When should I consider referring a patient with facial pain to a specialist for further evaluation?

Consider referring a patient with facial pain to a specialist for further evaluation in the following situations:

• When the facial pain is associated with persistent facial numbness or abnormal neurological signs, refer urgently for neuroimaging using a suspected cancer pathway referral.
• If the patient has unilateral facial pain triggered by touching the affected part of the face (suggestive of trigeminal neuralgia) and the pain is refractory to treatment, refer in line with the NICE guideline on neuropathic pain in adults.
• When there is scalp tenderness or jaw claudication suggestive of temporal arteritis, consider blood tests and follow local pathways for suspected giant cell arteritis; referral may be needed if diagnosis is uncertain or treatment is required.

These referral criteria help ensure timely specialist assessment for potentially serious underlying causes of facial pain.