Can Neck Problems Cause Trigeminal Neuralgia?

Posted in Neck Pain Disorders on Nov 16, 2021

The short answer is yes, neck problems can cause trigeminal neuralgia. Now, you might be wondering why you haven’t heard that a neck problem can cause trigeminal neuralgia before, especially if you’ve already been to the ENT, neurologist, and pain specialist and had every type of test you can think of, but everyone says everything is “okay.” Let’s skip the part about trying to categorise the type of trigeminal neuralgia you might be experiencing (e.g., Type I, II, III), and let’s look instead more generally at the two causes of trigeminal neuralgia.

The first type is where there is some type of clear lesion (e.g., growth, damage to blood vessels, etc) that you can clearly see on an MRI. Think of it like a cracked screen on your computer. You can see it, and you know that’s what’s there.  The second type is where something is affecting the way that your computer is working, like a computer virus. You can’t necessarily see it, but it is having an effect all the same. This is the type of trigeminal neuralgia that we’re talking about: the type of trigeminal neuralgia where a problem with your neck is affecting the way that the nerve and pain processing centres for your head, neck, and face.

In other words, you are definitely experiencing the pain and symptoms of trigeminal neuralgia, but not for the reasons that everyone else has been looking at.

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How Can Neck Problems Cause Trigeminal Neuralgia?

Without getting too detailed into the neurology of it all, the nerve centre of your brainstem that processes information from the trigeminal nerves is directly connected with the centres in the upper part of your spinal cord that transmit information about your head, brain, and neck.

So yes, the branches of the trigeminal nerve are nowhere near your neck … but the processing centre that they send all their information to is. So, what can happen if you actually have a neck problem is that the information from your head, neck or brain can “spillover” into thus processing centre, and trick your brain into perceiving that you are actually experiencing pain associated with trigeminal neuralgia. It is a case where your body can essentially play a trick on your brain because when you feel the pain isn’t where the problem is actually coming from in the first place.

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It is my STRONG opinion that every person who experiences trigeminal neuralgia should not only have a brain MRI to determine if they have the pathological variety that may require surgery - because when you may need a microvascular decompression (MVD) procedure, it works really well - BUT ALSO have a proper neck assessment to determine if the problem could instead be coming from your neck … because if so, you can have an MVD procedure, but the pain of trigeminal neuralgia will still be there.

How Can you Know if your Trigeminal Neuralgia is coming from a Problem in your Neck?

It is important to note that as much as we would like to think that it is, the body is not a linear machine. In other words, there are not always direct connections between A and B. What this means is that not all people who have a problem with their neck will experience trigeminal neuralgia: and not all people who have trigeminal neuralgia will have a problem with their neck.

It’s about probabilities. Now that said, if you are already experiencing trigeminal neuralgia and if you also have a few associated problems with your neck, it is quite very possible (if not probable) that your trigeminal neuralgia is coming from a problem in your neck. So, what are some of the signs that they might be connected to?

You experience headaches, migraines, neck or shoulder pain. You have signs of degenerative arthritis in your neck (yes, even if you are only 30 years old) Your posture is crooked (i.e., go look in a mirror and check if your head is sticking forwards or if you have one shoulder lower than the other) Your neck goes “click” on its own (… or worse, you feel the need to crack your own neck). All of these signs and symptoms suggest that you may have a problem with your neck, and if so, it could well be connected with your trigeminal neuralgia.

Upper Cervical Care - A Different Approach for Helping Trigeminal Neuralgia

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While there may be many options for helping people with neck problems that can be causing or related to trigeminal neuralgia, one of the most specific and qualified approaches maybe with what is known as a Blair Upper Cervical doctor. A Blair doctor is a specific type of chiropractor, who has completed advanced study in the relationship between the alignment of the upper part of the neck and neurological conditions including trigeminal neuralgia. Unlike a general chiropractor or general physiotherapist who may use neck manipulation or massage, a Blair doctor performs a very specific type of correction without the need to twist or stretch the neck.

The procedure begins with a detailed series of tests including physical and neurological assessment, and also customised 3D diagnostic images that help show the exact location, directions, and degree of misalignment in your neck that could be causing your symptoms. With this information, a Blair doctor is able to develop a personalised care strategy designed just for you to help you with your unique needs in achieving the healthcare goals that you desire.

References

Cruccu G, Finnerup NB, Jensen TS, et al. Trigeminal neuralgia: New classification and diagnostic grading for practice and research. Neurology. 2016 Jul 12;87(2):220-8. doi: 10.1212/WNL.0000000000002840. Epub 2016 Jun 15. https://www.ncbi.nlm.nih.gov/pubmed/27306631

Grgić V. [Influence of manual therapy of cervical spine on typical trigeminal neuralgia: a case report]. [Article in Croatian] Lijec Vjesn. 2010 Jan-Feb;132(1-2):21-4. https://www.ncbi.nlm.nih.gov/pubmed/20359155

Piovesan EJ, Kowacs PA, Oshinsky ML. Convergence of cervical and trigeminal sensory afferents. Curr Pain Headache Rep. 2003 Oct;7(5):377-83. https://www.ncbi.nlm.nih.gov/pubmed/12946291Vadokas V, Lotzmann KU. [Craniomandibular disorders and the cervical spine syndrome as differential diagnoses in suspected idiopathic trigeminal neuralgia.]. [Article in German] Schmerz. 1995 Jan;9(1):29-33. https://www.ncbi.nlm.nih.gov/pubmed/18415496

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Velásquez C, Tambirajoo K, Franceschini P, et al. Upper Cervical Spinal Cord Stimulation as an Alternative Treatment in Trigeminal Neuropathy. World Neurosurg. 2018 Jun;114:e641-e646. doi: 10.1016/j.wneu.2018.03.044. Epub 2018 Mar 14. https://www.ncbi.nlm.nih.gov/pubmed/29548953

Burcon M. Resolution of trigeminal neuralgia following chiropractic care to reduce cervical spine vertebral subluxations: a case study. J Vert Sublux Res 2009:1-7

Flory T, Chung J, Ozner J. Resolution of Facial Neuralgia Following Reduction of Atlas Subluxation Complex: A Case Study. J Upper Cervical Chiropr Res 2015:6-13

Grochowski J. Resolution of trigeminal neuralgia following upper cervical chiropractic care: a case study. J Upper Cervical Chiropr Res 2013:20-24

Rodine RJ, Aker P. Trigeminal neuralgia and chiropractic care: a case report. J Can Chiropr Assoc 2010;54(3):177–186

Zielinski E, Acanfora M. Resolution of trigeminal neuralgia following subluxation based chiropractic care: A case study & review of the literature. A Vert Sublux Res 2013:33-45

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Eriksen K, Rochester BP, Hurwitz EL. Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study. BMC Musculoskeletal Disorders 2011, 12:219 doi:10.1186/1471-2474-12-219. https://link.springer.com/article/10.1186/1471-2474-12-219

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