Trigeminal Neuralgia (TN)

Trigeminal neuralgia is a type of nerve pain that affects your face. You may feel a strong burst of pain in part of your face. It is usually on one side of the jaw or cheek. The pain may be burning or sharp, and so severe that you can’t eat or drink.

A flare-up begins with tingling or numbness in the area. Then pain starts to come and go, often in bursts that last anywhere from a few seconds to 2 minutes. During a flare of the condition, these bursts of pain may become more and more frequent until the pain almost never stops. The intensity of the pain can make it hard to get through your day. But it’s not life-threatening.

This chronic pain condition can flare up for a few weeks or months. Then the pain goes away for a while, sometimes years.

This pain condition happens most often in people older than 50. But younger people can also have it. Trigeminal neuralgia is more common in women than men. 

The pain can be triggered by pressure on your cheek. This pressure can come from a razor when shaving. Or from your fingers when putting on makeup. Brushing your teeth, standing in the wind, washing your face, eating, drinking, and even talking also may cause it.

Experts think that a blood vessel pressing against the trigeminal nerve triggers the pain. Sometimes multiple sclerosis (MS) causes the pain. In rare cases, a tumor may be the cause. An MRI should be done to make sure it is not a tumor or MS.

People with trigeminal neuralgia may have these symptoms:

• Flashes of severe pain in the cheek or jaw, rarely on both sides.

• Absence pain between the flashes of pain.

• The pain feels like electric shocks or like a knife.

• Pain is often triggered by touching, wind, eating, or brushing the teeth.

• Anxiety from the thought of the pain returning.

To diagnose trigeminal neuralgia, your healthcare provider will typically take your health history and do a physical exam. Giving your provider details about the pain may help with making a diagnosis. This includes things such as where and when the pain happens. Imaging tests may be used to try to rule out other causes of pain.

Most common over-the-counter and prescription pain medicines don’t work for people with this condition. Treatment for trigeminal neuralgia may include:

• Anticonvulsant medicine.

• Tricyclic antidepressants.

• Surgery, if medicine has failed.

• Acupuncture.

• Biofeedback.

• Stereotactic radiosurgery.

• Percutaneous balloon rhizotomy.

• Radiofrequency ablation.

Experts don’t know how to prevent trigeminal neuralgia. You may learn to avoid certain activities that seem to trigger the pain more than others.

This condition is not fatal. But the pain and anticipation of the pain can interfere with your life. Working closely with your healthcare provider will help you find the best pain management methods for you. Alternative therapies have also been shown to help. These include acupuncture and biofeedback.