Oro-facial and facial pain
Oro-facial pain refers to pain in and around the mouth and face pain being anywhere around the face.
This is something we work with frequently. We are often asked, as part of a multidisciplinary approach, to help identify whether a source of face/mouth pain is musculoskeletal (coming from muscles, joints, ligaments, bones …) or nerve related (like trigeminal neuralgia).
We do this through a thorough assessment and history to see if pain is amenable to physiotherapy and if not, what we suspect it could be and who the best profession is to help you with it. We also screen for any red flags that would need urgent medical attention.
Often pain presentations can be tricky and have multiple sources, for example someone can have trigeminal neuralgia AND TMD (jaw problems) AND migraine. We control and treat the things we can and work in with medical and dental specialists to get to a place where pain is managed/controlled/treated.
Types of face pain we can treat as physios:
TMJ (jaw) conditions: this can include pain from muscles (myalgia) and pain from the joint.
Referred pain/ headache from the jaw or upper neck. These areas can send pain into the mouth and face!
We can help with desensitising techniques for post hepatic or other recovering/managed neuralgias.
What we cannot treat:
We cannot fix/cure trigeminal neuralgia or post herpactic neuralgias. We can help with desensitising techniques and managing other structures like the jaw and neck which may help a portion of the pain. But the gold standard of care here is medical!
Tooth problems! we often work with your dentist to work out id a mouth pain is gum/tooth or TMJ related
burning mouth syndrome: this is a complex presentation and should be assessed by a oral medicine doctor.
We cannot fix/cure primary headache - true migraine and other primary headache disorders are multifaceted and often not solely musculoskeletal. We will still need a neurologist involved in your care.
How do we treat face pain?
We work out how irritable/cranky your symptoms are and find a sensible starting point.
We may or may not use manual therapy (“hands on” or needling) depending on the irritability and chronicity of your symptoms.
We often use tools like self treating and general or specific exercise to change pain presentations
We will take an inventory of other things that contribute to the pain experience like sleep, exercise and mental health to ensure you are in the best place possible to have a good result.
Simple strategies like cool and warm face washers can be simple ways of changing the experience quickly to allow for change too.