Nicholas Tzikas, MD, MPHHeadache & Facial Pain Medicine

Facial pain specialist

Facial pain is not one diagnosis.

Electric shocks, continuous burning, pain after dental work, and pain around the eye can arise from different systems. Telling them apart comes before choosing a treatment.

The evaluation

The pattern is the starting point.

Facial pain can resemble a dental problem, sinus disease, migraine, a jaw disorder, or pain arising from the trigeminal nerve. A careful history looks at exactly where the pain travels, how long it lasts, what triggers it, and whether sensation has changed.

Examination and targeted imaging are used when the pattern suggests nerve compression, a structural cause, or another condition that needs a different specialist. Care may be coordinated with dentistry, ENT, pain medicine, or neurosurgery when appropriate.

Anatomical illustration showing the trigeminal nerve and facial pain pathways
Small differences in location, timing, and triggers can point to very different diagnoses.

Common patterns

Brief, electric or triggered pain

Pain brought on by chewing, brushing teeth, light touch, or cold air may follow a trigeminal nerve distribution. The timing and triggers help distinguish trigeminal neuralgia from dental, jaw, and sinus pain.

Continuous aching or burning

Persistent pain may require a different approach. The evaluation considers prior dental or sinus procedures, altered sensation, post-herpetic pain, and persistent idiopathic facial pain.

Pain around the eye or temple

Attack length, tearing, nasal symptoms, restlessness, and response to specific medicines can separate cluster headache and related disorders from neuralgia and migraine.

Care options

Treatment follows the diagnosis.

Depending on the cause, care may include medication, targeted nerve blocks, or referral for an outside specialty procedure. The information here is general and is not a treatment plan.

Appointments are currently in East Hills, Long Island. Manhattan location coming soon.