Facial Pain versus Sinusitis

Dr. Amin Javer, MD, FRCSC, FARS, Otolaryngologist Facial Pain versus Sinusitis

Duration: 2 minutes and 31 seconds

In the case of differentiating facial pain versus sinusitis, there are several factors one can consider. Sinus pain is a fairly common symptom that patients experience and many patients feel like it's caused due to sinusitis, which is inflammation of the sinus cavities. In many cases the pain is actually due to the nerves that are running through the sinus cavities. These same patients may also experience congestion and discharge, however, a recent study showed that very often, when taking a CT scan people coming in with acute facial pain with the feeling that they're getting an acute sinus infection, that these patients have completely normal CT scans despite having all of these symptoms.

The cause of this is from the nerves being very irritated and there's an imbalance. Also, the endpoints of these nerves are on sinus mucosa, so when they're irritated the sinus mucosa gets irritated as well, which consequently results in the congestion and discharge symptoms. It can therefore mimic the symptoms of an acute sinus issue.

When you're trying to manage the patients with facial pain, the number one thing to do is to focus on education to help patients understand that what they may be experiencing is not an acute sinus infection and they don't need to be on antibiotics. They do however, potentially need to see someone who specializes in nerve pain like a neurologist or a pain specialist.

A neurologist or even a pain specialist may target the pain in multiple different ways. Sometimes they use an oral medication that targets the nerves, and sometimes with an injection into the muscles. For example, myofascial pain that's irritating the nerves may benefit from injecting steroids into the muscles from your neck and into your into your head in order to relax the muscles that may be causing the irritation to the nerve.

The neurologists or pain specialists may deem that the pain is trigged from a migraine history or any other any other kind of headache disorder. They may target the treatment with the right drugs based on this diagnosis.

If you experience facial pain that you feel may be related to nerve pain, please don’t hesitate to reach out to your local healthcare provider or ENT specialist for further assessment.

Presenter: Dr. Amin Javer, Otolaryngologist, Vancouver, BC

Local Practitioners: Otolaryngologist