Cervicogenic facial pain is tingling, burning or aching pain felt on the upper, middle or the lower part of the face. It can be one sided or bilateral. Cervicogenic facial pain as the name suggests originates due to bulging disc in the cervical spine. Human spine is made up of twenty four spinal bones. The first 7 bones are located in neck at the base of skull.They are called cervical spinal bones.
There is a gelatinous disc between two spinal bones that works as a cushion to reduce wear and tear. Problems in cervical spine such as bulging of the disc can be a reason for pain in neck, but sometimes it can also cause painful sensation on face.
What Causes Cervicogenic Facial Pain?
Normally the sensation on face is carried to and fro to the brain through trigeminal nerve.It is one of the twelve cranial nerves that originate directly from the brain. Thus diseases involving trigeminal nerve or its branches can cause abnormal sensation and pain in the facial region. Person suffering from trigeminal neuralgia, Bell’s palsy, GB syndrome are known to experience such type of tingling and burning pain.
However, the nucleus of the trigeminal nerve in the brain passes down to the 3rd segment (C3) of the spinal cord before innervating in face. Thus the nerve root of C3 and cells of trigeminal nerve partly get interconnected. When cervical roots of spinal cord are compressed due to problem in cervical spine such as slip disc, spondylosis, spondylolisthesis, or spinal canal stenosis patient may complain of abnormal painful sensation on face along with pain in shoulder, because of the interconnection. This is called cervicogenic facial pain.
The pain is usually unilateral, but sometime it may occur on both the sides of face. Bad posture and movement of neck are often the cause of such pain.
Cervicogenic Facial Pain Symptoms
Cervicogenic facial pain is itself a symptom. There may be many accompanying symptoms along with this type of pain. Such type of tingling and numbness on face is usually felt when the person extends his neck if he is suffering from cervicogenic facial pain. For example while looking upward worsen the pain.
Bending the neck sideways while looking back can also trigger tingling facial pain in case of pain originating from cervical spine disorder. Patient with this condition also has associated pain and stiffness of neck. There is disuse of neck muscles as patient tries not to move his neck because of pain.
Diagnosis And Treatment For Cervicogenic Facial Pain
There are many reasons that may cause facial pain. Often cervicogenic cause is missed while the doctor tries to diagnose the disease. At first he may rule out some of the common causes of facial pain. Once these disorders and problems are ruled out, cervicogenic cause for facial pain can be thought of. Thus it is a diagnosis of exclusion. Tests such as MRI, CT scan, EEG and EMG are useful in diagnosis of the condition.
Since disorders of cervical spine are the main cause of tingling pain in face, treatment is aimed at addressing that cause. Usually the patient needs conservative treatment which consists of antidepressant or antiepileptic or muscle relaxant medications.
Along with medications physical therapy plays important role to reduce such type of pain on face. Physiotherapy is extremely beneficial in certain cervical conditions such as spondylosis and slip disc. Other auxiliary measures such as acupressure, massage therapy, and homeopathic medicines are also found useful in treating this condition.