Head and Face Pain
It is common for people to suffer from occasional head pain, including headaches or face pain from a sinus infection. However, it is less common for people to suffer from ongoing severe bouts of head and face pain or craniofacial pain. Otherwise healthy people can become victims of relentless head and face pain for a number of reasons. Constant headaches, eye pain, facial pain or stiff neck and s
What it is
Trigeminal neuralgia produces brief shock-like pain triggered by light touch, eating or wind. Persistent idiopathic facial pain is a constant deep ache without trigger. Post-herpetic neuralgia follows shingles. Each has a different evidence-based treatment — generic "facial pain clinic" referrals often miss the distinction.
Symptoms and signs
- Sharp electric-shock pain in the face, triggered by touch, eating, shaving or cold air (trigeminal neuralgia).
- Constant deep, dull aching face pain that does not respect anatomical nerve territories.
- Burning, allodynic pain in the distribution of a previous shingles rash.
- Facial pain associated with eye watering, nasal congestion or eyelid drooping (trigeminal autonomic cephalalgias).
- New-onset facial pain in patients over 60 — particularly with jaw claudication or scalp tenderness, indicates giant cell arteritis until proven otherwise.
How we investigate
Detailed history, cranial nerve examination, dedicated trigeminal MRI (with FIESTA/CISS sequences) to assess for neurovascular contact. ESR, CRP and (in selected cases) temporal artery biopsy for suspected GCA. Dental and ENT cross-referral where indicated.
Treatment options at The Vesey
- Trigeminal neuralgia first-line — carbamazepine or oxcarbazepine titrated slowly to symptom control.
- Trigeminal neuralgia second-line — gabapentinoids, lamotrigine, baclofen, or referral for microvascular decompression / Gamma Knife.
- Persistent idiopathic facial pain — tricyclic and SNRI antidepressants, behavioural support, structured pain-medicine input.
- Post-herpetic neuralgia — gabapentinoid, topical lidocaine 5% plasters, capsaicin 8%, peripheral nerve blocks.
- Diagnostic and therapeutic blocks — sphenopalatine ganglion block, trigeminal branch blocks and occipital nerve blocks where indicated.
What is trigeminal neuralgia and how is it treated? +
Trigeminal neuralgia is a severe, episodic, electric-shock pain in the face triggered by light touch — eating, speaking, or a breeze. First-line treatment is carbamazepine or oxcarbazepine. For medication-resistant cases, referral for microvascular decompression or Gamma Knife radiosurgery is arranged at the consultation.
What is a sphenopalatine ganglion block and who is it for? +
A sphenopalatine ganglion (SPG) block is a targeted injection or intranasal application that numbs a nerve cluster at the back of the nasal cavity. It is used for cluster headache, hemicrania continua and some facial pain conditions. At The Vesey it is performed as a clinic procedure, typically taking 20 minutes.
Could my facial pain be giant cell arteritis (GCA)? +
GCA should be considered in anyone over 60 with new-onset headache, jaw pain when chewing (jaw claudication), scalp tenderness or visual symptoms. It is a medical emergency — untreated it can cause sudden permanent blindness. We will arrange urgent ESR, CRP and temporal artery assessment on the same day.
Is an MRI needed for facial pain? +
For suspected trigeminal neuralgia, a dedicated trigeminal MRI with FIESTA or CISS sequences is essential to look for neurovascular contact or compression. For most other facial pain, the history and examination guide the decision — we do not order MRI routinely without an indication.
Pricing at a glance
Initial neurology consultation £260 (60 minutes). Trigeminal MRI from £550. Peripheral nerve blocks from £800. Pain medicine consultation £260. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have facial pain that is not responding to first-line treatment, a diagnosis you are unsure of, or you are weighing surgical options (microvascular decompression, Gamma Knife) and want an independent neurology opinion first.
Cost and pathway
Initial neurology consultation £260 (60 minutes). Trigeminal MRI from £550. Peripheral nerve blocks from £800. Pain medicine consultation £260.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our consultant neurology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727