‘What’s Up Doc’ is a health column in association with The Crawley Observer, which gives you the opportunity to ask questions regarding general health and wellbeing.
Answers are provided weekly from our specialist consultants at Spire Gatwick Park Hospital, Surrey. If it’s a long-standing illness or simply a worry which you would like to get off your mind then we would like to help.
This question appeared in The Crawley Observer on Wednesday 31 July, to readers across Surrey and Sussex. The question and answer is below, as it appeared in the newspaper.
Read the response by Dr Jones Kurian, consultant in anaesthesia and pain medicine:
I am experiencing bad facial pain, along with swelling and flushing. I wonder if you know what it is, and if there is anything that helps with the pain. Thanks
Even though I do not have enough details to make a specific diagnosis about the symptoms that was put forward to me I will discuss about the facial pain syndromes that are often seen in the primary care setting. A careful history and examination would direct towards the diagnosis and guide the treatment.
Common presentations of facial pain include trauma and sinusitis, trigeminal neuralgia, postherpetic neuralgia, temporomandibular joint syndrome, cluster and migraine headaches. Other less common causes of facial pain include malignancy, vasculitis, and infection.
Facial pain associated with swelling and flushing could be originating from the sinuses or teeth. Once these sources are ruled out, cluster headache should be considered. Cluster headache afflicts mostly young men. The pain of a cluster headache is an intense, unilateral, deep orbital pain that radiates to the forehead, temples, cheek, neck, or ear. There may be associated conjunctival injection, tearing, and nasal congestion. Treatment of cluster headache may include oxygen therapy for abortive treatment, and regular medications for prevention.
Dr Jones Kurian is a pain medicine consultant with special interest in x-ray guided interventions to diagnose and treat head, neck and pain problem along with nerve root entrapments. Specialised procedures like provocative discography and radiofrequency denervation are done to diagnose and treat pain syndromes.