Everything you Need to Know about Trigeminal Neuralgia
What is Trigeminal Neuralgia?
Trigeminal neuralgia is a neurological disorder affecting the function of the trigeminal nerve (aka Cranial Nerve V or CN5), which supply sensation of your face, jaw, eyes and head. It is widely considered one of the most painful condition known to humankind, hence its synonym “the suicide disease.”
That name alone is especially frightening if you are experiencing trigeminal neuralgia because that is not the path you want to take. You have a family, friends and a life worth living! Still, when your condition strikes, it can be severe enough to break even the strongest human being.
If the pain is severe enough, many people are willing to do anything that their trigeminal neuralgia specialist is willing recommend:
- Strong and addictive medication just to block the pain.
- Surgical electric implants to modulate the pain.
- Even radiation therapy to burn or destroy the nerves at any cost!
But what if there could be another way?
What it is was possible to correct the underlying cause of your trigeminal neuralgia and not just treat the symptoms?
And what if it was possible to recover from trigeminal neuralgia without drugs or surgery?
Read to find out more.
Trigeminal Neuralgia Facts and Statistics
One of the cruelest things about trigeminal neuralgia is the sense that you are suffering alone.
From the outside, you appear 100% normal. On the inside is another matter.
Even your closest family understand the pain and limitations that you are experiencing, they don’t fully know the true feeling. Or the emotional distress in causes you.
And not just your stress, but also the stress in knowing how your condition is affecting the people around you.
Although you may not feel like it or have ever realised it before, trigeminal neuralgia is far more common that you’ve every known:
- Trigeminal neuralgia affects 1 per 500 - 1000-people
- That is 24,000 - 48,000 people plus their families living in Australia right now with trigeminal neuralgia
- 1200 more people will be diagnosed with trigeminal neuralgia in Australia this year
It isn’t exactly the type of statistic that you want to be part of with trigeminal neuralgia. Nevertheless, I share these numbers with you so that you know that you are not alone. And there are many people out there who both understand and who know exactly what you are experiencing … including many people who have been able to find solutions for their condition.
Trigeminal Neuralgia Symptoms
Trigeminal neuralgia is subcategorised based on the nature of your symptoms:
Type I (TN1) - aka “typical” neuralgia, characterised by sudden bursts of sharp, piercing pain in specific areas of your face
- Type II (TN2) - aka atypical neuralgia, characterised by an almost constant sensation of burning, gnawing or stabbing pain
Trigeminal neuralgia is further subdivided according to the distribution of pain along the three major branches of the trigeminal nerve:
- Opthalmic Division - eyes, behind-the-eyes and forehead.
- Maxillary Division - upper palate, upper teeth and sinuses
- Mandibular Division - lower palate, lower teeth, chin, TMJ and temporal bone (side of the head just above the ear)
Like an electrician who traces a faulty wire, knowing the pain distribution of trigeminal neuralgia can be useful in identifying the cause of the problem.
However, there is a very important detail about trigeminal neuralgia that your trigeminal neuralgia specialist may not have told you:
It is that the sensory processing centre of all of the pain and sensory information received by the branches of the trigeminal nerve is located in the brainstem and descends down into the upper part of your neck down to the level of the C2 vertebra.
In other words, the symptoms of trigeminal neuralgia may not always be the result of direct pressure on the nerve in your face.
It may also be because of an undiagnosed, untreated problem in your neck.
Trigeminal Neuralgia Pain
Trigeminal neuralgia has been described as, “the most severe pain disorder known to humankind,” ranking above childbirth, shingles and even kidney stones.
Many people who suffer trigeminal neuralgia describe the pain like an electric shock that “takes their breath away.” Others describe it like they’ve been stabbed in the face.
In a single word, “cruel” may be the best way to describe the condition in both its severity and insidious nature of attack.
In addition to pain, trigeminal neuralgia may also overlap with a variety of other nerve conditions:
- Glossopharyngeal neuralgia - pain affecting Cranial Nerve IX (CN9), which affects sensation in your throat and may also affect your ability to swallow or speak
- Facial Nerve Palsy (aka Bell’s Palsy) - weakness or asymmetry affecting Cranial Nerve VII (CN7), which causes the facial muscles to droop on one side with the affected eye unable to close
- Meniere’s Syndrome - dysfunction involving CNV and Cranial Nerve VIII (CN8), which causes the muscles of your inner ear to constrict, leading to ringing in the ears (aka tinnitus), loss of hearing and sudden episodes of vertigo
- Migraine - pain affecting Cranial Nerve X CN10), which affects sensation inside the skull and is also associated with visual, balance and abdominal symptoms
- Occipital Neuralgia - pain affecting Cervical Nerve 2 or 3 (C2 or C3), which affects sensation on the back of the skull and behind the ears
- Myofascial Pain Syndrome - non-specific pain affecting multiple zones of the face, jaw, head and neck, often overlapping with other syndromes such as chronic fatigue or fibromyalgia
For all the complications that can affect people with trigeminal neuralgia, the underlying problem remains: that we are dealing with an extraordinarily cruel, debilitating and life-disrupting condition.
Trigeminal Neuralgia Trigger Points
Trigeminal neuralgia is often associated also with trigger points of painful, fatigued muscles around the face, jaw and head.
The mandibular division of the trigeminal nerve is also the motor supply for your chewing muscles (masseter, temporalis and pterygoid muscles), which anchor into the TMJ and the sides of your skull. A pair of muscles known as the digastric and also the myohyoid are also controlled by the trigeminal nerve and may cause trigger points and pain under the chin, jawline, and ear area due to their attachments near the back of the skull.
The trigeminal nerve also controls the tensor veil palatine muscle, which is responsible for opening the Eustachian tube, and may contribute to a “blocked ear feeling” if it is in spasm. It also control the tensor tympani muscle, which tightens to protect your ear drum from loud noises, but also also contribute towards loss of hearing or ringing in the ears (tinnitus) if is it dysfunctional.
The trigeminal nerve also supples a relatively unknown muscle called the sphenomandibularis, which is believed may be responsible for pain behind the eyes.
Especially if you experience trigger points in your jaw, head or neck, these symptoms may be a very important clue to understanding the underlying cause of your symptoms.
Remember that the sensory processing centre for the trigeminal nerve descends to the level of the C2 vertebra in your upper neck. Therefore, it is possible that a trigger point and face pain problem may actually be a neck problem in disguise.
One study identified that 84% people who experience myofascial trigger points in the face, head or neck experience improvement when the underlying cause was addressed.
Another study concluded that due to the interconnectivity between the jaw and the upper neck that people experiencing TMJ dysfunction be co-managed by a team of practitioners: namely
1) a dental specialist and
2) an “upper cervical chiropractor,” which is a different type of chiropractic doctor who focuses on the alignment on the upper neck and nerve system.
So as it turns out, many chronic pain researchers and fibromyalgia specialists believe that myofascial pain syndromes and also conditions like trigeminal neuralgia are due to an underlying dysfunction involving the TMJ and the upper neck.
Trigeminal Neuralgia Diagnosis
Trigeminal neuralgia specialists have identified three additional categories of trigeminal neuralgia based on the underlying mechanism of the condition:
- Classic trigeminal neuralgia - an MRI diagnostic test clearly shows that a blood vessel or other structure is physically compressing against a branch of the trigeminal nerve, like a pebble in your shoe, and is the cause of your pain
- Secondary trigeminal neuralgia - an MRI diagnostic test shows some type of underlying pathological process is affecting a branch of the trigeminal nerve: e.g., a tumour, infection, bleed, or demyelination such as in multiple sclerosis,
- Idiopathic trigeminal neuralgia - an MRI diagnostic test shows nothing! In other words, your trigeminal neuralgia specialist cannot find the cause of your pain. It is this third category - the idiopathic trigeminal neuralgia - that is especially fascinating … but also frustrating. From a medical viewpoint, there is no pathological cause for the pain.
Therefore, there is no surgical procedure that can help, and the only medical treatment option are painkillers and opioids simply to try to numb the pain.
However, there is an often-forgotten natural principle about physiology and healing: every effect has a cause, and every cause has effects. In other words, things do not simply happen in the body without a reason. There is always a cause.
The difference with idiopathic trigeminal neuralgia is that we are now dealing with a functional disorder. Think of it like the difference between a computer with a cracked screen and a computer with a virus or malware. You can’t see the virus or the software problem, but it can still cause severe problems!
So in trigeminal neuralgia, if the underlying cause is a functional disruption to the way that your brain or spinal cord is able to process sensory information, it means that a different approach is necessary.
Trigeminal Neuralgia Treatment
The most common medical treatment options for trigeminal neuralgia focus on pain management or surgery.
In the case of classic trigeminal neuralgia where a blood vessel or other structure can be seen on MRI to be physically compressing or irritating a branch of the trigeminal nerve, the standard medical procedure is a microvascular decompression (MVD).
MVD is a brain surgery procedure, whereby a slip of teflon-like fabric is places between the nerve and the blood vessel in order to reduce friction and inflammation. Think of it like covering a blister with a bandaid so that your shoe doesn’t rub your foot raw.
Trigeminal neuralgia specialist surgeons have exceptionally good success with MVD for classic trigeminal neuralgia with 83-96% of people experiencing almost no pain after the procedure. For classic trigeminal neuralgia, MVD is truly the gold standard.
There may be two drawbacks to the MVD procedure:
- Approximately 50% of people will experience a relapse within 5-10 years following the initial procedure and therefore require another surgery. Such a relapse implies that the underlying mechanism for classic trigeminal neuralgia is still unknown.
- MVD only works for people with classic trigeminal neuralgia.
Unless an MRI shows clear signs of physical compression due to a blood vessel, microvascular decompression will simply not work. Therefore, for people who experience either secondary trigeminal neuralgia or idiopathic trigeminal neuralgia, MVD isn’t even an option.
Additional medical treatments for trigeminal neuralgia include radiosurgery (aka gamma knife), chemoneurolysis or rhizotomy for the purpose of nerve abatement to burn, kill or remove the branches of the trigeminal nerve.
Trigeminal neuralgia specialist surgeons agree that such aggressive and risky procedures with such high rates of failure and complications are not desirable treatment options for trigeminal neuralgia. But don’t forget that we are dealing with the most painful neurological condition known to humankind, otherwise known as the “suicide disease.”
Trigeminal Neuralgia Medication
When surgery is not an option, medication is the standard treatment for trigeminal neuralgia.
However, we aren’t talking about generic over-the-counter or even normal prescription medication. We are talking about some of the the strongest, most addictive and destructive pharmaceutical agents that currently exist.
Medical doctors and trigeminal neuralgia specialists hate prescribing this stuff too!
As a client once told me, her doctor told her that the medication she was taking would eventually cause liver damage, but it was the only thing that he knew that could help her so that she wasn’t just in pain the whole time.
What makes matters even scarier is that many people take combinations of these medications in high doses … and they still don’t experience much relief!
Plus the side effects including anxiety, depression, inability to concentrate, problems wit your memory, grogginess, insomnia, nausea, and the feeling of being a living zombie.
There is a time-and-place for all medications, and when you’re dealing with the most painful neurological condition known to humankind, you don’t want to go into the boxing ring against it with one hand tied behind your back.
In other words, you’d probably be willing to do anything - and I mean anything! - just to experience relief.
So what if there was another option top help you in your fight?
What if there was a natural option that could better help you as you do everything in your power to get your life back and experience relief from trigeminal neuralgia?
Because as you know: as necessary as medication might be, it only treats the symptoms?
What if there was a natural way to address the underlying cause of trigeminal neuralgia?
Trigeminal Neuralgia Cause
What many people find especially frustrating when they see a trigeminal neuralgia specialist is that so much of the focus is on your symptoms. In my opinion - and I’m sure you’ll agree! - what is most important is identifying the cause of your symptoms.
When you you that, then it doesn’t matter what you call it! You know what the underlying cause is, and then you know what you can do about it.
Idiopathic trigeminal neuralgia appears to be a functional condition affected by something else besides a brain lesion. There may be two plausible explanations for why a problem in your upper neck may actually be the underlying cause of your condiiton.
- Nerve Tension
One way of disrupting nerve function is through the process of nerve tension, also known as “increased mechanosensitivity.” In brief, a physical pulling on a nerve affects its function without deranging its normal appearance on MRI.
The C1 and C2 vertebrae have extraordinarily strong ligaments that anchor the bones onto your spinal cord. Disruptions to the normal alignment and movement of the C1 and C2 vertebrae are therefore hypothesised to represent a source of mechanical tension that can physically pull on the spinal cord, and therefore disrupt its normal function.
The hallmark for this type of process is if you observe that certain actions, activities, head or neck positions make your trigeminal neuralgia symptoms better or worse.
2. Nerve Convergence
Another way of disrupting nerve function is through the process of nerve convergence. In brief, several nerves supply sensory information into the exact same processing centre; however, the brain to make a “processing error,” which then causes you to feel like you are experiencing facial pain when the abnormal input is actually coming from somewhere else besides the trigeminal nerve. It is a process also known as “dysafferentation.”
As previously mentioned, the processing centre for pain and sensation from the trigeminal nerve descends into the upper neck at the level of C1 and C2 vertebrae. The C2 and C3 spinal nerves in your neck also supply pain and sensory information about your head and neck into this exact same centre. Problems with the C2 and C2 nerves are known to produce neck pain, headaches, migraines, TMJ pain and also occipital neuralgia.
Therefore, it is believed that abnormal sensory information involving the C2 vertebra and the adjacent nerves may be the actual source of abnormal input that the brain mistakenly interprets as the branches of the trigeminal nerve.
Is it any wonder why nothing has shown up on your brain MRI? It could well be because the actual problem is coming from your neck.
Trigeminal Neuralgia Risk Factors
Trigeminal neuralgia more commonly affects women and older people but seldom affects younger people.
When you consider the potential link between idiopathic trigeminal neuralgia and the neck, it actually reasons that one of the underlying risk factors for idiopathic trigeminal neuralgia may thus be old neck injuries.
- Whiplash - Women are typically more flexible than men. Unfortunately, they also tend to experience more severe symptoms such as neck pain, headaches, migraines post concussion syndrome, chronic pain, chronic fatigue or fibromyalgia syndrome which have been linked to head, neck and spine trauma.
- Old neck injuries - Neck injuries do not always cause immediate pain. There are three types of nerves in your neck: 1) sensory nerves that transmit pain and other feelings; 2) motor nerves that control muscles and posture; and 3) autonomic nerves that control blood vessel and organ functions. Only 1/3 of these nerves types transmit pain! Therefore, it is possible that an old injury that affected those other 2/3 nerve types created a structural change in your neck - just as degenerative arthritis - that you didn’t even realise was there!
- A new neck injury Often the onset of trigeminal neuralgia is accompanied by a catalyst such as a recent fall or head-neck stress injury. However, that injury may only be the “straw that breaks the camel’s back.” Even if your body has compensated for the older injury, it may not be able to compensate any more for the new injury. The result is that you “suddenly” develop the symptoms of trigeminal neuralgia because all the tension from this most-recent injury is now impacting your nerves and brainstem.
The more you think about this sequence of events, the more you realise it just makes sense.
If you don’t have a tumour, if you don’t have an infection, and if no trigeminal neuralgia specialist has been able to tell you what is going on, it just makes sense that the root of the problem could actually be coming from your neck!
Trigeminal Neuralgia Natural Remedies
A unique form of healthcare that focuses on the alignment of your atlas and axis - the C1 and C2 vertebra at the base of your brain - is a natural, drug free and powerful solution that could be one of the most important things in helping you with trigeminal neuralgia.
An upper cervical chiropractor, otherwise known as an atlas chiropractor or atlas doctor, is a different type of chiropractic doctor that focuses on the alignment on your neck - with special emphasis on the top two vertebrae, the C1 (atlas) and the C2 (axis) bones.
The way that atlas chiropractic works is by correcting the alignment of the bones in your neck, which can affect your nerve health:
- Proper alignment may help to restore normal nerve tension and function to the brainstem, which is the sensory processing centre for the trigeminal nerve
- Proper alignment may help improve sensory processing function, thereby reducing the risk of a “brain processing error” which may result in the symptoms of trigeminal neuralgia
- Proper alignment may help to restore normal motor control involving the facial and jaw muscles, which may also contribute towards myofascial pain syndromes.
One of the major differences is the level of precision that goes into an atlas correction. Unlike many forms of spinal manipulation, there is no twisting, cracking or popping the neck.
The tests that an upper cervical or atlas chiropractic doctor uses means that any treatment you receive is custom-tailored for your own neck, and as a result does not require any twisting or cracking.
By restoring normal alignment and movement through the top of your neck, this unique form of healthcare has been able to successfully help many people with trigeminal neuralgia using a completely natural and drug-free approach.
Trigeminal Neuralgia Pain Relief
When it comes to healing from trigeminal, even treating your neck with something as powerful as an atlas alignment or upper cervical care may be only the first step in the process.
It is one reason that we recommend a combined therapy approach when helping people with trigeminal neuralgia, including working with trigeminal neuralgia specialists who may recommend a range of therapies:
- Upper cervical care to help take care of your neck so that your brain and body have a better opportunity to heal
- Acupuncture, which has also been shown to assist reduce myofascial pain associated with trigeminal neuralgia
- Dental specialists, who may need to correct cranial or dental imbalances that are also contributing towards your pain symptoms
- Pain management strategies that include meditation, mindfulness, breathing exercises, and other activities that allow your brain the better opportunity to heal itself
- And yes, even medication - as little as possible - to assist you in the process as your body heals.
The process can be simple, but still requires time and your commitment.
One thing I know with certainty is that your body is always working to heal you. Therefore, even if you are dealing with significant challenges associated with trigeminal neuralgia, there may still be answers out there for you that you have not yet discovered.
Living with Trigeminal Neuralgia
There is life after trigeminal neuralgia.
The reason I know is because I have seen it in people who have suffered varying degrees of trigeminal neuralgia - from the mild discomfort to the life disabling - overcome their condition that once held such a firm trip over their life.
Some days, the only thing that may keep you going is the hope for a better tomorrow.
Personally, I don’t believe in giving people false hope. That’s painful and dangerous.
I believe in real hope that there is a solution for you. I realise there is nothing I can say to make it easier. When it comes to trigeminal neuralgia, what I simply know is that the best approach is a willingness to do whatever it takes to get your life life … and ideally in a logical order:
- Natural treatments first (including atlas and axis re-alignment)
- Medication second
- Irreversible surgery third
So even if you have done all kinds of treatments so far - you’ve seen all kinds of the trigeminal neuralgia specialists and spend all kinds of time and money - if you have not have your upper neck looked at, it could be the missing piece of the puzzle for you to finally experience the relief you’ve been looking for for so long.
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Upper Cervcal Chiropractic Case Studies
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Grochowski J. Resolution of trigeminal neuralgia following upper cervical chiropractic care: a case study. J Upper Cervical Chiropr Res 2013:20-24
Kessinger R, Matthews A. Resolution of trigeminal neuralgia in a 14-year-old following upper cervical chiropractic care to reduce vertebral subluxation: A case study. J Upper Cervical Chiropr Res 2012:77-84
Pederick FO. Cranial and other chiropractic adjustments in the conservative treatment of trigeminal neuralgia: A case report. Chiropr J Aust 2005;35(1):9-15
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