Atypical facial pain is a general diagnosis that is given to patients who exhibit symptoms of a chronic pain disorder that medical experts simply don’t know enough about. It can feel like a relief and a burden to receive a diagnosis like this. This brings up the question: is this diagnosis actually helpful?
Below, we talk about what atypical facial pain actually is and what you can do with the diagnosis. This means examining treatment and other types of support that are essential to coping with this frustrating and painful condition.
What Is Atypical Facial Pain?
Atypical facial pain (AFP) is a term that is used to describe very specific, usually excruciating pain that does not have a definite known cause or cure. This is also known as persistent idiopathic facial pain (PIFP). AFP/PIFP is part of a generic label to describe the pain that doesn’t fit the criteria of other facial pain syndromes.
The most commonly affected areas for people with AFP are the upper neck, jaw, ears, cheeks, teeth, and side of the face. People who have AFP describe the pain as:
- Pins and needles
- Hot or burning
- Sharp
- Stabbing
- Achy
- Throbbing
Certain factors can make this pain worse as well. Having one’s face exposed to extreme weather, for example; can greatly exacerbate the symptoms. Plus, the pain might be so bad that people avoid touching the impacted areas.
It can be challenging to get a diagnosis of AFP because there isn’t a test that would indicate if you have the condition. Rather, specialists often end up ruling out other diagnoses in order to get to this one. Tests such as MRIs, and CT scans can check for abnormalities with the nerves, blood vessels, and muscles to make sure that there isn’t another condition that could be causing the facial pain.
Oftentimes, this condition is misdiagnosed as trigeminal neuralgia: a condition that affects the trigeminal nerve and causes severe sensitivity, pain, and other symptoms to the face. However, one of the main differences between AFP and trigeminal neuralgia is that with atypical facial pain, the pain is chronic and continuous. With trigeminal neuralgia, the pain often comes and goes in periods.
The sensations of pain can vary, as shown above, but one of the criteria to be diagnosed with AFP is that patients must experience at least one of these types of pain in their face constantly for three months or more. This can make one’s day-to-day life quite challenging. What’s more frustrating is that, without knowing a definite cause for the pain, there’s really no way to know how to most effectively treat it.
What Are the Treatment Options for AFP?
Medical experts know that more information is needed on this condition to properly address it. But with the information that we do currently have, here are some treatment options for AFP:
Mental health help
People with AFP tend to notice that their condition worsens during times of stress. This could be a result of a couple of different things. To start, researchers predict that AFP could be related to the way that people’s neurotransmitters respond to specific types of pain. Studies show that AFP frequently develops in people who have mental health disorders like anxiety or depression.
It’s not known for sure, but one theory is that these conditions can trigger atypical face pain—or at the very least, make it more severe. Another theory is that the physiological response to stress (hyperawareness, tightening of facial muscles, lack of sleep, etc.) can contribute to someone experiencing more pain.
This is why one of the main treatment options for this condition is to receive mental health help. By working with a mental health professional, you can learn how to reprocess pain signals. Approaches such as cognitive behavioral therapy can help you to connect the mind and the body. This doesn’t change the fact that you are experiencing pain, but it can help you cope with it during the most challenging of times.
Certain techniques used in CBT are also effective in helping with AFP. Progressive muscle relaxation, for example, can help to ease the body of tenseness. In turn, one might be able to alleviate some of their head and neck pain from AFP or other reasons.
Medication
Currently, there is not a specific type of medication that is produced for atypical facial pain. There is no exact treatment, including medication, that can cure the root cause of AFP (since this is unknown). That said, doctors have found that certain antidepressants can be helpful in reducing the pain that patients with AFP feel. While it doesn’t fix the pain in the long-term, these medications can sometimes offer short-term relief.
However, experts recommend that people who take antidepressants for pain management also work with a mental health professional. Taking medication for any chronic pain condition comes with its own risks and rewards that must be carefully monitored. It’s important first and foremost to work with your doctor to see if medication to alleviate your facial pain would be beneficial. Factors to consider before trying new medication include:
- Your medical history
- Risk of addiction
- Conflicting treatments for co-occurring disorders
If antidepressants are a good treatment option for you, working with a mental health professional on top of taking these will not only help you to cope with the frustrations of atypical facial pain, but this combination of treatments will also ensure that you do not have any dangerous side effects from the antidepressants. These side effects often include worsening depression, anxiety, and suicidal thoughts or actions.
Nerve block
A nerve block is a procedure in which a local anesthetic is injected into specific nerves to either shut them off or dull their sensitivity to pain. For AFP, the trigeminal nerve is targeted by the injected medication. Though more research is needed on the full effectiveness of a nerve block for atypical facial pain, studies show that some patients have had tremendous relief with this procedure. Again, it’s always important to talk with your doctor before any procedure to make sure that this is the best option for you.
Coping with Atypical Facial Pain
A diagnosis of atypical facial pain can come with a lot of conflicting feelings because while it might shine light on some of the pain you are experiencing, it often leaves you with more questions than answers. In some ways, this diagnosis can serve as a guide on the next steps to take, including possible treatment options. Ultimately, more research is needed on this condition to truly understand its impact as well as what can be done about the pain that people with AFP feel.
Until then, find comfort in the fact that you are not alone with your pain. Even though atypical facial pain is rare, there are many other people just like you who are looking for answers on their chronic conditions. Make connections and raise awareness by joining the Pain Resource Community. Within this group, your voice is always heard.
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