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Treatment For Trigeminal Neuralgia

Treatment For Trigeminal Neuralgia

Trigeminal Neuralgia is a painful condition affecting the nerves in the face. It is 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 explore the treatment for trigeminal neuralgia.

girl with pain in cheek

The trigeminal nerve is the fifth pair (CN V) among the 12 pairs of cranial nerves, and is the largest. Running down each side of the head, this nerve is responsible for facial sensations, and motor functions, such as, biting and chewing. Pain results from disorders in the trigeminal nerve, and can be intense. Sufferers describe the pain as electrifying, sudden, and sharp. These bouts of pain often lead to anxiety because the person is always anticipating the next attack. In this post, I will explore the treatment for trigeminal neuralgia.

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 – this nerve is purely sensory and involves the eye, upper eyelid and forehead.

2. The maxillary nerve – this nerve is also purely sensory, affecting the lower eyelid, upper lip and gum, cheek, and nostril.

3. The mandibular nerve – this nerve is both sensory and motor, and controls movement in the jaw, lower lip area and gum, and controls chewing.

Typically, disorders of the trigeminal nerve affect only one side of the face, however, this isn’t always the case, and pain is felt on both sides in a condition called bilateral trigeminal neuralgia. The location of the pain depends on which of the three nerves is affected.

Cranial nerves chart

Trigeminal Neuralgia Pain

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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 is actually referred to as The Suicide Disease. Before effective treatments became available, people with this condition would resort to suicide to escape the unrelenting pain. The firing, or short-circuiting, of the nerve is what causes the intense pain. In fact, some patients equate the unbearable pain with that of a screwdriver being rammed into the side of their face.

Due to its severity, the pain from Trigeminal neuralgia must be treated. It’s not something 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
  • Typically involves only one side of the face with the pain concentrating in the cheek, jaw, teeth and lips
  • First-division pain, in the forehead and eye area, occurs less often
  • 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 teeth brushing. Eating, chewing, laughing, and even, excessive talking are all potential triggers
  • Trigeminal nerve pain may get worse over time with the attacks happening more frequently
  • Remission can occur where no pain is felt for a period of time

Common Causes Of 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 nerves. This contact can degrade the myelin sheath surrounding the nerve fibers. This myelin sheath is crucial, in order to, insulate the nerve.

Without this protective coating, the nerve fibers  short circuit causing 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, initially, may believe their pain to be associated with dental procedures. Some sufferers will even get root canals and teeth extracted, thinking it to be the 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 in trigeminal neuralgia.

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More serious causes of TN could be related to myelin sheath damage typical of 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 in the case of a stroke. An MRI would be a good diagnostic tool in these cases. Viruses that lie dormant in the nerve root are also implicated in TN.

Viruses become active when the adrenal glands become stressed. Address your adrenal health to put the virus back into remission. Another condition that is associated with a dormant virus that has become active is shingles.

Here is one of my favorite adrenal support supplements.

Treatment For Trigeminal Neuralgia Pain


This is a condition that cannot be ignored as the pain can be debilitating. 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 to consider. IV doses of Dilantin are used to treat acute pain, so unrelenting, it must be treated immediately.

The downside to prescription meds is they may stop working over time, resulting in higher and higher doses, and more and more side effects, including memory impairments, dizziness, and an unsteady gait. At this point other alternatives should be considered.

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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 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 often returns in a 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. The now-injured nerve has diminished sensation. Radiation to the nerve stimulates a healing process, restoring the insulation on the nerve fibers over time. Pain relief is not immediate, and may take a few weeks to notice a difference. This is a non-invasive treatment method that can be done on an out-patient basis.

The numbness created by this procedure, while providing welcome relief from the pain, may lead to permanent numbness.  Unfortunately, pain often returns in up to half of patients after a few years.  Procedures 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 is quite high.

Check out this book: “Acupuncture and Moxibustion for Primary Trigeminal Neuralgia”

Alternative Therapy Options

Alternative treatments like homeopathy, acupuncture, and meditation may prove helpful in conjunction with medical treatments. Trigger-point therapy is worth trying. Also called pressure-point therapy, pressure is applied to the side of the face not affected by pain. Often, a measure of relief can be obtained by massaging the nerve branch on the opposite side of the affected area. Do this technique immediately at the first sign of pain or discomfort.

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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, visit your doctor to determine if you have trigeminal neuralgia, and to consider treatment options.

Have you experienced the pain of trigeminal neuralgia? Let me know in the comments:)



8 thoughts on “Treatment For Trigeminal Neuralgia”

  1. 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. 

  2. 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!

  3. 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!

  4. 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” >Here’s an interesting article on Trigeminal Neuralgia and stem cell therapy. Thanks so much for reading and for your insightful comment! 


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