Feature Article

Facial pain: a biopsychosocial problem

E Russell Vickers, Michael J Cousins, Michael K Nicholas



Facial pain can be difficult to diagnose as patients often have a long history of pain, complex symptoms and few clinical signs. Psychological factors can magnify the reported intensity of pain and complicate the taking of a detailed and relevant history. A multidisciplinary approach is needed to diagnose and treat patients with chronic facial pain.

Key Points

  • Facial pain should be diagnosed carefully; consider undetected pathology such as neuropathic pain and obtain psychological (and possibly psychiatric) assessment.
  • Patients with facial pain report pain that is usually constant and severe, and their expectations of pain relief may be unrealistic.
  • Co-existing pain states may be present in the facial region increasing the complexity of diagnosis and treatment.
  • Diagnosis and treatment of chronic facial pain requires a multidisciplinary approach, with long term management co-ordinated by the patient’s GP.