Facial pain is a common and often confusing symptom because the face contains a dense network of nerves, muscles, bones, and glands. When a person feels pain in the cheek area, the source is not always the cheek itself, but frequently structures located nearby, such as the jaw, teeth, or sinuses. Understanding the characteristics of the discomfort, whether it is a dull pressure or a sharp, electric jolt, can help in identifying the underlying cause. This overview explores some of the most frequent reasons people experience pain in their cheeks, ranging from common infections to specific nerve disorders.
Pain Originating from Sinuses and Infections
Inflammation within the paranasal sinuses, specifically the maxillary sinuses, is a frequent cause of cheek discomfort. These large, air-filled cavities are located directly behind the cheekbones. When they become inflamed or infected, the resulting pressure is felt keenly in the mid-face region. This condition, known as maxillary sinusitis, often presents as a constant, dull ache or a feeling of facial fullness that worsens when bending over or lying down.
The pain is caused by the blockage of the ostia, the drainage pathways, leading to a buildup of fluid and pressure inside the sinus cavity. Acute sinusitis symptoms are often accompanied by thick, discolored nasal discharge, congestion, and sometimes a fever. Because the roots of the upper back teeth extend close to the floor of the maxillary sinus, sinus pressure frequently causes pain that feels like a toothache across multiple upper teeth.
Pain can also be referred to the cheek from issues in the mouth, particularly a dental abscess. This infection, often starting deep inside a tooth’s pulp due to decay or a crack, creates a pus-filled pocket that causes intense, throbbing, or shooting pain. Similarly, a painful, impacted wisdom tooth, which does not have enough room to erupt properly, can cause referred pain and swelling in the back of the jaw that radiates forward into the cheek.
Skin infections can also cause cheek pain. Cellulitis, a bacterial infection of the deeper layers of the skin, causes a rapidly spreading area of redness, swelling, warmth, and tenderness on the cheek. A viral infection like Herpes Zoster (shingles) can affect the nerves of the face, causing a painful rash and burning sensation corresponding to the path of the affected nerve.
Disorders of the Jaw and Muscles
The temporomandibular joints (TMJ) connect the jawbone to the skull and are a common source of cheek pain when dysfunctional. A temporomandibular joint disorder (TMD) occurs when this joint or the surrounding muscles are inflamed, misaligned, or injured. This leads to pain often felt in the cheek, jaw, and around the ear, frequently accompanied by a clicking, popping, or grinding sound when the mouth is opened or closed.
Jaw and cheek muscles can become sore and painful due to habits like bruxism, the grinding or clenching of the teeth. Clenching places strain on the masseter muscles, the large chewing muscles that run from the cheekbone down to the lower jaw. This chronic muscle strain leads to soreness, fatigue, and radiating pain in the cheeks and temples. This tension can be exacerbated by stress, which often triggers subconscious clenching throughout the day.
Pain can also be referred to the cheek from tension in the neck. Muscle tension headaches, for example, can cause tightness that radiates into the face. A problem originating in one area, such as a muscle spasm in the neck, can be perceived as discomfort in the cheek.
Facial Nerve and Glandular Issues
Trigeminal neuralgia is a chronic pain condition involving the trigeminal nerve, the fifth cranial nerve responsible for sensation in the face. It is characterized by sudden, intense bursts of pain often described as an electric shock or stabbing sensation. These episodes are typically brief, lasting only seconds to a couple of minutes, and often affect one side of the face, including the cheek.
The pain from trigeminal neuralgia is often triggered by light touch, brushing teeth, chewing, or even a cool breeze. The condition is most commonly caused by a blood vessel compressing the nerve as it exits the brainstem, which wears away the protective myelin sheath over time.
Salivary gland problems can cause swelling and tenderness in the cheek area. The largest salivary glands, the parotid glands, are located near the ears and extend over the cheeks. Conditions such as parotitis cause swelling and pain, often worsening when eating as the gland attempts to produce saliva. Salivary stones (sialolithiasis) can also block the ducts, leading to painful swelling in the cheek as saliva backs up behind the obstruction.
When Cheek Pain Requires Urgent Medical Attention
While many causes of cheek pain are manageable with self-care or routine medical treatment, certain symptoms signal a potentially serious problem that requires immediate consultation with a healthcare professional.
- Sudden, severe, or unbearable pain, especially if it is the worst pain ever experienced.
- Pain accompanied by a high fever, chills, or rapidly worsening swelling, indicating a spreading or severe infection like a dental abscess or cellulitis.
- Pain occurring following a recent trauma, such as a fall or impact, which may indicate a facial bone fracture.
- Facial pain associated with new neurological symptoms, such as facial weakness, numbness, drooping, or vision changes.
- Persistent pain that does not improve after several days of home care or pain that interferes significantly with daily activities like eating or sleeping.