Chronic facial pain can be very confusing both to the patient and healthcare provider. This can be direct pain - involving nerves that supply the face or indirect (referred) pain from other structures in the head such as blood vessels. The pain may be related to migraine, muscular syndromes such as TMJ, herpetic or rheumatic disease or injury. Many sufferers have had sinus and dental surgeries in the past.
Trigeminal neuralgia is a common cause of facial pain characterized by shooting pains in the face, often triggered by touching affected areas.
Facial pain may be difficult to treat and usually requires trial and error with various medications. Perseverance by both the healthcare provider and the patient is necessary. The antidepressants and/or the anticonvulsants can be helpful in some cases.