Do you suffer from trigeminal neuralgia (TN)?
Are you looking for a home remedy to help with the symptoms?
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerves in the face. These nerves, also called the 5th cranial nerves, are composed of three branches. The three branches V1(ophthalmic), V2(maxillary), and V3(mandibular) are responsible for transmitting nerve impulses from the face to the brain. They also assist with motor functions such as chewing. Trigeminal neuralgia, also known as Fothergill’s disease, usually occurs in those fifty years of age and older and is more common in females.
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Trigeminal Neuralgia Symptoms
- Electric shock-like feeling on one side of the face.
- Pain may be caused by applying makeup, brushing teeth, chewing, or touching the face.
- Painful attacks may become more frequent and worsen over time.
- Pain attacks may last from seconds to a few minutes.
- Pain that doesn’t respond to traditional pain medication.
- Light sensitivity.
- Spontaneous facial pain.
Causes of Trigeminal Neuralgia
We are not certain as to what causes trigeminal neuralgia. We think it is the result of trigeminal nerve compression. Blood vessels can press against the nerve and if the nerve is damaged, pain may occur. Other possible causes are:
- Facial trauma.
- dental procedures.
- Tumors or cysts.
- Malformed blood vessels.
Trigeminal Neuralgia Treatment
Medications: Traditional painkillers such as acetaminophen and ibuprofen are generally ineffective against trigeminal neuralgia. Prescription medications are often utilized, specifically anticonvulsants. These include:
Carbamazepine (Tegretol)
Phenytoin (Dilantin)
Gabapentin (Neurontin)
Topiramate (Topamax)
Side Effects of Anticonvulsants: The main side effects of these types of medications are drowsiness, dizziness, nausea, and fatigue. Please consult your physician or pharmacist for more specific information.
Surgical Treatment: There are several surgical options available to treat trigeminal neuralgia.
Microvascular Decompression Surgery (MVD): This procedure works by inserting a cushion between the vessel and part of the trigeminal nerve. An incision is made behind the ear and a small portion of the skull is removed. This procedure helps approximately 80% of sufferers and is thought to be the longest-acting treatment. Risks of MVD include:
- Hearing loss
- Facial numbness
- Bleeding
- Infection
- Paralysis
- Leaking of CSP
Rhizotomy: This is an outpatient procedure and is also effective in about 80% of patients. The patient is placed under general anesthesia and a hollow needle is placed through the cheek. The affected nerves are treated with heat (electrical current) or chemicals (glycerin or glycerol). This procedure takes about 30 minutes and pain relief is immediate.
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Prevention: If you know things that cause trigeminal neuralgia flare-ups, avoid them. Examples include windy weather, spicy foods, and rubbing certain areas of the face. Keep a food diary to determine if particular foods can cause pain. Some common culprits are bananas, caffeine, and citrus fruits. Hot and cold liquids can also cause flare-ups. If this happens, using a straw might help.
Medical History and Neurological Exam: One of the best ways to help trigeminal neuralgia pain is to remove the underlying cause. To discover the source of the electric shock-like pain, a medical history should be obtained. Other disease processes such as diabetes can lead to nerve pain and make the symptoms of trigeminal neuralgia worse. A complete neurological exam can help to differentiate trigeminal neuralgia from other types of neuropathic pain conditions.
Electrical Stimulation: Transcutaneous Electrical Nerve Stimulation (TENS) and Transcranial Magnetic Stimulation (rTMS) are treatment options that use electrical current to block pain signals transmitted by damaged nerves. These options are non-invasive, well-tolerated, and can be a good option for trigeminal pain management.
Topical Pain Relievers: Topical agents have the advantage of working locally. This typically leads to fewer side effects. There are several creams, ointments, patches, and rubs that can be used to treat painful episodes. In the hospital where I practice, we use lidocaine ointment and patches, Diclofenac gel, and menthol creams for pain relief.
Nutritional Supplements: Several natural products can help relieve nerve pain. When selecting a pain management strategy, side effects are important. I believe natural supplements should be tried before prescription medications because the side effects of anticonvulsants are usually more severe and can negatively affect the quality of life.
Turmeric: Turmeric contains curcumin which has been shown to help with pain and inflammation. This includes nerve pain. Curcumin may promote the regeneration of nerves after nerve injuries. Curcumin has also been shown to inhibit nerve pain transmission.1
Another study showed that curcumin can promote nerve regeneration after nerve fibers are damaged.2
Trigeminal neuralgia is a painful condition that can interfere with daily activities and diminish the quality of life. The intense pain of trigeminal neuralgia can be treated with anticonvulsant medication, topical pain relievers, and turmeric. There are also outpatient and inpatient surgical procedures available. Electrical stimulation is a less intrusive option and may also be effective. Always remember to consider natural remedies such as acupuncture as well.
I believe it is always prudent to try natural remedies and nutritional supplements before prescription medications and surgical procedures whenever possible. The side effects of medications and the surgical risks can be extensive.
If you think you may be suffering from trigeminal neuralgia, it is a good idea to visit a neurologist. Review your treatment options and pick the one that best fits your situation. If you have any questions about this topic or any other health and wellness issue, please feel free to contact me using the author box below. I am always willing to help.
Thank you for reading this blog post and enjoy a happy, healthy life.
Michael J. Brown, RPh, BCPS, BCPP
Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.
Feel free to send Michael a message using this link.
- Liu S, Li Q, Zhang MT, Mao-Ying QL, Hu LY, Wu GC, Mi WL, Wang YQ. Curcumin ameliorates neuropathic pain by down-regulating spinal IL-1β via suppressing astroglial NALP1 inflammasome and JAK2-STAT3 signalling. Sci Rep. 2016 Jul 6;6:28956. doi: 10.1038/srep28956. PMID: 27381056; PMCID: PMC4933926.
- Ma J, Liu J, Yu H, Wang Q, Chen Y, Xiang L. Curcumin promotes nerve regeneration and functional recovery in rat model of nerve crush injury. Neurosci Lett. 2013 Jun 28;547:26-31. doi: 10.1016/j.neulet.2013.04.054. Epub 2013 May 10. PMID: 23669643.
