Objective To explore the effect of short-wave physiotherapy instrument with different power levels on patients with hemifacial spasm and its effect on pain degree and spasm improvement. Methods From October 2021 to December 2022, 30 patients with facial inflammatory diseases treated with short-wave physiotherapy instrument in Sanshui District Institute for Disease Control and Prevention of Foshan City were selected as the research objects. According to the random number table method, they were divided into group A, group B and group C, with 10 patients in each group. Group A was given a power of 10 W gear, group B was given a power of 20 W gear, and group C was given a power of 30 W gear. The pain degree, facial spasm intensity and quality of life of the three groups were compared. Results The VAS score of group C was lower than that of group A and group B after the 8th, 16th and 24th treatment and the first month after the end of all treatment (P <0.05), but there was no significant difference in VAS score among the three groups at 3 and 6 months after the end of treatment (P >0.05). The score of facial spasm intensity in group C was lower than that in group A at and 3 months after treatment (P <0.05), but there was no significant difference in the score of facial spasm intensity among the three groups at 6 months after treatment (P >0.05). The DLQI score of group C after the 8th, 16th and 24th treatment and the first month after the end of all treatment were lower than those of group A (P <0.05), but there was no significant difference in DLQI score among the three groups at 3 and 6 months after the end of treatment (P >0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P >0.05). Conclusion The application effect of short-wave physiotherapy instrument in patients with hemifacial spasm is exact. The treatment effectiveness and safety of the three power levels are high, but the power 30 W level has better effect on improving pain degree and facial spasm in the short term, which is conducive to improving the quality of life of patients.