Cheek Bone Pain

Cheek Bone Pain: Causes and Treatment Options

Cheek Bone Pain: Causes and Treatment Options

By Ann McCulloch

The key to relief from cheek bone pain is to identify the most probable underlying cause.

Cheek bone pain can be a bothersome symptom that interferes with everyday activities and reduces your overall quality of life. Identifying the underlying causes of cheek bone pain is crucial for effective treatment. This article covers various triggers of cheek bone pain of cheek bone pain, with a special focus on causes associated with the temporomandibular joint (TMJ) and related structures. Additionally, we explore standard treatment options that can provide relief from these symptoms.

Table of Contents

We’ll first answer several common questions.

Does my check bone hurt due to referral pain?

One of the important things to understand about cheek bone pain is that it’s often a form of referred pain. “Referred pain occurs when the sensation of pain is experienced in an area of the body that is not the actual source of the problem”, according to Dr. Sachi Mehrotra, a board-certified Orofacial Pain Specialist working out of Southern California.

Can clenching teeth cause cheekbone pain?

Yes, because your clenching muscles are attached to your cheek bones.

Causes of people’s cheekbone cases will vary based on individual things like muscle tension, stress, clenching, and grinding teeth. They can all contribute to TMD problems. Individuals may experience localized tension in their cheeks or at their jaw joints. We know that jaw and cheekbone pain often co-occur; additionally, headaches in the temple are a common symptom of possible TMJ issues.

Can your cheek bones hurt if you chew too much?

Some people habitually clench and grind their teeth and are unaware of it while they sleep. They can end up grabbing and chewing their cheeks and wake up wondering why their cheek hurts. Grinding your teeth leads to overworking the muscles under your cheeks. When you persistently grind or clench your teeth, your muscles also work, leading to a state of continual overworking. This overworking of muscles can become painful. This may also occur with excessive gum chewing.

Compared to other causes of pain in the cheek and temple area, TMJ worsens with jaw movement and improves with jaw relaxation.

Do I see a doctor or dentist for cheek bone soreness?

If you think the soreness is related to your jaw, you should seek proper diagnosis of by a trained professional who can help identify the specific TMD subtype and guide appropriate treatment plan, like a dentist trained in TMJ issues or an orofacial pain specialist. Some doctors also have training in TMD issues, but if the problem is in your teeth, you will probably wind up seeing a dentist anyway.

Can stress cause cheek bone pain?

When stressed, people tend to tighten their facial and jaw muscles or clench their teeth. If this state is sustained, it can result in pain or temporomandibular joint disorder (TMJ). This is partly why cheekbone pain is often felt in tandem with chronic jaw pain or TMJ. People who complain of frequent sore cheeks and temples in their facial regions after waking up should be evaluated for bruxism.

Why does my cheek bone hurt when there was no direct blow?

A direct blow to the cheekbone, such as may occur to domestic violence victims, can be a challenging injury to deal with due. Not only is physical pain involved, but it also has a potential psychological impact. However, most often, cheekbone pain is “referred pain” from another cause. For example, excessive grinding of bruxism or teeth clenching over works the muscles that move your jaw. This commonly causes the neck, cheekbones, temples, and joints to have pain. This condition is known as TMJ disorder.

To address complex issues like this, doctors usually develop a “differential diagnosis”, a list of all potential causes of the pain. By generating this list and evaluating their likelihood, they can narrow down and determine the most accurate diagnosis.

Differential Diagnosis for Cheek Bone Pain Associated with Facial Pain

  • Sinusitis: Infections in the maxillary sinus (right under the cheek bone) can be a source of your pain. If this is the case, look at other common symptoms such as nasal congestion, headache, allergies, and pressure around the eyes.
  • Dental Issues: Tooth infections, dental abscesses, or gum disease can all refer pain to the cheekbones. To help determine if this is the cause, you can do a self-exam to see if you have bleeding gums, look for dental carries, or tap on your teeth to see if this is the cause.
  • TMJ Disorders: The temporomandibular joint and related structures are a common cause of cheek bone pain. Do you grind your teeth, have facial tension, suffer from temple headaches? Does your jaw click? Do you have pain with chewing? Is there pain when you press on the muscles of chewing? If any of these are present, you may have a TMJ disorder.
  • Neuralgia: Trigeminal neuralgia may cause pain in the cheek area. The pain is often described as a sudden, electric shock-like sensation, which can be triggered by simple activities like eating, speaking, or even gentle touches to the face. Among the other causes of cheek bone pain, this condition would cause the most intense and distressing pain.
  • Facial Trauma: Injuries or trauma to the face, such as fractures or contusions. Even without a direct blow to the face, facial trauma can result in cheek bone pain. If this is the cause, you’d probably know it. However, it’s something to keep in mind if you have a prior history of trauma and they used plates to fix it. It may indicate your dental implant is infected.

Can TMJ Cause Cheek Bone Pain?

Checkbone pain can be referred pain

Yes, cheek bone pain is often associated with temporomandibular disorders (TMDs), which affect the jaw joint and its surrounding structures. TMDs can cause discomfort and pain in the cheek area due to the intricate interplay between the jaw joint, facial muscles, and surrounding tissues.

List of common TMD symptoms:

  • Jaw pain: TMDs can cause jaw pain, which can be localized to the jaw joint or radiate to the surrounding areas.
  • Jaw clicking or popping: Many with TMDs experience clicking, popping, or grating sounds when they open or close their mouths.
  • Limited jaw movement: TMDs can cause limited jaw range of motion or difficulty/discomfort when trying to fully open the mouth.
  • Facial pain: TMJ-related facial pain can occur in various areas, including the jaw, temples, cheeks, or around the ears. The pain may be intermittent or constant and may worsen with jaw movement.
  • Ear symptoms: TMDs can cause ear-related symptoms such as earaches or a feeling of fullness or pressure in the ears.
  • Headaches: Many individuals with TMDs experience headaches, which can range from mild tension headaches to more severe migraines. Around 60% of the time, chronic headaches and TMDs are experienced together [1].
  • Neck and shoulder pain: TMJ-related discomfort can radiate to the neck and shoulders, leading to muscle tension, stiffness, or pain in these areas.
  • Facial muscle fatigue: TMDs can cause facial muscle fatigue, especially after activities that involve prolonged chewing or talking.

What could cause cheek bone and teeth pain?

If multiple symptoms listed above match your personal experience, your cheek bone pain is likely related to an underlying TMD. The underlying causes of TMDs can vary, including jaw misalignment, muscle tension or dysfunction, arthritis, or trauma to the jaw. If your teeth are also involved, it can either be another form of referred pain or from the teeth itself.

How to Treat TMJ Facial Pain When my Cheeks Hurt?

Common treatments for TMD-related cheek bone pain:

  • Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation. Be sure to check with your doctor before starting any medications.
  • Oral appliances: Oral appliances, like anterior bite plane splints, alleviate the strain on the jaw joint and relax the overactive jaw muscles. By creating a smooth and even biting surface, anterior bite plane splints help reduce excessive clenching or grinding of the teeth, which can contribute to TMD-related cheek bone pain.
  • Jaw exercises: Performing specific jaw and tongue exercises that promote facial relaxation can be an effective intervention for TMD-related cheek bone pain.
  • Stress management techniques: Stress can contribute to TMD pain. Relaxation exercises, deep breathing, meditation, or counseling can help reduce stress levels and minimize pain.
  • Hot/cold therapy: Applying heat or cold to the affected area can provide temporary relief from TMD-related pain. Warmth helps relax muscles and improve blood circulation, while cold can reduce inflammation and numb the area.

Many structures make up a person’s cheeks. A person’s various facial expressions result from muscle contractions and changes in blood flow that manifest physically through our cheeks.

Three bony structures that have a role in cheek formation:

  1. Zygomatic bone.
  2. Maxilla bone.
  3. Mandibular bone.

However, typically, people who complain of cheek bone pain actually have muscle and nerve-related factors.

Four primary cheek muscles: [2]

Name Location Function
Masseter muscle The masseter muscle courses from your cheek bone to your jaw, originating from the zygomatic arch and inserts along the angle and lateral surface of the mandibular ramus. This muscle contributes to the lateral fullness of the cheek, but its primary function is mastication. It works with other muscles to move and stabilize your jaw and temporomandibular joint. It is primarily responsible for the elevation of the mandible and some protraction of the mandible.
Buccinator muscle This muscle is located deeper in the cheek. It is your major facial, underlying cheek muscle. The buccinator muscle’s function is to hold food boluses in the mouth against the teeth during mastication. It holds the cheek to the teeth and assists with chewing.
Zygomaticus major muscle It extends from each zygomatic arch (cheekbone) to the corners of the mouth. It is a muscle of facial expression which draws the angle of the mouth superiorly and posteriorly to allow one to smile. The average muscle can contract with a force of 200 g.
Risorius muscle The risorius muscle is located on either side of the lips in most individuals. It extends from each zygomatic arch (cheekbone) to the corners of the mouth. It arises from the fascia over the parotid gland, and inserts into the angle of the mouth. It retracts the angle of the mouth during smiling and is supplied by the facial nerve (CN VII). It has a greater percentage of slow muscle fibers and contains a more intricate configuration of innervation of extrafusal fibers than other skeletal muscles throughout the body.

Additional muscles in the cheek region

Additional muscles located in the cheek region are: Orbicularis oculi muscle (lower border) Levator labii superioris muscle. Levator labii superioris alaeque nasi muscle. Levator anguli oris muscle. They function closely with facial nerves. The trigeminal nerve will give sensory innervation to the entire face, including the cheeks. The trigeminal nerve also delivers motor innervation to the masseter muscle. [3]

The National Institute of Health (NIH) states, “There are seven cranial pairs of somitomeres which invade the pharyngeal arches to form the myoblasts that give rise to the larynx, pharynx, and muscles of facial expression and mastication (including the masseter muscle).”

Evan Goldman, PhD, MEd’s June 11, 2022, Anatomy, Head and Neck, Masseter Muscle article also talks about Masseter muscle rigidity (MMR). It is also known as “jaws of steel”. It may occur with the use of succinylcholine and is defined as limb muscle flaccidity with jaw muscle tightness.

The TMJ sits right behind a major nerve in the face, which is at the center of a network of nerves that cross and connect throughout the face, head and neck. So when the TMJ is affected, pain can spread throughout the eyes, ears, mouth, forehead, cheeks, tongue, teeth and throat. Even the muscles of the neck and upper back can become involved.” – TMJ: The Small Joint That Can Cause Big Pain by Penn Medicine

The Speed2Treat Kit is a self-care kit that includes all the treatments mentioned above. It’s an excellent resource for effectively managing TMD symptoms and alleviating related cheek bone pain. People can administer self-care interventions that can be easily incorporated into their daily routine before having to see a specialist.

Takeaways for People Suffering from Check Bone Pain

  1. It’s important to recognize that cheek bone pain is often a form of referred pain, meaning that its source may not be directly located in the cheek area itself.
  2. Understanding the underlying cause of cheek bone pain is crucial for effective management and relief. By identifying the specific factors contributing to the pain, you can take effective steps toward finding appropriate treatment and achieving relief.
  3. If you suspect that the underlying cause is TMJ related, the Speed2Treat Kit is an excellent self-care resource you can use before going to see a medical professional.

CONCLUSION: Knowledge of the Cheek and Face Assists Diagnosis

If you experience cheek pain, jaw muscle rigidity leading to an inability to open your mouth, jaw sprain and strain, and/or the ability to smile normally, seek help without delay.

How to Find a TMJ Provider

Author bio

AAnn McCullochAnn McCulloch, MBA is co-founder and president of Orofacial Therapeutics, this site, and oversees the company’s expanding portfolio of resources and tools for jaw and headache pain diagnosis and treatment. Her chronic jaw pain issues continue to inspire her to investigate the needs and challenges of patients suffering from orofacial pain.

 

References

[1] Yakkaphan P, et al, Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis, https://journals.sagepub.com/doi/full/10.1177/25158163221097352, May 2022

[2] John D. Nguyen, et al,Anatomy, Head and Neck, Cheeks, https://www.ncbi.nlm.nih.gov/books/NBK546659/, August 2022; Alex M. Germann, et al, Anatomy, Head and Neck, Risorius Muscle, https://www.ncbi.nlm.nih.gov/books/NBK540999/, June 2022;
https://en.wikipedia.org/wiki/Zygomaticus_major_muscle

[3] Prachi Jain, et al, Anatomy, Head and Neck, Orbicularis Oris Muscle, https://www.ncbi.nlm.nih.gov/books/NBK539869/, August 2022