We all know the pain of a headache, but what about pain that arises from below the brain? Cranial nerve pain is an overarching category for pain that originates from nerves that enervate your neck, head, shoulders, and face. Challenging to diagnose and often debilitating, this type of pain can make everyday life very difficult. Here’s what you should know about its causes and treatments that can help.

What causes cranial nerve pain?

To understand what causes cranial nerve pain (also known as cranial neuropathy), it is important to have some basic knowledge of the anatomy of cranial nerves.

We have 12 distinct pairs of cranial nerves, all of which originate underneath the brain before weaving through the skull and branching off to different parts of the head, neck, and torso.

These 12 cranial nerve pairs and their functions, from front to back, are the:

  1. Olfactory nerve: Smell
  2. Optic nerve: Vision
  3. Oculomotor nerve: Detecting light and eye movement
  4. Trochlear nerve: Eye movement
  5. Trigeminal nerve: Facial sensation and movement
  6. Abducens nerve: Eye movement
  7. Facial nerve: Expression, taste, tear and saliva production
  8. Vestibulocochlear nerve: Hearing and balance
  9. Glossopharyngeal nerve: Swallowing, speech, gag reflex
  10. Vagus nerve: Swallowing, gag reflex, muscle control (heart and other organs)
  11. Accessory nerve: Neck and shoulder movement
  12. Hypoglossal nerve: Tongue control

You can see how these nerves control various muscles, transmit sensory information, and help interpret signals (e.g., pain).

Facial nerves diagram

When it comes to cranial nerve pain, there are usually two nerves or nerve groups involved: the trigeminal nerves and another group of nerves that originates in the second or third vertebrae of the neck called the occipital nerves. While cranial nerve pain can originate from the other cranial nerves, these two nerves and nerve groups are the most common culprits.

Damage to the nerves that cause cranial pain can occur in several different ways.

Trauma

Any injury to the head, neck, face, or torso can result in cranial nerve damage.

Especially in car accidents, soft tissue trauma may not appear at first, but instead develop over weeks, with cranial nerve pain a result.

Underlying medical conditions

There are several different medical conditions that can lead to nerve damage and pain throughout the body. These include:

  • Multiple sclerosis
  • Fibromyalgia
  • Porphyria
  • Some infections, such as AIDS or shingles
  • Chronic renal insufficiency

Diabetes is also common cause of many types of nerve pain, including cranial nerve pain. If diabetes is not well managed, wide fluctuations in blood sugar levels can cause nerve damage that results in pain.

Compression of the nerves

Compression of the cranial nerves due to blood clot, high blood pressure, muscle tension, or tangled veins and arteries can result in spontaneous and shooting nerve pain.

This compression causes 80-90% of cranial nerve pain in cases of trigeminal and occipital neuralgia. High blood pressure that causes the veins and arteries to compress the cranial nerves is a common cause of pain.

What are common cranial nerve pain symptoms?

Cranial nerve pain symptoms can vary depending on the patient and a variety of other factors. The most common symptoms include burning or stabbing pain. Pain can feel like an electric shock, or it may start as a tingling sensation across the face, neck, head, and shoulders. For some patients, pain becomes a dull, nearly constant ache. Cranial nerve pain sufferers may also feel pain inside their mouth. This can make eating and drinking unple