribing antibiotics, pulling your tooth, or performing a root canal.

Over-the-counter (OTC) pain medication can treat facial pain caused by cluster headaches or migraine.

However, sometimes facial pain caused by headaches doesn’t respond to OTC medications. Your doctor may prescribe a stronger medication for pain relief if this is the case.

Last medically reviewed on August 5, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Shingles (herpes zoster) (2019).
cdc.gov/shingles/about/index.html
Sinus infection (Sinusitis). (2017).
cdc.gov/antibiotic-use/community/for-patients/common-illnesses/sinus-infection.html
Zakrzewska JM. (2013). Differential diagnosis of facial pain and guidelines for management. DOI:
10.1093/bja/aet125

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Medically reviewed by J. Keith Fisher, MD — By April Kahn — Updated on August 6, 2019

9 Causes of Pain in Your Cheekbones and Teeth

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Medically reviewed by Christine Frank, DDS — By Valencia Higuera on August 20, 2021

Pain in your cheekbones and teeth can range from a dull ache to throbbing pain. Pain can be acute and resolve on its own, or gradually worsen over time.

Determining the exact cause of cheekbone pain or pain in your teeth can be challenging. Here are a few common causes as well as recommended remedies for pain relief.

A sinus infection, also called sinusitis, is inflammation or swelling in your sinus tissue. This is the air-filled cavity located near your nose.

You have four paranasal sinuses, with the largest of your sinuses (the maxillary sinus) located in your jaw near your cheekbones.

Inflamed sinus tissue causes different symptoms like:

runny nose
headache
nasal congestion
facial pain in your cheeks

Pain and discomfort can also spread to your teeth.

Bacteria in your mouth due to improper dental hygiene can cause a tooth abscess. This is an infection that affects teeth, gums, and bones, but can spread to your cheekbones and surrounding tissue if left untreated.

An abscess also increases the risk of osteomyelitis. This is an infection that spreads to your bone, such as your jawbone. Symptoms of this infection include:

severe jaw pain or facial pain
fever
chills
sweating
fatigue

Your temporomandibular joint connects your jawbone to your skull. It acts as a hinge, allowing your jaw to move in different directions.

Sometimes, this joint can become displaced, injured, or damaged by arthritis. This causes pain when swallowing, chewing, or talking as well as a cracking or popping sound when moving the jaw.

A nerve disorder like trigeminal neuralgia can also trigger cheekbone pain and pain in your teeth.

The trigeminal nerve provides feeling to your face. Pressure on this nerve can cause pain in your jaw, teeth, or cheeks.

The exact cause of the compression isn’t understood, but certain actions might trigger this disorder:

chewing
vibration
brushing your teeth
talking
head movements

A common cause of a toothache is tooth decay or a cavity. This is when holes develop in the hard surface of a tooth. A toothache can be a dull ache or sharp pain. You might also have:

swelling
fever
headache

Other dental problems can cause a toothache, too, such as:

cracked tooth
broken filling
eruption of new teeth (wisdom teeth)

Keep in mind that it’s not uncommon to have cheekbone pain and pain in your teeth after a dental procedure. This includes pain after:

tooth extraction
a root canal
dental filling

Cheek and teeth soreness is normal. But call a dentist if swelling or pain continues or worsens after 3 days.

Teeth grinding (bruxism) is another cause of cheekbone and teeth pain.

Teeth grinding often happens during sleep, so you might be unaware of this problem. But prolonged grinding can cause:

headaches
facial pain
earaches
disrupted sleep
broken teeth
pain in the temporomandibular joint

Periodontal disease, or gum disease, destroys the soft tissue in your mouth as well as your bones that support your teeth. This condition is often due to improper dental hygiene.

If left untreated, a severe infection can cause tooth loss. The infection can also spread to other parts of your body and is thought to increase your risk of conditions like heart disease. Research is still ongoing regarding the link between gum disease and heart disease, so the exact link is still unclear.

Coronary artery disease is often associated with chest pain, shortness of breath, and lightheadedness. But it can also manifest as facial pain and discomfort in the jaw, cheek, and neck.

Risk factors for coronary artery disease include:

having overweight
lack of physical activity
improper nutrition
smoking

Complications of coronary artery disease can include:

abnormal heart rhythm
angina
heart attack
sudden death

Depending on the underlying cause of cheekbone and teeth pain, the following home remedies might help relieve discomfort:

Take an over-the-counter medication to relieve sinus pressure and congestion.
Avoid hot or cold foods and drinks to reduce sensitivity in your teeth.
Apply a cold compress to your cheekbones to ease inflammation and swelling.
Eat soft foods or liquids, such as soup or cooked vegetables.
Avoid certain jaw movementsuntil pain stops, such as chewing gum or wide yawning.
Practice stress-relieving techniques to relax your jaw muscles and relieve symptoms of TMJ and teeth grinding.
Use a mouthguardat night to stop grinding your teeth.

Call a doctor if you have severe cheekbone pain or pain in your teeth. Worsening pain could indicate conditions that need to be treated as soon as possible to prevent further complications, such as:

dental cavities
periodontal disease
nerve damage
infection

If left untreated, an infection can advance and enter your bloodstream. Symptoms of infection include:

sharp pain
swelling
redness
fever
chills
nausea
discharge from your mouth

Call a doctor if you have facial pain after a trauma, such as falling or getting hit in your face.

Seek emergency treatment if you have symptoms of coronary artery disease, including:

chest pain
weakness
discomfort in your arms
shortness of breath

Your doctor can complete testing to diagnose or rule out heart conditions.

If you have a sinus infection or a tooth infection, you will likely need antibiotics to treat the infection.

A doctor or dentist might also recommend a dental procedure depending on the underlying cause of pain in your teeth. This can include:

removal of your wisdom teeth or a damaged tooth
dental filling
root canal or other procedure to repair a badly damaged tooth

A severe dental infection might require surgery to remove damaged gum tissue and bone.

Coronary artery disease may require medications, changes to your diet or exercise, or surgeries to help improve your heart function by reducing plaque buildup in your arteries.

Pain in your cheekbones and teeth isn’t always serious, and pain might improve on its own with self-care.

But some causes of pain require medical attention. Call a doctor or dentist if you have severe discomfort, worsening of symptoms, or symptoms of an infection.

Last medically reviewed on August 20, 2021

How we reviewed this article:

Fukuda K. (2016). Diagnosis and treatment of abnormal dental pain.
ncbi.nlm.nih.gov/pmc/articles/PMC5564113/
Heart disease. (2021).
cdc.gov/heartdisease/index.htm
Renton T. (2011). Dental (odontogenic) pain.
journals.sagepub.com/doi/10.1177/204946371100500102
Teeth grinding. (2020).
nhs.uk/conditions/teeth-grinding/
TMJ (temporomandibular joint & muscle disorders). (2018).
nidcr.nih.gov/health-info/tmj/more-info
Trigeminal neuralgia. (2019).
nhs.uk/conditions/trigeminal-neuralgia/treatment/
Zakrzewska JM. (2013). Differential diagnosis of facial pain and guidelines for management.
bjanaesthesia.org/article/S0007-0912(17)32972-0/fulltext

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Aug 20, 2021

Written By

Valencia Higuera

Edited By

Tim Jewell

Medically Reviewed By

Christine Frank, DDS

Copy Edited By

Sofia Santamarina

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Medically reviewed by Christine Frank, DDS — By Valencia Higuera on August 20, 2021

Pain in the face: causes, diagnosis, treatment

Home » Symptoms of diseases

There can be many causes of facial pain. The main ones are diseases of the teeth, paranasal sinuses (often the maxillary), diseases of the eyes, oropharynx, pain in the region of the root of the tongue, diseases of the temporomandibular joint, trigeminal neuralgia, sympathy in the pathology of the facial nerve.

Basic information

In 90% of cases facial pain is caused by dental diseases (2. Gerschman J. A., Reade P. C. Orofacial pain. Aust. Fam. Physician, 1984, 13:14-24), most often with caries and periodontitis.

Trigeminal neuralgia is a rare disease. Its prevalence is 90,014 – 155 cases per 1 million population. The average age of onset is 50 years. More often, trigeminal neuralgia is caused.
Neuralgia (sympathalgia) of the facial nerve (manifested after neuritis of the facial nerve)
Glossopharyngeal neuralgia
Neuralgia of the superior laryngeal nerve
Neuralgia of the hypoglossal nerve
Postherpetic neuralgia
Painful muscular-fascial dysfunction
Facial psychalgias
It is necessary to distinguish between the causes of facial pain and pain in the ear. These pains are similar.
Sinusitis is usually observed after infectious diseases of the upper respiratory tract.
Swimming and diving increase the risk of sinusitis.
In all cases of sinusitis exclude diseases of the teeth
Often pain in the face is caused by pathology of the temporomandibular joint of the just joint (arthritis or arthrosis. The nature of the damage to this joint can be determined by asking the patient and taking an anamnesis. Physical examination will help establish the diagnosis.

Additional list of possible causes of facial pain

Dental disease
Diseases of the cervical spine
Diseases of the teeth
Eye diseases
Herpes zoster (viral pathology)
Diseases of the nasopharynx (including neoplasms)
Diseases of the oropharynx
Ulcers (aphthous stomatitis, infectious diseases, injuries)
Neoplasms of the oral cavity and bones of the skull
Gingivitis and stomatitis
Tonsillitis
Lichen planus erosive
Diseases of the paranasal sinuses
Diseases of the parotid gland
Mumps
Expansion of the parotid duct
Malignant neoplasms
Arthrosis (arthritis) of the temporomandibular joint of the just joint
Psychogenic pain
Facial migraine
Glossopharyngeal neuralgia
Horton’s headache
Trigeminal neuralgia, etc.

To establish a diagnosis, a patient with facial pain must be interviewed by a doctor and examined. A neurological examination is required to clarify the nature, cause and level of facial pain. Clarification of the diagnosis is carried out using MRI of the head and brain. Of great importance is the assessment of the state of the vessels of the neck and head. In some cases, it makes sense to conduct an x-ray of the neck and joints of the head if a pathology of the spine is suspected. The diagnosis of facial pain is complex and requires differential diagnosis.

Patients often ask the question: Can facial pain (prosopalgia) be due to a disc herniation? The answer is unequivocal – it can’t.

Treatment of pain in the face

( See more here)

An effective treatment can only be with a correct diagnosis. Diagnosis and treatment of facial pain is carried out at the Center “Meddiagnostics”.

Cheek pain – causes, diagnosis and treatment

Cheek pain is observed in traumatic injuries, osteomyelitis, neuralgia, bruxism, myofascial syndrome, dental and otolaryngological diseases, some types of headache and facial pain. It can be dull, sharp, short-term, long-lasting, aching, bursting, twitching, shooting. Often occurs due to irradiation, combined with pain in neighboring anatomical structures. The cause of the symptom is established according to the survey, dental and otolaryngological examination, additional studies. Therapeutic measures include pain relief, etiopathogenetic therapy, surgical interventions.

Why my cheekbone hurts

Traumatic injuries

The most common injury to the cheekbone area is a bruise. Occurs in fights, less often – when falling or hitting a hard surface (for example, a door jamb). The pain is moderate and subsides quickly. Local edema and hyperemia are observed, abrasions are possible. Opening the mouth is not difficult, speech is not changed. All symptoms disappear within a few days or 1-2 weeks.

When the zygomatic bone is fractured, the pain is very sharp, intense. Bruising is detected, swelling quickly spreads to the adjacent parts of the face. Pain is noted when trying to open the mouth, numbness of the cheek, wing of the nose and upper lip, sometimes diplopia. If the integrity of the maxillary sinus is violated, nosebleeds develop, subcutaneous emphysema is possible. When the fragments are displaced, a step is felt in the cheekbone area.

The zygomatic bone is involved in the formation of the wall of the orbit. If the bone wall of the orbit is damaged, along with the symptoms listed above, limitation of the mobility of the eyeball, visual impairment, subcutaneous emphysema, exophthalmos or endophthalmos are found. Orbital injuries can also be accompanied by double vision, strabismus, and in severe cases, blindness.

Osteomyelitis

Severe jerking, throbbing pain in the cheekbone may be due to post-traumatic osteomyelitis. The disease develops after an open fracture, surgery on the zygomatic bone and nearby tissues. The wound becomes edematous, its edges turn red. Suppuration, intoxication, general hyperthermia are observed. After opening the abscess, pain and inflammation subside, a fistulous tract forms in the wound area.

Neuralgias

Burning, shooting pains in the cheekbone, resembling an electrical discharge, are characteristic of lesions of the second branch of the trigeminal nerve. Pain sensations spread from the side of the face to the center, capture the upper part of the cheek, upper jaw, upper lip, nasal mucosa. Attacks of neuralgia last up to 2 minutes, are repeated many times, forcing patients to freeze in place.

In patients with ganglionitis of the pterygopalatine ganglion, intense prosopalgia in the zone of the cheekbone, eye, hard palate and base of the nose prevails, but the symptom is never clearly localized, since a large number of nerve branches causes the spread of pain to neighboring parts of the face, gums, teeth, sometimes the back of the head , neck, temple and ear. A distinctive feature of the pathology is pronounced vegetative symptoms: lacrimation, hypersalivation, hyperemia and swelling of half of the face.

Ganglionitis of the geniculate ganglion is sometimes the cause of radiating pain in the cheekbone, although pain in the ear radiating to the back of the head, face, and neck is more typical for this variant of ganglioneuritis. Pain sensations are paroxysmal in nature, in some patients they are combined with neuritis of the facial nerve.

Cheek pain

Muscle involvement

In patients with bruxism, bilateral aching pain in the cheekbones is due to overexertion of the masticatory muscles during repeated nocturnal episodes of teeth grinding. Drowsiness, headache and toothache, soreness in the jaw area are possible. Chips, cracks, hyperesthesia and pathological abrasion of teeth are often observed. With myofascial syndrome, pains increase gradually, are the result of constant muscle tension when the jaws are clenched against the background of overloads, stressful situations, and neurotic disorders.

Dental pathologies

Irradiation to the cheekbone is observed when the upper premolars and molars are affected on the corresponding side. In some cases, the pain in the cheekbone is so pronounced that it prevails over pain in the area of the teeth. A symptom can be observed after tooth extraction, with alveolitis, pulpitis, periodontitis. With deep caries, it does not spontaneously occur, it is associated with the ingress of food into the carious cavity.

Otolaryngological diseases

The maxillary sinus is located in the body of the maxillary bone. Its wall borders on the zygomatic bone, which causes pain to spread to the cheekbone when this sinus is affected. The symptom appears in the following diseases:

Acute sinusitis. There are arching pains in the projection of the sinus, cheekbones, root of the nose and forehead, aggravated by palpation. Intoxication syndrome, fever, nasal congestion are revealed.
Aerosinusitis. A similar localization of painful sensations is noted with aerosinusitis (if the maxillary sinus is affected), but hyperthermia and intoxication are added only with secondary infection.
Acute pansinusitis. A bright clinical picture is characteristic. There are chills, febrile temperature, severe intoxication. The general condition is severe. Pain from the cheeks and cheekbones extends to the eyebrows, orbits, crown and back of the head, sometimes radiates to the lower jaw, is combined with a constant diffuse headache, with a prolonged course, they are supplemented by progressive neurological disorders (insomnia, weakness, paresthesias).

In addition, acute arching pain in the cheekbone is typical of one of the orbital complications of sinusitis – orbital osteoperiostitis. The spread of the inflammatory process to the lower outer wall of the orbit causes the involvement of the zygomatic bone. Along with the symptoms of sinusitis, significant edema of the periorbital tissue, exophthalmos, displacement and limitation of eye mobility are found.

Other causes

Headaches with possible radiating to the cheekbone are observed in diseases with a completely unexplained etiology – cluster headache and paroxysmal hemicrania. Sometimes the epicenter of pain in the cheekbone with spread to other areas is noted with atypical facial pain. Pain syndrome of psychogenic origin against the background of stress or overwork is formed in emotionally unstable, suspicious people. In some cases, the symptom is found in patients with hypochondria, occurs with delusional and hallucinatory disorders.

Diagnosis

The cause of pain in the cheekbone is determined by the maxillofacial surgeon. According to the indications, the patient is referred to an otolaryngologist, neurologist, and other specialists. During the survey, the time and circumstances of the onset of the symptom, the dynamics of its development, the presence of other manifestations indicating the nature and localization of the pathological process are established. As part of a dental examination, dental diseases are excluded.

When determining the etiology of neuropathic pain, an important role is played by the study of trigger points, special tests (for example, with dicaine and adrenaline in ganglionitis of the pterygopalatine ganglion). To clarify the diagnosis, the following procedures are prescribed:

Radiography. X-ray examination of the zygomatic bone, orbit or maxillary sinus is used for trauma, osteomyelitis, sinusitis, pansinusitis. It allows you to determine the type and severity of the pathology, determine the need for additional methods or treatment tactics.
Other imaging techniques . Used at the final stage of the examination with ambiguous radiographic data. Provide detailed information about the localization, features and prevalence of the pathological focus.
Otolaryngological examination . Indicated in ENT diseases. May include anterior rhinoscopy, diagnostic puncture, and probing of the maxillary sinus.
Laboratory tests . Inflammation is characterized by leukocytosis with a shift to the left, an increase in ESR. In purulent processes, according to the results of sowing the material on nutrient media, the pathogen is determined, and antibiotic sensitivity is established.

Dental treatment

Treatment

Conservative therapy

Analgesics are used to eliminate intense pain. The list of other therapeutic measures is determined depending on the characteristics of the pathological process:

Traumatic injuries . Patients with a fresh fracture of the zygomatic bone without displacement are shown a protective regimen, sparing nutrition, physiotherapy. If there is an offset, reposition is performed, then the maintenance is carried out in the same way as in the previous case.
Osteomyelitis . The basis of treatment is antibiotic therapy, taking into account the sensitivity of the pathogen. Antibiotics are administered intramuscularly, as part of a surgical intervention – intraosseously. They or nitrofurans carry out washing of the surgical wound.
Neuralgias . Patients with lesions of the trigeminal nerve are prescribed anticonvulsants, antispasmodics, antihistamines, drugs to improve microcirculation are used as adjuvants. With ganglionitis, the nasal cavity is lubricated with dikain, sometimes ganglionic blockers are used. Along with general remedies for neuropathic pain, therapeutic blockades are effective.
Dental diseases . Taking into account the nature of the pathology, the tooth socket is washed or the tooth cavity is treated, followed by the application of anti-inflammatory and regenerating pastes. The list of general action agents includes sulfonamides and antibiotics.
Inflammation of the paranasal sinuses . Patients are recommended antibacterial, anti-inflammatory, detoxifying and antihistamines, immunocorrectors. Punctures are performed, Yamik catheter is installed.

Surgical treatment

The following surgical interventions are possible:

Traumatic injuries plastics.
Osteomyelitis : opening and draining the wound, removing mini-plates and other structures (if any).

Pain in cheekbone under eye: Causes, Diagnosis, Treatment & More

Causes, Diagnosis, Treatment & More

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9 Causes of Pain in Your Cheekbones and Teeth

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Pain in the face: causes, diagnosis, treatment

Basic information

Additional list of possible causes of facial pain

Treatment of pain in the face

Cheek pain – causes, diagnosis and treatment

Why my cheekbone hurts

Traumatic injuries

Osteomyelitis

Neuralgias

Muscle involvement

Dental pathologies

Otolaryngological diseases

Other causes

Diagnosis

Treatment

Conservative therapy

Surgical treatment

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