Trigeminal Neuralgia and Facial Pain

Trigeminal neuralgia is sudden, severe facial pain. It's often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums. It usually happens in short, unpredictable attacks that can last from a few seconds to about 2 minutes. The attacks stop as suddenly as they start.

Most of the time patients confuse this pain with dental pain. Even at times they undergo tooth extraction, one after other without any relief. 

Q. What causes trigeminal neuralgia?
A.There are multiple causes of trigeminal neuralgia. But most of the time there is no pathology detected and it is the abnormality in the nerve itself which leads to pain generation. This condition is called Idiopathic neuralgia. At times on MRI, we may detect compression of nerve with blood vessels. 

Q. How painful is trigeminal neuralgia.?
A.Pain is very severe and it comes as electric shock like pain. It is felt on one side of face. Pain is triggered by even touch. It comes for few seconds to few minutes. The pain is so distressing that sometimes it is also called “suicidal pain” 

Q. How to relieve trigeminal neuralgia pain?
A.Management starts with medications to suppress the abnormal pain signals. The medicines used are in class of anti convulsant and anti depressants, as these medicines also have role in pain medicine. 

If medical management fails that means, if there is not much relief or the doses are causing some side effects, the pain specialist or the pain doctor may advise you for some minimally invasive brain procedure to block the pain signals. 

Q. How do I brush my teeth?
A.Use soft tooth brush and avoid irritating tooth pastes containing mint and salt. At times it is not possible to even shave. You may use anti septic mouth wash if u are not able to brush your teeth. 

Q. What is the best treatment for trigeminal neuralgia
A.Most of the patients respond to medical management by pain specialistsPain doctors will start titrating the doses of medicine till you have significant relief. At times, they may add another class of medicine. The dose adjustment usually takes 4-6 weeks. It may even take longer. 

When medical management fails, minimally invasive pain procedures like Radiofrequency ablation of trigeminal nerve is the best and the safest technique, if surgery is not indicated. 

Q. How does Radiofrequency ablation of trigeminal nerve helps in relieving pain of neuralgia? 
A.Radiofrequency ablation or RFA blocks the pain signals from reaching brain. You may feel slight numbness in the area of pain after the procedure but that usually doesn’t affect your activities. RFA takes 2-4 weeks for its affect and during this time your pain specialist will start tapering the doses of medications. 

The pain may come back after 6 months to one and half year and the same procedure can be repeated. Surgical microvascular  decompression MVD , is considered when the blood vessels is compressing the trigeminal nerve or Trigeminal Root. 

Q. Can dental extraction or tooth extraction help in relieving the pain?
A.Most often trigeminal neuralgia is confused with dental pain. At times dental infection leads to swelling over face and pain is felt on the cheeks too. Your pain specialist, will be able to detect the exact cause of pain. 

Many times patient undergo multiple tooth extraction without any relief. 

Q. Who are the best doctors to treat trigeminal and other neuralgias like glosspharyngeal neuralgia, occipital neuralgia ?
A.Pain specialist are trained in diagnosing acute and chronic pain states. This is especially important, because if the diagnosis is not established, it is difficult to treat conditions and at times lead to unnecessary treatments too. 

Pain doctors not only manage pain with medications but they also are experts in minimally invasive procedures for pain management

Q What are other causes of facial pain?
A.Face pain is also caused by tooth aches, herpes infection, parotic gland inflammation or infection, migraine, sinusitis.


To book an appointment straight away you can use our online booking form


IPSC center of excellence in pain management, offers a variety of courses every month throughout the year for doctors wishing to specialize in pain management.

  • Multidisciplinary course covering early diagnosis and effective management of acute, chronic and cancer pain.
  • Authored by experts in the field of pain management or related disciplines.
  • Developed and endorsed by the Faculty of Pain Medicine of the IPSC Experts.
  • Contains standardized, high-quality content, relevant for all practitioners.