Trigeminal Neuralgia is a painful condition affecting the nerves in the face. It’s also called tic douloureux. The human body has 12 pairs of cranial nerves that pass through small holes at the base of the skull. These nerves relay information from the brain to various parts of the body. In this post, I’ll uncover what triggers trigeminal neuralgia.
The trigeminal nerve is the fifth pair of cranial nerves that run down each side of the head. It’s responsible for facial sensations, and motor functions, such as biting and chewing. Intense pain can result from disorders in the trigeminal nerve. Sufferers describe the pain as electrifying, sudden and sharp. Bouts of pain often lead to anxiety because the person is always anticipating and dreading the next attack.
Table of Contents
The Facial Nerves
As its name connotes, the trigeminal nerve is made up of three branches, also referred to as divisions:
1. The ophthalmic nerve: is purely sensory and involves the eye, upper eyelid and forehead.
2. The maxillary nerve: is also primarily sensory, affecting the lower eyelid, upper lip and gums, cheek, and nostrils.
3. The mandibular nerve: is both sensory and motor, and controls movement in the jaw, lower lip area and gums.
Typically, disorders of the trigeminal nerve affect only one side of the face, however this isn’t always the case. Bilateral trigeminal neuralgia is a condition where pain is felt on both sides of the face. The location of the pain depends on which of the three nerves is affected.
Trigeminal Neuralgia Pain
Pain caused by trigeminal neuralgia is not your garden-variety type of pain. In fact, this type of facial pain can be so severe that it’s actually referred to as The Suicide Disease. Before effective treatment options became available, people with this condition would resort to suicide to escape the unrelenting pain.
The short-circuiting, or firing, of the nerve is what causes the intense pain. Some patients have equated the unbearable pain to that of a screwdriver being rammed into the side of their face. Because the pain is so severe, it must be treated. This isn’t the type of pain that can be put on the back burner and dealt with later.
- Pain comes on suddenly
- Is described as electrifying and shocking
- Pain is described as sharp, stabbing and burning
- Can be unrelenting and severe
- Common pain medications are not sufficient for people suffering from TM
- Usually involves only one side of the face, with pain concentrating in the cheek, jaw, teeth and lips
- First-division pain in the forehead and eye area occurs less often
- Pain may last for only a few seconds but could last for several minutes, an hour, or even be constant
- Can be triggered by simple activities like applying makeup or brushing your teeth. Eating, chewing, laughing, and even, excessive talking are all potential triggers
- Pain may worsen over time, with the attacks happening more frequently
- Remission can occur where no pain is felt for a period of time
What Triggers Trigeminal Neuralgia?
The most common cause for this type of neuralgia is pressure on the trigeminal nerve caused by a neighboring blood vessel. As we age, our arteries elongate, creating possible contact with nerves. This contact can degrade the myelin sheath surrounding the nerve fibers. Myelin sheath is crucial as it insulates nerves.
Without this protective coating, nerve fibers can short-circuit and cause the pain associated with TN. This is why trigeminal neuralgia is most often seen in people over 50. Interestingly, women are affected more than men, with elderly women being at the highest risk. Those suffering from this type of neuralgia may initially believe their pain to be the result of previous dental procedures.
Many people desperate for relief will get root canals and teeth extracted, hoping to get to the underlying cause of their pain. Dental problems should be ruled out as a likely cause. Neuralgia pain can also resemble the discomfort associated with an abscessed tooth. If you’ve ever experienced an abscess, you know how painful it is. This gives you a glimpse into the severity of the pain trigeminal neuralgia can cause.
Myelin Sheath Damage And Viruses
More serious causes of TN could be related to myelin sheath damage incident to multiple sclerosis. A tumor pressing on the nerve is a less-likely cause, but one that should be ruled out, as should any kind of facial trauma resulting from an injury, accident or any surgery involving the mouth or sinuses.
Injury to the trigeminal nerve itself should be investigated, as well as the possibility of stroke. An MRI is a valuable diagnostic tool in these cases. Viruses that lie dormant in the nerve root are also implicated in TN. Viruses can become active when the adrenal glands are stressed.
The take home message here is to address your adrenal health in order to put the virus back into remission. Another condition that is associated with a dormant virus that has become activated is shingles. Click here to read about one of my favorite adrenal support supplements.
[Read More: Retroviruses and Their Correlation to Cancer]
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Pain Relief
Trigeminal neuralgia is a condition that can’t be ignored, that’s how debilitating the pain can be. Medical treatments include Tegretol, which can suppress the pain entirely in some people. Like any medication, there are side effects, and higher doses are needed over time to suppress the pain. Lyrica and Dilantin are other prescription options. High doses of Dilantin are used to treat unrelenting acute pain that needs to be addressed immediately.
The downside to prescription meds is they may stop working over time, resulting in the need for higher and higher doses, with increasingly more side effects, including memory impairments, dizziness, and an unsteady gait. At this point other alternatives should be considered.
Microvascular Decompression
A micro neuro-surgical procedure called microvascular decompression (MVD) is one such option that has proven helpful in many cases of TN. A small opening in the skull is made to determine which artery is pressing on the trigeminal nerve.
The pressure on the nerve is relieved by moving the blood vessel aside, and placing a pad to ensure that no further compression occurs in the future. The affected nerve can then heal and the myelin sheath regenerate. The majority of patients obtain complete relief after surgery, however pain can return in a small percentage of people.
Gamma Knife Treatment
Gamma knife treatment is a form of focused radiation therapy that uses a laser beam to target and radiate the trigeminal nerve to diminish sensation. Radiating the nerve stimulates a healing process to gradually restore the insulation on the nerve fibers. Pain relief is not immediate and may take a few weeks to notice a difference. Gamma knife treatment is a non-invasive treatment method that can be done on an out-patient basis.
Sadly, the numbness that is created via radiation, while providing welcome relief from the pain, may lead to permanent numbness. Pain may return in up to half of patients opting for this type of treatment, however they may enjoy relief for years before the pain returns. Procedures for trigeminal neuralgia are also available where needles are inserted into the face to heat or compress the nerve using a micro-balloon. While these techniques don’t carry the risk associated with surgery, recurrence of pain can be quite high.
Check out this book: “Acupuncture and Moxibustion for Primary Trigeminal Neuralgia”
Complementary Therapy Options
Complementary treatments like homeopathy, acupuncture, and meditation may prove helpful in conjunction with medical treatments. Trigger-point therapy, also called pressure-point therapy, is also worth trying. Pressure is applied to the non-affected side of the face during this type of therapy. A measure of relief can often be obtained by massaging the nerve branch on the opposite side of the affected area. However, this technique must be done at the first sign of pain or discomfort for it to be effective.
Key Points
If you are experiencing sudden, intense and debilitating pain on one side of your face, that is concentrated in your cheek or jaw area, schedule an appointment with your doctor to determine if you have trigeminal neuralgia, and to consider your treatment options.
Have you experienced the pain of trigeminal neuralgia? Let me know in the comments:)
References:
(1) NCBI: Trigeminal Neuralgia
(2) NCBI: Trigeminal neuralgia and its management
(3) PubMed: Trigeminal neuralgia – diagnosis and treatment
(4) National Institute of Neurological Disorders and Stroke
(5) News Medical Life Sciences: Trigeminal Neuralgia News And Research
(6) Science Daily: Prospect for more effective treatment of nerve pain
(7) Neurology: Trigeminal neuralgia: New classification and diagnostic grading for practice and research
(8) Nature Reviews Neurology: Trigeminal neuralgia linked to demyelination in multiple sclerosis
(9) SDS Journal: Trigeminal neuralgia: case report and literature review
(10) The Facial Pain Research Foundation: Pain Through Pandemic Living with Trigeminal Neuralgia during COVID-19
Disclaimer: This article is strictly for informational purposes only and is not intended to be medical advice.
Hi, your post on symptoms and treatment for Trigeminal Neuralgia is educational, and your research is helpful. Presently, I do not have Trigeminal Neuralgia, but regarding your post, I have a friend who is experiencing it. I will share your post on my social media feeds so that people who have it can learn about it.
Thanks for sharing my post and for taking the time to comment. Trigeminal Neuralgia is a painful condition and the more people that can learn about it, the better.
I have never heard of Trigeminal Neuralgia, before. This sounds just awful. Reading the symptoms and signs of this condition I can see why people right away think it’s a dental issue. It is astonishing how a nerve issue can be so debilitating. The amount of pain that is causes sounds horrible.
I really enjoyed reading this post and learning about something new. You have really opened my eyes to this condition. Thank you and great job.
Hi Coralie,
Trigeminal Neuralgia can be debilitating and yes, it’s not surprising that people initially think it’s a dental issue. Nerve pain can be excruciating. People who have this condition, truly suffer. Fortunately, there are strategies that can be employed to mitigate the pain.
Thanks so much for reading!
I am a trigeminal neuralgia patient. And I must say, your information is pretty accurate. The pain is indescribable. When I have what I call a “flare”, I’m in bed with a heating pad and about 4 different medications to try and get rid of it. When everything fails (happens a lot) I end up in the emergency room. I actually have one of the rarest cases seen. I have bilateral trigeminal neuralgia 1, 2, and 3.
#tnwarrior
Hi Elizabeth,
Thanks for reading and commenting on my article. I am soooo sorry that you have had to deal with trigeminal neuralgia. I have never experienced it so have no idea the degree of pain that you’ve experienced. That’s heartbreaking that you’ve ended up in the emergency room. I can’t imagine. Have you tried homeopathy or acupuncture?
Wow, that is something I do not want to experience; I’d have been in a panic, had I all of a sudden, felt like an electrical shock was running down my face. I’d be afraid to try the meds, though, simply because the cost of the side effects seem as debilitating as the pain. Meds would be a final resort, I’d probably try Gamma Knife or alternative methods first and hopefully they would work.
Hi Todd,
Yes, for sure, you do not want to experience the debilitating nerve pain of trigeminal neuralgia. It’s a miserable condition. Medications do come with side effects, which definitely has to be taken into account when choosing treatment options.
Fortunately, people can have favorable outcomes with some of the alternative and conventional treatments I talked about in my post. Thank you for reading!
I have not experienced this type of pain, nor am I aware of any associates of mine suffering either. The first thing I wondered if this has any relationship with Bell’s Palsy. But that is caused by some kind of trauma to the seventh cranial nerve, not the fifth. Both my father and sister had Bell’s Palsy, which doesn’t seem to have the same pain element as Trigeminal Neuralgia.
You had mentioned some relief from acupuncture. I’m wondering if chiropractic procedures would be of some assistance as well, perhaps an adjustment relieving pressure on the nerve. My final thought is whether this might be a prime disability that stem cell therapy may offer some relief for.
There may even be a double benefit since the needles used in injecting stem cells sometimes could give an acupuncture benefit in the short term while the stem cells start their regeneration process. This process has been successful with other painful issues in the neck area, as well as inflamed joints, etc.
Hi Mike,
I’m not aware of Trigeminal Neuralgia having a relationship with Bell’s Palsy. I knew a woman who had Bell’s Palsy, and although disfiguring, it wasn’t painful, and from what I understand, it is often temporary. I didn’t know it stemmed from a cranial nerve as well. Very interesting.
Acupuncture is apparently supposed to bring some relief, and I wouldn’t be surprised if chiropractic adjustments would also be helpful to if pressure on the nerve can be relieved I’m only somewhat familiar with stem cell therapy for Trigeminal Neuralgia. That makes sense that injection of stem cells could give an acupuncture benefit.”“Here’s an interesting article on Trigeminal Neuralgia and stem cell therapy. Thanks so much for reading and for your insightful comment!
Thank you!
Very helpful, great, and insightful, article. Your article even triggered me to research further on other parts of the nerve system and it makes me realize how our nerve system works amazingly.
I am actually one of those who are experiencing this. The pain is excruciating. The length of the pain is somewhere between 5 to 10 sec or less in my case, thus far. It could be triggered by any normal daily activities such as when I brush my teeth, wash my face (even with very light touching), chewing or even when I talk or am yawning. The pain is short, sharp, like electric pulse that electrifies my upper left corner (above my eye brows). Throughout reading online I believe my scenario is on the first branch – Ophthalmic – and exclusively temporal branch I believe. (it is not painful on lower jar or in the cheek area, that’s why I believe it only affects my V1 area (no V2 or V3). Went to see specialist few months ago, took MRI, it seemed to be going away for a short period of time and I thought that it was ok but now the symptoms seem to come back. As a matter of fact I’ve already made appointment to see my specialist again. Your article further confirmed my findings and it’s helpful that it sheds some more info about other alternative (therapy) treatment etc. I am not always a big fan of medication treatment (afraid of long term side effect unless it’s the last resource) so I will try these massage and other therapy technique in the meantime.
One thing they say about this issue occurs mostly on female, above 50 and I am actually a male.
Thanks again for your article.
Hi Johnny,
Thank you so much! I’m glad you learned something from my article. I’m really sorry to hear about your nerve pain. It’s definitely one of the worst kinds of pain. I hope your specialist can give some ideas for relief. I’m with you – I’m not a fan of medication either. Too many side effects and prescription drugs lower the body’s energy. Best of luck to you. I appreciate you taking the time to leave a comment:)
Thank you so much for this article. About six weeks ago I suddenly had pain in my teeth and at first I thought I was having dental issues. The pain quickly spread to all of my teeth in the left side of my mount and my jaw, cheek, and even my temple. It lasted over 24 hours. I thought it was just a fluke thing until it happened again 2 weeks later on the same side of my face. It happened again last night but only lasted an hour. It’s returned again tonight going on the third hour. Always the left side. Ten years ago I had a brain aneurysm and had a titanium clip placed around it, positioned at the base of my brain. The incision is on the left side of my skull and I’ve had weird facial pains ever since but not as severe and long lasting as what I am experiencing now. I debate going to the ER every time it occurs but I’m afraid they won’t believe me. I have a telegraph appointment with my GP tomorrow and I really hope she has experience with this…reading this article has been so helpful so thank you again!
Hi Germaine,
That’s quite an experience you’ve had. I’m so sorry for your pain. Nerve pain is definitely the most exquisite, and it sounds like it could possibly be trigeminal neuralgia. I understand your issue about going to the ER with each occurrence. Crossing my fingers for you that your GP has experience with what you’re going through, and specifically trigeminal neuralgia. Please do keep me posted on your progress. Thank you so much for comment. God bless!