Can Neck Problems Cause Trigeminal Neuralgia?

Posted in Neck Pain Disorders on Jun 6, 2022

Straight up, yes, neck problems absolutely can cause trigeminal neuralgia! Yet when it comes to treatment for trigeminal neuralgia, it probably isn’t something that your GP or your specialist, or even your surgeon said much about. The reason that you are here is that you’ve been doing your independent research about how neck problems can cause trigeminal neuralgia. Why the disconnect? I recommend that you go to a website called pubmed.com. It is a research database with all kinds of articles about various things including medical syndromes. If you type the term “trigeminal neuralgia” you will find that almost all articles talk about drugs and surgeries. Almost nothing about how neck problems can cause trigeminal neuralgia.

So, why hasn’t anyone told you about the role of the upper neck in particular and trigeminal neuralgia? Why have you had to find out about this yourself? Unfortunately, it is because the resources that teach the doctors and trigeminal neuralgia specialists don’t talk about it! Whether it is classic, bilateral, atypical, Type I, II or any other flavors of trigeminal neuralgia that you can think of, the alignment, movement, and health of your upper neck is a critical factor that may be able to help trigeminal neuralgia naturally and without drugs or surgery.

Neck Problems and Trigeminal Neuralgia - It’s about Somatosensory Dysafferentation

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Your brain is the central hub or power plant that regulates every life function in your body. It sends messages going outwards and also processes information coming back into it. The term “afferentation” refers to those types of neural messages that come from your body and go back to your brain. The term “somatosensory” refers to those particular types of sensory messages that involve muscles, ligaments, and joints that include pain, pressure, and proprioception (i.e., muscle tone, balance, and position sense). 

The term “somatosensory dysafferentation” refers to abnormal sensory information from the periphery that is processed in your brain as there is a problem. Garbage in, garbage out. In this way, your brain and body are wired so that you can experience sensory problems, including a syndrome such as trigeminal neuralgia even though the location of the trigeminal nerves may not be where the problem is actually coming from. More on that later.

So, the central processing center that receives all information from the branches of the trigeminal nerve is called the Spinal Trigeminal Nucleus which is located in the brainstem and descends down into the upper part of the spinal cord around the level of the C2-C3 in your neck. 

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Of important note, the Spinal Trigeminal Nucleus does not only receive information from the trigeminal nerves. it also receives information from the nerves in your upper neck which goes to your skull, head, brain, neck, and shoulders. All of this information from the muscles, ligaments, and joints in this entire zone of your body are processed in the exact same primary processing center in your brain.

Now, here’s the interesting and important part. Your brain, like a computer, can only process so much information. If it is overwhelmed with too much information, specifically corrupted or negative information such as pain, the information can spill over and be misinterpreted. In other words, noxious stimuli that are coming from the upper neck can be misinterpreted as an abnormal sensation on the face. Voila! Here is the recipe for a type of trigeminal neuralgia where your brain MRIs show that everything appears quite normal, which is a sign that where you feel the pain is not where the pain is coming from.

Upper Cervical Spine and the Trigeminal Neuralgia

Due to its proximity to that central processing unit, but also the types of nerves that are located in this area, the upper cervical spine is one of the most important contributing factors that can be involved with trigeminal neuralgia. The upper neck is comprised of the base of your skull, your atlas (C1) axis (C2), and C3 cervical vertebrae. These vertebrae contain a series of tethers known as myodural ligaments not found anywhere else in the body that anchor the spinal cord so that it does not get compressed or crushed when you move your head. However, if these vertebrae are ever injured - not broken or dislocated, but entrapped or shifted just outside their normal resting centre of gravity, they may impart physical tension directly upon the spinal cord itself. In other words, those exact same structures designed to protect your brain cord can now harm it.

Of additional note, the C1-C2 vertebrae are responsible for 50% of all the total rotation in your neck. If this particular area is affected, it can produce a huge amount of rotational strain that, like wringing a dishcloth, can produce a variety of neurological problems. Furthermore, the orientation of the C1-C2 vertebrae also mirrors the orientation of the TMJ. Thus, an upper neck problem can produce TMJ problems just as a TMJ problem can produce an upper neck issue.

It is for this reason that we may appreciate that trigeminal neuralgia is not a thing that we can usually see on MRI like a tumor or bleed or lesion. Instead, it is a type of functional neurological disorder that is a consequence or an effect, not a cause, of other things in the body not working or moving the way that they are supposed to.

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Trigeminal Neuralgia Treatment without Drugs or Surgery

When it comes to healing trigeminal neuralgia, people have two general options: Drugs and surgery to treat the effects (i.e., pain) Specific treatment to resolve the underlying cause When it comes to a syndrome as severe as trigeminal neuralgia, we are not opposed to option #1. It is severe even that we do advise people to take what they need to take. That said, it is important to understand what drugs and even surgery are. They are supports that help make life easier and give you the time to identify and resolve the underlying cause. They do not treat or fix the underlying cause, only the effects.

Even with trigeminal neuralgia, there may still be multiple layers involved with the underlying cause including a complex of physical, chemical, and mental-emotional problems all wrapped in a tangled web. Fortunately, one of the best and easiest places to start is with the alignment, movement, and health of your upper neck. In this way, a unique approach to healthcare known as Upper Cervical Care and the Blair Technique is often able to help people with trigeminal neuralgia.

Upper cervical care is a special division of chiropractic that focuses specifically on the relationship between the vertebrae in your upper neck (C1 and C2) and your nervous system. Unlike general spinal manipulation, upper cervical techniques do not employ twisting, stretching, or cracking the neck and require years of advanced study. Among the primary forms of upper cervical care which includes the NUCCA and Atlas Orthogonal approaches is what is known as the Blair Technique. The Blair Technique recognizes that all human beings are different on both the outside and the inside. Therefore, by taking these unique differences into account, we are able to offer the most precise, custom-tailored approach to care that is possible in order to help people get well and stay well.

Dr. Jeffrey Hannah is an advanced certified instructor with the Blair Technique. In his 15 years of clinical experience, he has also studied the Atlas Orthogonal and QSM3 work (derived from NUCCA) to enhance his overall clinical awareness of how the vertebrae in the upper neck can affect the brain and body function. Dr. Hannah is a published author, international lecturer, and recognized leader in the field of upper cervical specific chiropractic.

Dr. Hannah practices in North Lakes (north Brisbane) and works with patients from across Australia experiencing a variety of syndromes related to the upper neck including trigeminal neuralgia. Our practice, Atlas Health Australia, offers a 15-minute complementary phone consultation so that we may answer any questions you have and explain the process so that you can decide if upper cervical care is right for you. To schedule a consultation, please click the Contact Us link on this page, or call us direct at 07 3188 9329.

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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/12946291

Vadokas 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 

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

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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 literature. A Vert Sublux Res 2013:33-45

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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