Trigeminal neuralgia is also known as TGN or TN. It’s a chronic pain disorder that targets the trigeminal nerve. The trigeminal nerve is one of 12 cranial nerve pairs on the head. There are three branches that make up the trigeminal nerve:
- Ophthalmic Nerve (V1)
- Maxillary Nerve (V2)
- Mandibular Nerve (V3)
These are the nerves responsible for the sensory messages between your brain and your face. They are also linked to the muscles that are responsible for chewing and swallowing food.
If you are suffering from trigeminal neuralgia, you will feel pain from the mildest of facial stimulation. Something as simple as putting on makeup, washing your face or brushing your teeth can trigger a lot of pain. At times it gets so bad, even wind blowing on your face can be painful. Trigeminal neuralgia patients describe the painful sensation as a shock-like, electric or stabbing pain. The pain is so intense, it can be mentally and physically incapacitating, making it one of the most painful experiences you can ever endure.
This disorder can affect one or more of the nerve branches mentioned above. More often the pain is restricted to one side of the face, and it often affects the jaw and the lower face. There are rare cases where it can affect both sides of your face, and at different times, or at the same time in the case of bilateral trigeminal neuralgia.
Classic or typical trigeminal neuralgia, also abbreviated as TN1 or Type 1 causes sudden, sporadic and extreme pain on the face, with each episode lasting a few minutes or seconds. The attacks happen in speedy succession and can last a number of hours.
Atypical trigeminal neuralgia, abbreviated as TN2 or Type 2 is more prolonged. The aches are constant, though the pain has a lower intensity than typical trigeminal neuralgia. It is also possible to experience both types of trigeminal neuralgia simultaneously.
You can experience the painful attacks infrequently, with some people going for months or even years before they feel the pain. In some cases, the pain is chronic and affects the ability of the patient to go about their normal activities. This can easily spiral down into depression. The attacks start off as short and mild attacks, but over time, they progress into frequent soaring painful bursts.
Every year, hundreds of thousands of people are diagnosed with trigeminal neuralgia. This disorder can happen to anyone at any age but is reportedly more common in individuals who are over 50 years of age. Apart from that, women are more predisposed to experiencing trigeminal neuralgia than men. In recent years, scientists have conducted research in an attempt to identify some of the causes of trigeminal neuralgia, and there is a very high likelihood that some of the cases can be genetically inherited. Some of the common risk factors for trigeminal neuralgia include multiple sclerosis and hypertension.
Currently, there are so many treatment options that are available for trigeminal neuralgia. As a result, you do not have to feel condemned to a lifetime of excruciating pain when you have this disorder.
Trigeminal Neuralgia Causes
Trigeminal neuralgia can be associated with a lot of conditions. Generally, trigeminal neuralgia is an idiopathic condition. This means that there is no known cause. The disorder starts with pressure on your nerves. This irritates the nerves and in the long run, they misfire.
Damage to the myelin sheath that protects the nerves is one of the possible causes of trigeminal neuralgia. This can happen as a result of normal aging, or in other cases, when you suffer from diseases like multiple sclerosis.
You can also endure damage to the trigeminal nerve in the aftermath of a stroke, surgery or in most cases an accident. Thy rare cases of this happening, but it is also possible to get trigeminal neuralgia when a tumor compresses on the trigeminal nerve.
Trigeminal Neuralgia Symptoms
The most obvious sign of trigeminal neuralgia is a sharp, stabbing pain persistent on one side of your face. In most patients, this pain starts out of nowhere and is spontaneous. The pain is too severe, and even the lightest of touches can make it worse. It is important to note that the pain bouts that are associated with trigeminal neuralgia barely ever happen at night when you are asleep. This is one of the simplest ways of telling it apart from migraines. Migraines can be so painful and might even wake you up when you were deep asleep.
Initially, you might endure just a single painful attack. However, over time the pain might persist every few hours after the first attack, and at times the attacks are seconds apart. Between each attack, you might not experience any symptoms, because the pain can even resolve completely.
It is possible to notice subsiding pain over time, especially if your disorder persists for months or years. However, this disorder recurs without any warning, so it might be difficult to make preemptive-preventive measures.
Unfortunately, this is a progressive condition. Over time, the pain attacks get worse, and the duration between the attacks when you are not feeling any pain become fewer and last a shorter time.
It is possible to confuse trigeminal neuralgia with a dental problem, especially since the pain usually starts in the jaws. As a result, there are patients who have in the past gone for root canals in an attempt to get relief for a problem that they do not have, only to realize later on after seeing a specialist upon persistent pain, that they do not have a dental problem.
The following are some of the patterns that you might experience as symptoms of trigeminal neuralgia:
- Localized pain in the gums, teeth, jaws, cheeks, and lips. In rare occasions, you can feel pain on your forehead and in the eyes.
- Severe jabbing pain for a brief period, that feels like an electric shock
- Constant burning or aching pain sensation
It’s important to note that trigeminal neuralgia is not a life-threatening or fatal disorder, but the pain can be so debilitating it will affect the way you live your life. A lot of the patients end up not being able to control the facial twitching they experience. More often, they end up twitching to the point where the face forms a steady grimace.
A lot of patients who have had trigeminal neuralgia for a long time end up suffering depression and anxiety, afraid that the pain might return. This level of uncertainty even pushes some patients to stop or avoid some of the activities that they often engage in on a daily basis. The fear of unknown and sudden attacks also makes people tend to run away from normal social interactions.
Diagnosing Trigeminal Neuralgia
A diagnosis of trigeminal neuralgia will often depend on the medical history of the patient, and the way the symptoms manifest in them. Other than that the doctor will also put the patient through neurological and physical examinations. There are lots of conditions that might be responsible for facial pain. Therefore, the symptoms that you feel might not be easy to point unto one condition. Because of this reason, it can be difficult to get a correct diagnosis of trigeminal neuralgia. The description of the location, type of pain and what triggers the pain might make it easier to identify the problem as trigeminal neuralgia.
There are tests that are used to diagnose and rule out other possibilities, making the conclusion that you have trigeminal neuralgia.
Physical Examination. This is a situation where the doctor will ask you questions about the specific symptoms you are experiencing, in order to see if they correlate with trigeminal neuralgia.
Neurological Examination. In this case, the doctor examines and touches different parts of your face so they can locate the part where the pain is localized. This will also help them identify the branches of the nerves that have been affected.
The doctor will also conduct reflex tests so that they can tell whether the symptoms you are experiencing are as a result of nerve compression or any other condition that you might not be aware of.
Magnetic Resonance Imaging (MRI). You will be subject to an MRI scan. This scan helps the doctor determine whether you have a tumor or multiple sclerosis, which might be the reason behind your trigeminal neuralgia. It might not be very easy to see a blood vessel that is close to the nerve root, even if you use the best quality MRI scans. These scans are very helpful only when you have a tumor or multiple sclerosis. Otherwise, the scan will barely ever reveal the real reason behind your irritation.
In some cases, you do not need testing to diagnose trigeminal neuralgia. In the course of a physical examination, the doctor will discuss your medical history. The doctor will know you have trigeminal neuralgia when you shield your face to protect it from touch. This reflex action is often considered one of the most important diagnostic indicators because, in most of the cases where you might experience pain like having a toothache, you tend to hold your face or rub the affected part in order to relieve the pain. However, with trigeminal neuralgia, you will be trying to avoid even the lightest possible touch.
Treatment for Trigeminal Neuralgia
There are different methods of treating trigeminal neuralgia. The first course of action is to get medication. In some cases, patients will only use the medicines provided and they will feel better. Over time, however, there are patients whose bodies adapt and no longer respond to the medicine. In fact, in some rare instances, the patients developed dire side effects. In such scenarios, the possible course of action is surgery or injections to ease the pain and attempt to restore normalcy.
The problem with surgery for trigeminal neuralgia is that it may or may not succeed. The periods where you enjoy freedom from pain after surgery might also vary from one person to the other. In fact, there are some patients whose surgeries even made their situation worse and had to endure a lot more pain than they had before.
In the event that your trigeminal neuralgia is caused by an underlying condition like multiple sclerosis, the best way to treat it is to treat the underlying condition. This should be the primary focus of attention, and perhaps use pain management mechanisms at the same time.
Radiofrequency thermal lesioning is another procedure that is used to destroy the nerve fibers that are linked to the pain you are feeling. It is done under sedation. The doctor inserts a needle through your face, guiding it to the part of the trigeminal nerve that passes through an opening at the base of the skull. With the needle safely in place, you will be woken up from sedation. The doctor inserts an electrode that sends an electrical current to the nerves. You have to be awake for this to indicate where you feel the tingling sensation. Once the doctor determines the part of the nerve where you feel the pain, you are sedated again. The doctor heats the electrode until the nerve fibers are damaged. In case the pain persists, the doctor will have to create more lesions.
Glycerol injection – The doctor inserts a needle into an opening at the base of your skull through your face. The needle is guided to the trigeminal cistern where the doctor injects sterile glycerol. This blocks pain signals by damaging the trigeminal nerve.
Balloon compression is another method that has been successful in controlling pain for most people. You will feel transient facial numbness for a while.
Trigeminal Neuralgia Medication
The drugs that are administered for trigeminal neuralgia are supposed to block pain signals or reduce the pain signals that are sent to your brain.
These include the following:
Antispasmodic Agents. These are muscle relaxers that can either be taken in isolation or taken with anticonvulsants
Anticonvulsants. These medicines prevent your nerves from reacting to irritation
Botox Injection. Studies have been carried out in the past, which indicate that Botox injections can help you get pain relief from trigeminal neuralgia, especially if you have tried using medicine and failed. There is still a lot of research going on in this field.
Alternative Trigeminal Neuralgia Treatments
Given the side effects that are often associated with normal medicine, there are research scientists and traditional medicine enthusiasts who have in the recent past advocated for complementary techniques in managing trigeminal neuralgia. These techniques will, in most cases, be used alongside the normal medicine you are given by a physician. Before starting on any alternative treatment procedure, it is advisable that you consult a doctor so that they can advise you on the contraindications of the method you are about to start using. Besides, the alternative therapies for trigeminal neuralgia all have different success levels and may or may not work well for you as they have done for someone else.
To promote their well-being, some patients consider low impact exercises, meditation, yoga, aromatherapy, and creative visualization. Some of the other options that have brought success for patients include nutritional therapy, vitamin therapy, biofeedback, upper cervical chiropractic, and acupuncture. It is also possible to enjoy minor pain relief after having a botulinum toxin injection. This injection blocks the sensory nerves so you do not feel the pain.
You will notice that over time, the medicines and alternative treatments that you use for trigeminal neuralgia become ineffective. In such a scenario, you should think about surgical procedures. The success of a surgical procedure to treat trigeminal neuralgia will depend on your preference, the nature of pain you are feeling, your physical health and whether or not you have had other surgeries in the past. The doctor will walk you through these and other options that you have before you proceed, so you have all your options laid bare.
Surgery for Trigeminal Neuralgia
Surgery for trigeminal neuralgia can be carried out as an outpatient procedure. In complex situations, you might need general anesthesia for this. You will feel numb on your face for a while. Sadly, even if the surgery was a success, there is always a chance that your trigeminal neuralgia might recur after a while.
There are different types of surgical procedures that can be used to treat trigeminal neuralgia. These include the following:
Gamma Knife Radiosurgery. Here radiation is used to focus on the trigeminal nerve
Microvascular Decompression. This is a procedure used to remove or move blood vessels that are interfering with the nerves
Rhizotomy. A process where the nerve fibers are destroyed. There are different ways of going about this, so talk to your doctor about it for proper understanding.
Home Remedies for Trigeminal Neuralgia
To help you manage trigeminal neuralgia, you do not always have to use conventional medicine. There are lots of home remedies that you can use. Most of these might already be in your kitchen. As a precautionary measure, it is advisable that you consult your doctor before you start using any of these remedies. This is to enable them to look at your medical history, the remedies you plan on using, and advise you on the best course of action, especially to fend off the possibility of an allergic reaction.
Modify Your Diet. You should include lots of monounsaturated fatty acids in your meal plans. These fatty acids are useful in efficient metabolism and as a result, they help reduce inflammation. They are present in natural foods like grapeseed oil, avocado, nuts, corn oil, sesame oil, groundnut oil, hazelnuts, canola oil, peanuts, cashews, and almonds.
Omega-3 fatty acids will also help you strengthen your trigeminal nerve, alongside other cranial nerves. There are a lot of fruits and vegetables that contain Vitamin B and the Omega-3 fatty acids that you need. These include parsley, legumes, kale, mint, pumpkin seeds, flaxseed, walnuts, oatmeal, yogurt, soymilk, juice, milk, eggs, leafy greens, cheese, whole grains and so forth.
Another group of foods that you need to include in your diet is Vitamin A foods, like mangoes, parsley, tomatoes, sweet potatoes, apricots, broccoli, cabbages, carrots and frozen peas. They will help you boost your immune system.
Ashwagandha Oil. This oil can be applied to give you relief from the pain you are feeling. It has good anti-inflammatory properties that go a long way in providing relief when you need it. Other than that, it also has antioxidants that make you heal faster, by supporting your immune system. This oil has been used in so many homeopathic cases as a sedative, therefore it will also induce a sensation of calmness in your nervous system.
Rosemary. One of the main reasons why rosemary will be useful when you are suffering from trigeminal neuralgia is its analgesic properties. It will help you get pain relief. It has unique properties that strengthen your nerves, which makes it a good option when struggling with trigeminal neuralgia. Apart from that, rosemary is also an antioxidant, which acts to support your immune system, making you heal faster. It is a nerve sedative, so it makes your nerves calm down, providing anxiety relief in the process. Even when suffering from a traumatic experience, applying rosemary can help you calm down. You will get the same benefits when you take rosemary tea. However, as a precautionary measure, pregnant women are advised to avoid taking rosemary in any form.
Avocado Carrot Juice. This is a blend of two juices that are very healthy and loaded with nutrients and minerals that your body needs. From this blend, you will receive important nutrients that provide relief from neuralgia. Avocado is a known source of Vitamins B3, B5, and folic acid. Carrots, on the other hand, are a good source of Vitamins B6, B5, B1, B2, C, A and folic acid.
One of the roles of thiamin (Vitamin B1) is the maintenance of your nervous system. Other than that, it also helps you by encouraging normal, healthy brain activity, and memory boost. Niacin (Vitamin B3) also has a maintenance function and supporting hormone synthesis. It also serves the body as an antioxidant.
Pantothenic acid (Vitamin B5) produces the steroid hormones. Vitamin B6 helps in keeping your nervous system functioning well and strengthens your immune system. The role of folic acid in the body is to maintain the immune system and prevent defects in the neural tube. Vitamin C helps in the production of stress hormones. Finally, Vitamin A helps your body by making your immune system heal faster. Together, all these nutrients go a long way in making sure that your nervous system is working accordingly, and your immune system has all the support it needs to get stronger and keep you healthy.
Almond Milk. When you are suffering from trigeminal neuralgia, one of the best options you have is drinking almond milk. This milk provides a lot of nutrients that you need in fighting trigeminal neuralgia. Instead of buying packaged backs, you will be better off preparing your own almond milk, especially if you are to enjoy the full benefits that almonds have to offer. It is one of the best sources of Vitamin B (Riboflavin).
Riboflavin is important in the body, given that its absence affects your body’s ability to absorb iron. Almond milk also has Vitamin B3, whose role includes hormone synthesis and antioxidant properties, among other roles.
Almond milk also contains biotin. Biotin helps in maintaining a good health. This milk is also a good source of other useful minerals and nutrients such as potassium, iron and Vitamin E, which is tasked with keeping the body safe from neurodegenerative diseases. To sum it up, almond milk has a direct positive impact on your nervous system and will help you heal faster, making it one of the best remedies you should consider when you have trigeminal neuralgia.
Cayenne Pepper. This is an ingredient that is common in a lot of kitchens, but we barely know how or when to use it to our advantage. Take a pinch and mix together with some olive oil. Cayenne pepper contains capsaicin. This is an active agent that helps your system block pain by reducing the content of Substance P, a chemical that sends pain signals between your nerves.
However, in case you tend to bleed easily, or your body is extremely sensitive to cayenne pepper, you should avoid it completely. Olive oil in the mixture has moisturizing properties, which allow the mix to get deeper into your skin. This blend has lots of antioxidants, which will help you heal faster and boost your immune system. Other than that, it also has anti-inflammatory properties which will help you get relief from trigeminal neuralgia by reducing inflammation.
Relaxation. You should find out the things that make you calm down and try to do them often. This is aimed at helping you reduce stress and anxiety. Consider getting some hobbies to help you relax, or anything that might improve your concentration. Anything that can calm down your nerves or help you be creative and take the focus away from your nerves will be helpful in dealing with trigeminal neuralgia.
Compress. Get ice packs or heat packs and place them over your jaws. This can help you get immediate relief. A compress works by soothing the muscle ache.
Foods You Should Avoid
Most people do not know this, but there are some foods that might make you feel more pain. The trigeminal nerve and the associated fibers are important in all sensations you feel on your face. For this reason, any type of food that induces a change in your mouth can be a trigger for pain. Some of the foods that are included in this category are foods that induce cold, sourness, sweetness and heat. Therefore, you should stay away from mint, hot sauce, salsa, and chili.
Foods with sharper sensations are more likely to activate signals that set off pain triggers. There are people who have even recorded problems with spices like nutmeg, ginger, black pepper, and cinnamon. In case the nose is your primary trigger zone, you might struggle when eating foods that have a very strong odor, or steamy foods.
It is important to note that the type of pain you feel is an individual concern. Therefore, the things that stimulate pain on your face might not necessarily stimulate pain on someone else’s face or make them feel the same way you do. There are people who experience reduced pain when they stop taking soft drinks, chocolate, tea or coffee.
Some foods that you should be wary of are those that contain trans fats, saturated fats and anything else that has a high glycemic index. These are foods that stimulate inflammation. They produce a lot of saturated fats which hinder the body’s ability to repair the nerves damaged in your face. Therefore, you should consider staying away from ghee, butter, suet, lard, tallow, cottonseed oil, coconut oil, palm kernel oil and dairy products.
Potatoes, beer, rice, white bread, cake, soft drinks, commercial creels have a high glycemic index, so you should avoid these too. Apart from the food you eat, a lot of trigeminal neuralgia patients experience pain as a result of environmental changes, food, engaging in different activities and so forth. There are no specific dietary requirements to relieve neuropathic facial pain. However, you need to be very keen on the things that cause you pain, so you can cut them out of your schedule altogether.
Living with Trigeminal Neuralgia
It is not easy living in constant pain, so people who live with trigeminal neuralgia do not have an easy experience. The pain associated with trigeminal neuralgia is intense, chronic and the patients can often feel depressed or isolated.
The fact that you might even be forced to shy away from social interaction can subdue an individual that was once cheerful and bubbly and turn you into a loner. Other than that, the pain might interfere with your sleep patterns, leaving you more vulnerable to pain and suffering in other aspects of your life.
This disorder has the potential to affect your interaction with family members, friends, workmates and as a result, will affect your productivity and the quality of your life.
The best way to live with trigeminal neuralgia is to look for supportive therapy groups or counseling sessions in your neighborhood where you can interact with other people who are living with trigeminal neuralgia. You can learn from their pain management techniques, and the feeling of being with people who are going through the same thing can give you a sense of belonging.