There are two possible causes for the pain in both cheeks: 1. It could be localized mumps. It is usually caused by herpes virus infection, with one or both parotid glands appearing red, swollen and painful, and the local enlargement is very obvious, accompanied by skin flushing and skin temperature increase. The diagnosis can be confirmed by a local ultrasound or a blood test that shows elevated blood amylase. 2. The lymph nodes in the cheek area are enlarged. The most common is acute pharyngitis, tonsillitis or other upper respiratory tract infections, and the infected bacteria or viruses invade the lymph nodes in both cheeks, resulting in swelling and pain in the lymph nodes, which can usually be felt as hard, granular objects, and painful when pressed. These hard objects are usually mobile and can also be diagnosed by local ultrasound.