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Facial Pain (Myofacial Pain)

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Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES.

Also Known As:

Myofacial Pain; Face Pain; Craniofacial Pain; Neuralgic Facial Pain; Facial Pain, Neuralgic; Pain, Craniofacial; Pain, Face; Pain, Myofacial; Pain, Neuralgic Facial; Pain, Orofacial; Orofacial Pain; Pain, Facial

Networked: 759 relevant articles (74 outcomes, 109 trials/studies)

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Disease Context: Research Results

Related Diseases

1.	Pain (Aches)
2.	Trigeminal Neuralgia (Tic Douloureux)
3.	Headache (Headaches)
4.	Neoplasms (Cancer)
5.	Neuralgia (Stump Neuralgia)

Experts

1.	Tamaddonfard, Esmaeal: 8 articles (10/2015 - 02/2010)
2.	Sessle, Barry J: 7 articles (01/2015 - 01/2005)
3.	Erfanparast, Amir: 6 articles (10/2015 - 02/2010)
4.	Iwata, Koichi: 6 articles (01/2015 - 01/2009)
5.	Pollock, Bruce E: 6 articles (03/2014 - 08/2004)
6.	Yeo, Jin-Fei: 5 articles (03/2009 - 05/2002)
7.	Forssell, Heli: 5 articles (10/2007 - 11/2003)
8.	Sipilä, Kirsi: 4 articles (01/2016 - 01/2005)
9.	Gay-Escoda, Cosme: 4 articles (10/2015 - 01/2006)
10.	Shinoda, Masamichi: 4 articles (01/2015 - 05/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Facial Pain:

1.	Amitriptyline (Elavil)FDA LinkGeneric 11/01/1987 - "We conclude that amitriptyline is effective in the treatment of chronic oral-facial pain and that its efficacy is independent of its effects on depression. " 06/01/2005 - "The aim of this study was to assess the efficacy of low-dose amitriptyline in patients with atypical facial pain for one-year follow-ups. " 11/01/1987 - "The efficacy of amitriptyline was evaluated in 28 patients with chronic oral-facial pain. " 06/01/2005 - "Data obtained from this study suggested that amitriptyline may be preferred in patients with atypical facial pain for rapid, satisfying analgesic effects. " 06/01/2014 - "Patients with mid-facial pain were treated with low-dose amitriptyline for eight weeks. "
2.	Botulinum Toxins (Botulinum Toxin)IBA 06/01/2015 - "Botulinum toxin has been shown to be effective in the treatment of oro-facial pain due to muscular disorders and the same is discussed in detail in this review literature. " 08/01/2015 - "Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection." 06/01/2015 - "Botulinum toxin in the treatment of muscle specific Oro-facial pain: a literature review." 01/01/2013 - "Our results are in line with the clinical experience and suggest that botulinum toxin can be re-administered in orofacial pain treatment." 01/01/2007 - "A critical review of the use of botulinum toxin in orofacial pain disorders."
3.	Serotonin (5 Hydroxytryptamine)IBA 09/01/2013 - "Women with tension-type facial pain who failed to respond to treatment had significantly lower blood serotonin than women in the control group. " 03/20/2013 - "Transition to persistent orofacial pain after nerve injury involves supraspinal serotonin mechanisms." 01/01/2000 - "Plasma and serum serotonin levels and their relationship to orofacial pain and anxiety in fibromyalgia." 01/01/1999 - "Pain, allodynia, and serum serotonin level in orofacial pain of muscular origin." 01/01/1989 - "The effect of the serotonin antagonist iprazochrome was studied in 30 patients with atypical facial pain and 10 control nonpain volunteers. "
4.	Sumatriptan (Imigran)FDA LinkGeneric 09/01/1996 - "A double-blind, placebo-controlled, crossover, study to evaluate the efficacy of subcutaneous sumatriptan in the treatment of atypical facial pain." 09/01/1996 - "Further studies are necessary to test the effects of prolonged subcutaneous and oral multiple dose administration of sumatriptan for the treatment of atypical facial pain." 05/01/1997 - "Atypical facial pain: a double-blind placebo-controlled crossover pilot study of subcutaneous sumatriptan." 09/01/1996 - "However, this data is not sufficient to suggest the clinical utility of subcutaneous sumatriptan (6 mg) for the management of atypical facial pain. " 09/01/1996 - "A double-blind, placebo-controlled crossover study was undertaken to assess the efficacy and tolerability of sumatriptan in patients with atypical facial pain. "
5.	alpha-Fetoproteins (AFP)IBA 03/01/1999 - "The aim of this study was to evaluate the yield of objective electrophysiological testing of the trigeminofacial system in atypical facial pain (AFP). " 08/01/2002 - "Both for medical and dental specialists, patients with facial arthromyalgia (FAM) and acute or chronic atypical facial pain (AFP) often represent a clinical challenge. " 09/01/1985 - "Significant age and personality differences were uncovered when these subpopulations were compared to subjects with atypical facial pain (AFP). " 04/01/1983 - "Atypical facial pain (AFP) patients classically present with a chronic discomfort that is neither anatomic nor dermatomal in distribution. " 10/02/2007 - "To investigate contribution of neuropathic mechanisms to clinically diagnosed atypical facial pain (AFP) using neurophysiologic and thermal quantitative sensory testing (QST) and comparing findings in AFP with those in definite trigeminal neuropathic pain (TNP). "
6.	Antidepressive Agents (Antidepressants)IBA 01/01/2013 - "Inconclusive results of a systematic review of efficacy of antidepressants on orofacial pain disorders." 12/01/2012 - "Efficacy of antidepressants on orofacial pain: a systematic review." 01/01/2013 - "More randomised controlled trials are needed to come to a firm conclusion for the use of antidepressants for orofacial pain disorders." 01/01/2013 - "Because of the heterogeneity of treatment modalities and the low number of trials per disorder there was limited evidence to support the effectiveness of antidepressants in orofacial pain disorders. " 12/01/2012 - "More randomized controlled trials are needed to come to a firm conclusion for the use of antidepressants for orofacial pain disorders."
7.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2013 - "The patient was treated with corticosteroids, and his facial pain improved markedly. " 01/01/2014 - "High-dose corticosteroids proved somewhat effective against SFN as facial pain, but reducing the corticosteroid dose proved difficult, as symptoms were refractory to other immunosuppressants and pain-control drugs such as anti-epileptics and anti-depressants. " 09/01/2001 - "There were significant (p < 0.05) improvements in subjective scoring for headache, nasal discharge & blockage, sense of smell and daily activity but not for facial pain, when montelukast was added along with other alterations in chronic rhinosinusitis medication (all receiving intra-nasal corticosteroids). " 05/01/1998 - "Most current pharmacologic management approaches in the treatment of orofacial pain conditions, including TMDs, involve the use of antidepressants, anticonvulsants, muscle relaxants, corticosteroids, and nonsteroidal anti-inflammatory drugs. " 08/01/2006 - "Topical medications such as anesthetics and anti-inflammatories, oral medications such as anti-inflammatory drugs and skeletal muscle relaxants, injections such as local anesthetics and corticosteroids, and vapocoolant sprays are some examples of the modalities used by clinicians to manage orofacial pain conditions. "
8.	Pindolol (LB 46)FDA LinkGeneric 06/01/2013 - "A Randomized Controlled Trial comparing the efficacy of low-dose amitriptyline, amitriptyline with pindolol and surrogate placebo in the treatment of chronic tension-type facial pain." 09/01/2013 - "Serial blood serotonin levels in a randomized controlled trial comparing the efficacy of low-dose amitriptyline, amitriptyline with pindolol and surrogate placebo in patients with chronic tension-type facial pain."
9.	Dothiepin (Dosulepin)IBA 02/11/1984 - "These results are clear evidence of the efficacy of dothiepin in psychogenic facial pain, though the drug may be needed for up to a year." 02/11/1984 - "Ninety three patients took part in a two centre double blind controlled clinical trial designed to assess the efficacy of dothiepin (Prothiaden) as compared with placebo and a soft biteguard in the treatment of psychogenic facial pain. " 01/01/1983 - "An account is given of a two-centre controlled clinical trial to assess the efficacy of dothiepin (Prothiaden) against placebo and a soft bite-guard in the treatment of psychogenic facial pain. "
10.	Pain-FreeIBA 06/01/2012 - "This short-term observational study suggests that there are no major differences between patients with different craniofacial pain conditions and pain-free individuals in terms of jaw-muscle EMG activity recorded with a single-channel EMG device during sleep. " 06/01/2007 - "The aim of this study was to compare panoramic radiographic findings between subjects with reported facial pain and pain-free controls in a population-based sample of 34-year olds. " 12/01/2006 - "In five of six studies in which investigators specifically analyzed whether there is any relationship between postradiosurgical trigeminal dysfunction and facial pain outcomes, there was a statistically significant greater chance of patients being pain free without medications if new trigeminal dysfunction developed after radiosurgery. " 07/01/1997 - "The purpose of this study was to assess the degree to which symptomatic treatment seeking facial pain sufferers (N = 25), symptomatic non-treatment seeking facial pain sufferers (N = 48), and healthy pain-free controls (N = 70) differed on the Rational Beliefs Inventory (RBI). " 03/01/2014 - "Initially after MVD, 8 patients (80%) were pain-free and subsequently tapered off medications for their facial pain. "

Therapies and Procedures

1.	Splints 01/01/2004 - "Even in the most studied area, stabilization splints for myofascial face pain, the results do not justify definite conclusions about the efficacy of splint therapy. " 01/01/2014 - "After splint treatment for 8 weeks, a significant reduction in orofacial pain frequency and intensity was reported, and significant improvement in TMJ function was observed. " 06/01/2015 - "The findings of this study did not show stabilisation splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counselling alone in the treatment of TMD-related facial pain over a 1-year follow-up." 01/01/2013 - "Overall, the improvement in both signs and symptoms of orofacial pain was observed 81.4 % of patients after using occlusal stabilization splint for 6 months. " 07/01/1982 - "This preliminary study suggests that short-term splint therapy is effective in eliminating mild to moderate facial pain and dysfunction while reducing bruxistic behaviour. "
2.	Injections 11/01/2003 - "To evaluate the safety and efficacy of such injections in a selected group of patients with intractable head or face pain. " 01/01/2009 - "Some dentists propose administering botulinum neurotoxin injections to treat orofacial pain. " 08/01/2006 - "Using oral medications, infusions and injections for differential diagnosis of orofacial pain." 10/01/1995 - "Forty-six patients with idiopathic facial pain were subjected to a specific protocol of local anesthetic injections to sequentially block branches of the mandibular nerve to determine the effects on his/her pain. " 03/01/2005 - "Trigger point injections are sometimes used with excellent results in the treatment of muscle spasm in myofacial pain and low-back pain. "
3.	Transcutaneous Electric Nerve Stimulation (TENS) 01/01/1983 - "In comparison with high or low frequency TENS, vibratory stimulation was found to be as effective and in some patients even more effective in reducing chronic musculoskeletal or orofacial pain. " 11/01/1988 - "Therefore, TENS should be seen as a simple, safe and effective method of treatment for many forms of chronic facial pain, as opposed to other invasive surgical procedures." 09/01/1995 - "Transcutaneous electrical neural stimulation (l.f.-h.i. TENS), employed in dentistry, allows masticatory muscles relaxation, temporary clearance of muscular and periodontal proprioceptive input and even oro-facial pain relief. " 03/01/2014 - "[Transcutaneous electrical nerve stimulation therapy in reduction of orofacial pain]." 01/01/1995 - "Most practitioners familiar with electrical modalities are aware that TENS is a physiologically-specific therapy for treating and resolving facial pain related to various neurological and/or myofascial conditions. "
4.	Radiotherapy 01/01/2014 - "Although focal radiotherapy induced remarkable tumor shrinkage and relieved ocular motor disturbance and facial pain, his visual acuity did not improve. " 06/01/2007 - "In the present article, we review the clinical presentation of cancer-associated orofacial pain at various stages: initial diagnosis, during therapy (chemo-, radiotherapy, surgery), and in the post-therapy period. " 06/01/2007 - "In the second part, we review the clinical presentation of cancer-associated orofacial pain at various stages: initial diagnosis, during therapy (chemo-, radiotherapy, surgery), and in the post-therapy period. " 01/01/2003 - "Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. " 04/09/1988 - "The interval between presentation with the pain and the discovery of the lung cancer varied between 6 wk and 4 yr. Radiotherapy cured the facial pain in 7 cases. "
5.	Lasers (Laser) 10/01/2012 - "Is low level laser effective for the treatment of orofacial pain?: A systematic review." 11/01/1990 - "The efficacy of low power laser stimulation in the treatment of chronic oro-facial pain conditions was investigated in a double-blind placebo controlled modified cross-over study in 40 patients. " 09/01/2003 - "In conclusion, the results of this study do not support an effect of low-power laser exposure on masseter muscle microcirculation in patients with chronic orofacial pain of muscular origin." 09/01/2003 - "The aim of this study was therefore to investigate the immediate effects on masseter muscle blood flow by low-power laser exposure in patients with chronic orofacial pain of muscular origin in comparison to healthy individuals. " 10/01/2013 - "The adjunct therapeutic effect of lasers with medication in the management of orofacial pain: double blind randomized controlled trial."