Understanding Nerve Pain: What You Need to Know

Nerve pain, also known as neuropathic pain, is a type of discomfort that arises when nerves are damaged or irritated. Unlike the dull ache of a sore muscle or the throb of a dental cavity, nerve pain can feel sharp, burning, electric, or even like a stabbing sensation. It can be confusing and frustrating—especially when it occurs in the face, mouth, or jaw.

What Causes Nerve Pain?

Nerve pain can be triggered by many different factors, including:

• Injury or trauma: Surgery, dental procedures, or accidents can sometimes injure nerves.
• Infections: Certain viral infections, like shingles or herpes simplex, can affect nerves in the face.
• Nerve compression: Pressure on a nerve from a blood vessel, tumor, or bone structure can lead to ongoing pain.
• Chronic conditions: Conditions like diabetes or multiple sclerosis can damage nerves over time.
• Unknown causes: In some cases, we may not find a clear reason—this is called idiopathic neuropathic pain.

How Does It Feel?

Patients describe nerve pain in different ways, such as:

• A sudden electric shock or jolt
• Tingling or “pins and needles”
• A constant burning or searing feeling
• Pain triggered by light touch, brushing teeth, or even a breeze

It may be constant or come and go in bursts. In the orofacial region, it can affect areas like the lips, cheeks, tongue, jaw, or even around the eyes.

Common Types of Nerve Pain in the Face

Here are a few examples:

• Trigeminal Neuralgia: A sharp, shooting pain affecting the trigeminal nerve, often on one side of the face.
• Postherpetic Neuralgia: Persistent pain after a shingles outbreak, often involving the eye or forehead.
• Painful Post-Traumatic Trigeminal Neuropathy: Nerve pain after an injury or dental work that affects trigeminal nerve branches.
• Burning Mouth Syndrome: A chronic burning sensation in the tongue, lips, or palate without an obvious cause.

Diagnosis and Evaluation

Diagnosing nerve pain begins with a detailed history and examination. We ask about the nature of the pain, what triggers it, and how long it lasts. Imaging studies (like MRI or CT scans) and diagnostic nerve blocks may be used to help pinpoint the cause.

Sometimes, blood tests are also done to check for underlying conditions such as diabetes, vitamin deficiencies, or autoimmune diseases.

Treatment Options

Managing nerve pain can be challenging, but many options are available:

• Medications:
  • Anticonvulsants (e.g., gabapentin, carbamazepine)
  • Antidepressants (e.g., amitriptyline, nortriptyline)
  • Topical agents (e.g., lidocaine patches, capsaicin cream)
• Procedures:
  • Nerve blocks or injections
  • Radiofrequency ablation
  • Surgical decompression (for cases like trigeminal neuralgia)
• Lifestyle and supportive care:
  • Stress management
  • Physical therapy or acupuncture
  • Cognitive behavioral therapy for coping strategies

Why It’s Important to Seek Help

Nerve pain often doesn’t go away on its own, and it can significantly impact your quality of life. Difficulty eating, talking, or even smiling can take a toll on your emotional well-being. Early diagnosis and treatment offer the best chance for relief.

As an orofacial pain consultant , my role is to work with you to understand your symptoms, identify the cause, and create a treatment plan tailored to your needs. Living with nerve pain can be difficult — but you don’t have to face it alone.