What is Atypical Facial Pain?

Atypical facial pain is a chronic pain condition affecting the face, jaw, or mouth, but without a clear structural or nerve injury cause. Unlike trigeminal neuralgia, which causes sharp, electric-shock-like pain along a specific nerve branch, atypical facial pain tends to be constant, dull, or aching and often does not follow a clear nerve distribution.


It is sometimes referred to as Persistent Idiopathic Facial Pain (PIFP) and can be difficult
to diagnose. It may coexist with other conditions such as jaw disorders (TMD), dental issues,
or previous facial trauma.

What are the symptoms?

You may experience:
  • Constant, dull, or aching pain in one area of the face
  • Pain that does not follow a specific nerve or dental root
  • Unilateral or bilateral facial discomfort
  • Sensitivity to touch or pressure in the affected area
  • No obvious cause on scans, dental exams, or nerve testing

The condition can be frustrating and may be linked to stress, previous injury, or altered nerve processing.

How is it diagnosed?

Diagnosis is based on:
  • A detailed clinical history and examination
  • Exclusion of conditions such as trigeminal neuralgia, TMD, dental disease, sinus issues, or nerve compression
  • Imaging (MRI or CT) may be performed to rule out other causes
  • Atypical facial pain is a diagnosis

What treatments do we offer?

We take a supportive and multidisciplinary approach to managing atypical facial pain:

1. Peripheral Nerve Blocks

  • In selected cases, we may offer supraorbital, infraorbital, or mental nerve blocks
  • These involve injecting local anaesthetic near the superficial branches of the trigeminal nerve to reduce pain signalling
  •  A response can help reduce pain and guide further treatment, including pulsed radiofrequency

2. Trigger Point Injections

  • If facial muscle tension contributes to the pain (e.g. masseter, temporalis), we may offer trigger point injections
  • These can reduce muscle tightness and local pain amplification

3. Stellate Ganglion Block (for upper face or sympathetic pain)

  • Where symptoms suggest a sympathetic component (burning, temperature sensitivity), a stellate ganglion block may be helpful in modulating nerve activity

4. Pulsed Radiofrequency Treatment

  • For patients with partial relief from blocks, we may consider pulsed RF targeting peripheral branches of the trigeminal nerve
  • This non-destructive technique can provide longer-lasting relief while preserving normal nerve function

5. Medication Optimisation

  • We offer a structured review of your current medications to ensure they are safe, effective, and appropriate. Our focus is on minimising side effects, reducing medication burden, and improving outcomes.
  • In line with local prescribing guidelines, our clinic does not prescribe opioids or pregabalin — these medications must be managed by your own GP.
  • We can, however, provide recommendations to your GP as part of your overall care plan and support safe deprescribing or substitution where  appropriate.

Self-Management & Supportive Strategies

You may experience:
  • Advice on jaw care, relaxation techniques, posture correction, and gentle facial desensitisation
  • Where appropriate, we may recommend input from:
    o Oral medicine or dental specialists
    o Clinical psychology for pain coping strategies
    o Specialist physiotherapy for head and neck rehabilitation

What to expect from treatment

  • Atypical facial pain can be challenging to treat, but many patients find benefit through a combination of targeted interventions, education, and supportive care
  • We aim to help you reduce pain intensity, regain function, and minimise medication use
  • Treatment is delivered on a day-case basis, with follow-up arranged as needed