People who have trigeminal neuralgia (TN), which is also called tic douloureux,
TN is typically associated with a nerve injury, lesion, or blood vessel pressing on the nerve, which classifies it as a neuropathic pain disorder. People with multiple sclerosis (MS) can also get the condition.
The trigeminal nerve is a major nerve in the head that carries signals between the brain and the face. It’s one of 12 sets of cranial nerves.
The trigeminal “nerve” is actually a pair of nerves: one extends along the left side of the face, and one runs along the right side. Each of those nerves has three branches, which is why it’s called the trigeminal nerve.
Pain from TN can be triggered by something as simple as washing your face, brushing your teeth, or talking.
Typically, symptoms of TN come in waves and are followed by periods of remission. For some people, TN becomes a progressive condition with increasingly shorter periods of remission between painful attacks.
Other types of pain associated with MS
Faulty sensory signals can
Regular exercise, including stretching, can ease some types of pain.
Remember to report any new pain to your doctor so that underlying problems can be identified and treated.
About half of people with multiple sclerosis (MS) experience chronic pain, according to the National Multiple Sclerosis Society. TN can be a source of extreme pain for people with MS, and
The American Association of Neurological Surgeons (AANS) says that MS is one of several possible causes of TN. TN occurs more often in women than men, which is also the case with MS. The most common cause of TN is nerve compression from a vein or artery.
MS causes damage to myelin, the protective coating around nerve cells. TN may be caused by myelin deterioration or the formation of lesions around the trigeminal nerve.
In addition to MS, TN may be caused by a blood vessel pressing on the nerve. Infrequently, TN is caused by a tumor, tangled arteries, or injury to the nerve. Facial pain can also be due to temporomandibular joint (TMJ) disorder or cluster headaches, and sometimes follows an outbreak of shingles.
Treatment for TN can include both alternative therapies and medications in consultation with your doctor. In some cases, it may require surgery.
Medications for trigeminal neuralgia
According to the AANS, the most common drug doctors prescribe for the condition is carbamazepine (Tegretol, Epitol).
It helps control the pain, but may become less effective the more it’s used. If carbamazepine doesn’t work, the source of the pain may not be TN.
Another commonly used medication is baclofen. It relaxes the muscles to help ease the pain. The two drugs are sometimes used together.
If you’d like to try some alternative therapies to manage TN pain, research shows a number of treatments may have some success in alleviating symptoms of chronic pain conditions. These include:
- tai chi
- traditional Chinese herbal medicines like moxibustion, which is the burning of mugwort leaves, may enhance acupuncture treatment
- acupoint injections of a sterile solution to your pain trigger points to help deactivate them while you receive acupuncture treatment
- therapeutic massage of the nerve area
Surgeries for trigeminal neuralgia
If medications aren’t enough to control the pain of TN, surgery may be necessary. Several types of operations are available.
The most common type, microvascular decompression, involves moving a blood vessel away from the trigeminal nerve. When it’s no longer pushing against the nerve, the pain may subside. Any nerve damage that occurred may be reversed.
Radiosurgery is the least invasive type. It involves the use of beams of radiation to try to block the nerve from sending pain signals.
Other options include using gamma knife radiation or injecting glycerol to numb the nerve. Your doctor can also use a catheter to place a balloon in the trigeminal nerve. The balloon is then inflated, compressing the nerve and injuring the fibers that cause pain.
Your doctor can also use a catheter to send an electric current to damaged nerve fibers that are causing pain.
If you have MS, you should always report new pain to your doctor. New symptoms aren’t always due to MS, so other causes must be ruled out and diagnosis can be difficult.
Your doctor will perform a comprehensive neurological exam. Most people will need to have an MRI to rule out either MS or a tumor as the cause.
Some types of TN can be diagnosed by taking a course of specific medications and seeing how you respond to them. The site of the pain can also help
TN is a painful condition that currently has no cure, but its symptoms can often be managed. A combination of medications and surgical options can help relieve the pain. Support groups can help you learn more about new treatments and ways to cope.