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All About Trigeminal Neuralgia Pain

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Trigeminal neuralgia is a chronic ache condition. It affects the trifacial neuron. It handles transmitting sensations from the face to the brain. The ache can occur due to various activities, such as brushing teeth, talking, or eating.

The condition is more common in women than men and usually occurs after age 50. The exact cause of nerve pain in the face is not known. But it’s believed to be related to the compression or irritation of the trifacial neuron. Blood vessels or tumors irritate it.

The pain associated with trigeminal neuralgia can be debilitating. And it impacts a person’s life. Therapy options range from medications to surgery. And the effectiveness of each option varies depending on the individual case.

This article will focus on the: 

  • Trigeminal neuralgia causes.
  • Signs.
  • Diagnosis.
  • Therapy options. 

We will also provide practical advice on managing and coping with the ache.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia, also known as tic douloureux, is a neurological disorder. It affects the trifacial neuron. The trifacial neuron handles transmitting sensations from the face to the brain. It is the largest of the cranial neurons. And it has three branches that control sensations in different areas of the face.

Trigeminal neuralgia is sudden, severe, and stabbing pain in the face. The ache can occur due to even mild stimuli, such as touching the face, eating, or speaking. The attacks of ache can be brief, lasting only a few seconds, or they can be longer, lasting up to several minutes. The ache is often described as a sharp, shooting, or electric shock-like sensation.

The exact cause of a condition is not fully understood. But it’s thought to be in connection with compression or irritation of the trifacial neuron by blood vessels or tumors. In some cases, the condition may occur due to a genetic mutation.

The illness is more common in women than men and is most often seen in individuals over 50. But It can also be associated with other conditions. 

Based on our own experience, the diagnosis is based on the patient’s history and a physical examination. Extra neurologiacal tests, like magnetic resonance imaging (MRI), may help. It’s to rule out other conditions that may be causing the ache.

Therapy options for illness can vary. They depend on the severity of the trigeminal neuralgia symptoms. Anticonvulsants and muscle relaxants may help manage the ache. In some cases, surgery may be necessary. It’s to relieve the compression or irritation of the trifacial neuron.

What Causes Trigeminal Neuralgia?

The exact cause of the condition is not fully understood now. But thanks to our knowledge gained in practice, we found out that it’s related to the compression or irritation of the trifacial neuron.

In most cases, the condition occurs due to a blood vessel. It puts pressure on the trifacial neuron, causing it to malfunction. The malfunction results in the sudden and severe pain associated with trigeminal neuralgia. The blood vessel may be a vein or artery pressing on the neuron or an abnormal blood vessel in the brain.

The illness can also occur due to a tumor pressing the trifacial neuron. In rare cases, the condition may occur due to multiple sclerosis. It affects the central nervous system. And it can damage the myelin sheath that surrounds neuron fibers.

In some cases, the cause of the condition may be idiopathic, meaning it is unknown. But some cases may occur due to a genetic mutation.

Factors that may increase the risk of developing the condition include age. The condition is more common in individuals over the age of 50. And as for the gender, it is more common in women than men. Previous facial trauma or dental surgery may also increase the risk.

Trigeminal Neuralgia Symptoms

Trigeminal Neuralgia Symptoms

The ache can occur due to even mild stimuli, such as touching the face, eating, or speaking. The attacks of ache can be brief, lasting only a few seconds, or longer, lasting up to several minutes. The trigeminal neuralgia pain is a sharp, shooting, or electric shock-like sensation.

Trigeminal neuralgia symptoms can be similar to those of other conditions. They are dental problems, sinus infections, or temporomandibular joint (TMJ) disorders. It is vital to seek medical attention if you are experiencing signs. Prompt diagnosis and therapy can help manage the ache and improve quality of life.

Now let’s look at the most common signs individuals with TN may experience.

Facial Twitching or Spasms

Facial twitching or spasms refer to involuntary movements in the muscles of the face. They can affect the jaw or cheek. These movements can be quick or prolonged and may be visible to others. According to our experience, they can occur due to various reasons. Those are neurological disorders, stress, or fatigue.

Sensitivity to Touch

Sensitivity to touch in the affected area of the face can be a result of various conditions. They include neuron damage, infections, or trauma. The affected area may become very sensitive to touch, causing discomfort or ache. Even a light touch or breeze can cause trigeminal neuralgia pain. It makes it difficult to carry out daily activities such as grooming or wearing clothes.

Changes in Facial Sensation

Changes in facial sensation can include a numb or tingling sensation. This can occur due to neuron damage or compression and infections. Or other underlying medical conditions can play a role. The affected area may also feel cold. Or they can have a burning sensation. It can further affect a person’s daily life.

Difficulty Eating or Drinking

Nerve pain in the face and sensitivity in the affected area can make it difficult to eat or drink. This can lead to weight loss or malnutrition. It can further exacerbate the condition. Difficulties in chewing, swallowing, or opening the mouth can be a result of various conditions. Those are temporomandibular joint disorder (TMJ) or neuron damage.

Depression or Anxiety

Chronic ache can lead to depression or anxiety. It can further impact a person’s quality of life. The constant discomfort, ache, and difficulties in carrying out daily activities can lead to feelings of helplessness and hopelessness. Medical help and support manage the physical and mental aspects of this condition.


The condition can be classified into two types. They’re based on the pattern of trigeminal neuralgia symptoms:

  • Classic (Type 1). It’s sudden, severe, and stabbing ache in the face, usually on one side. The trigeminal neuralgia pain occurs due to mild stimuli. They are touching the face, eating, or speaking. The attacks of ache can be brief, lasting only a few seconds, or longer, lasting up to several minutes. The ache is often described as a sharp, shooting, or electric shock-like sensation. Between attacks, individuals with classic one may have no signs.
  • Atypical (Type 2). It’s a constant, dull ache or burning sensation in the face, usually on one side. The ache is less severe than the classic one. But it is often more persistent. Individuals with an atypical type may also experience sudden, sharp ache. But it is less common than in the classic type.

Trigeminal Neuralgia Treatment

Trigeminal Neuralgia Treatment & Diagnosis

Diagnosis typically involves a thorough medical history and physical examination. It includes a neurological examination. Tests like MRI may rule out other trigeminal neuralgia causes. Those can be a tumor or multiple sclerosis.

Therapy aims to relieve ache and prevent future attacks. Anticonvulsants can be effective in reducing ache. It’s done by decreasing the excitability of the trifacial neuron. Other medications may include baclofen, lamotrigine, and phenytoin.

Our data show that, in some cases, medication is not effective. Then, other illness therapy options may help: 

  • One option is microvascular decompression surgery. It involves moving or cushioning blood vessels. Those may be compressing the trifacial neuron. 
  • Another option is Gamma Knife radiosurgery. It uses focused radiation to damage the trifacial neuron and reduce ache signals.

Radiofrequency ablation or balloon compression may also damage the trifacial neuron. And it reduces ache. But these procedures may carry a higher risk of facial numbness or other side effects.

Note that not all trigeminal neuralgia treatments may be appropriate for every individual. The choice of therapy will depend on factors such as:

  • The severity of ache.
  • The age and health status of the individual.
  • The underlying cause of the condition.

According to our experience, besides medical trigeminal neuralgia treatment, lifestyle modifications can also be helpful. Avoiding triggers such as cold or hot foods, applying heat or cold to the affected area, and practicing stress-reducing techniques such as yoga or meditation may all help to reduce ache and prevent future attacks.


Diagnosis of nerve pain in the face typically involves: 

  • A thorough medical history.
  • Physical examination.

The healthcare provider will ask the individual about their signs. It includes the location, duration, and frequency of ache. They will also ask about any factors triggering or worsening the ache. Those are eating, speaking, or touching the face.

A neurological examination will also be conducted. It’s to assess the function of the trifacial neuron. The healthcare provider will examine the face for any signs of:

They may also use a cotton swab or other stimulus. It’s to test the individual’s ability to feel touch and ache in different areas of the face.

Imaging tests like MRI may also rule out other possible trigeminal neuralgia causes. MRI can provide detailed images of the brain and neurons. It can help to identify any structural abnormalities or lesions. They may be contributing to the individual’s signs.

A diagnosis of the condition is typically based on the individual’s signs and physical examination findings rather than imaging tests alone. In some cases, imaging tests may not reveal any abnormalities. But the individual may still be diagnosed with nerve pain in the face. The diagnosis is usually based on their signs and response to cure.

Healthcare providers may also classify the condition based on its underlying cause. The condition can occur due to a blood vessel compression of the trifacial neuron. Then doctors classified it as type 1. But the condition can occur due to a structural abnormality such as a tumor or cyst. Then it’s classified as type 2.


Nerve pain in the face is a debilitating condition. It causes intense facial ache. It’s often triggered by common activities such as eating, speaking, or brushing teeth. The exact cause of nerve pain in the face is not fully understood. But it’s believed to involve compression or irritation of the trifacial neuron.

Signs of trigeminal neuralgia can be severe and impact a person’s quality of life. But with an accurate diagnosis and appropriate therapy, many individuals with illness can experience significant relief from their signs.


  • What does trigeminal neuralgia pain feel like?

Trigeminal neuralgia pain is typically described as sharp, electric shock-like, or stabbing pain. It’s focused on one side of the face. The pain can occur due to common activities such as eating, speaking, or brushing teeth. And it can be intense and debilitating.

  • What triggers trigeminal nerve pain?

Trigeminal nerve pain can occur due to a variety of factors. They’re: 

  1. Touching face.
  2. Brushing teeth.
  3. Exposure to cold or hot temperatures. 

In some cases, even light pressure or a gentle breeze on the face can trigger an attack of pain.

  • How do you stop trigeminal neuralgia pain fast?

There are several strategies to stop trigeminal neuralgia pain quickly: 

  1. Applying heat or cold to the affected area.
  2. Taking over-the-counter pain medications such as ibuprofen or acetaminophen. 
  3. Practicing stress-reducing techniques such as deep breathing or meditation. 
  • What are the risk factors for developing trigeminal neuralgia?

Risk factors for trigeminal neuralgia include aging. The condition is more common in older adults. Also, certain medical conditions like multiple sclerosis or a tumor in the brain or skull can play a role. Women may also be at slightly higher risk for developing the condition.

  • Can I cure trigeminal neuralgia?

There is no cure for trigeminal neuralgia. But with appropriate treatment and management, many individuals can experience significant relief. Treatment may involve medication, lifestyle modifications, and in some cases, surgery or radiation.

  • Is trigeminal neuralgia a life-threatening condition?

Trigeminal neuralgia is not typically a life-threatening condition. But the intense pain can be debilitating and impact a person’s quality of life. It is vital to work closely with a healthcare provider. It’s to develop an individualized treatment plan. It can help to manage symptoms and improve quality of life.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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