When Facial Pain Won’t Go Away: Why Trigeminal Neuralgia Requires Expert Care

Trigeminal neuralgia (TN) is a relatively rare condition that’s diagnosed in approximately 150,000 American adults per year. It’s characterized by sharp, sudden facial pain that can make daily activities, such as brushing your teeth or chewing, uncomfortable and challenging.

At Palm Beach Pain Institute in Delray Beach, Florida, board-certified pain management physician Marcie Merson, MD, specializes in diagnosing and treating TN.

This article explains why TN happens, highlights some of its most common symptoms, and outlines why professional treatment is necessary to help manage symptoms and prevent them from worsening. 

Understanding trigeminal neuralgia

Trigeminal neuralgia (TN), a chronic neurological disorder, causes sudden, sharp, or intense facial pain. It occurs when something, such as a blood vessel, puts excess pressure on the trigeminal nerve, which transmits sensation from the face and helps control the muscles used for biting and chewing.

There are several types of TN, including:

Primary (classic) TN

Primary TN is the most common type and occurs when a blood vessel, typically the superior cerebellar artery, pushes on the root of the trigeminal nerve.

Secondary TN

Secondary TN occurs when an underlying medical condition, such as multiple sclerosis, damages the trigeminal nerve. Secondary TN is quite rare, tends to affect younger people, and may affect both sides of the face.

Idiopathic TN

Idiopathic TN occurs randomly, for no obvious reason. Like other types of TN, it causes sharp, sudden facial pain that can interfere with daily activities.   Somtimes trauma or dental procedures can cause TN.

Common symptoms of trigeminal neuralgia

The most common symptom of trigeminal neuralgia is sharp, intense pain that typically affects one side of the face. Many people report that the pain feels like an electric shock or stabbing sensation. Some patients also experience muscle spasms that occur alongside the pain.

In between TN attacks, you may also feel sensations, such as:

• Throbbing
• Numbness
• Burning
• Dull achiness

TN symptoms are often categorized in two ways:

Paroxysmal TN

People in this category experience sudden, intense episodes of facial pain that last anywhere from a few seconds to two minutes. There are typically breaks between these episodes, though attacks can occur in clusters over time.

TN with continuous pain

People in this category experience ongoing facial pain, alongside muscle spasms and burning sensations. These symptoms are often harder to treat because there are no breaks between episodes.

Why trigeminal neuralgia is often misdiagnosed

People with TN often see several experts and undergo multiple tests before identifying the source of their symptoms. That’s because TN can mimic other common conditions, including:

• Dental issues, such as cavities and gum disease
• Sinus headaches
• Temporomandibular joint (TMJ) syndrome

Some people even undergo dental treatments, like root canal therapy, only to experience ongoing discomfort. If this scenario sounds similar to your experience, it’s important to seek evaluation from a specialist like Dr. Merson.

Why professional treatment is essential for managing trigeminal neuralgia

If you experience recurring pain or muscle spasms on one side of your face and your symptoms don’t improve, it’s important to identify the cause. Prompt diagnosis and treatment may reduce symptom severity and improve your quality of life. It can also prevent you from unnecessary dental or medical procedures.

To diagnose TN, Dr. Merson reviews your health history and asks about your symptoms, including where the pain occurs, what it feels like, and whether certain activities such as brushing your teeth worsen it. She also completes an exam and orders diagnostic imaging, such as an MRI, to determine if  a blood vessel or tumor is pressing on your trigeminal nerve. 

Once Dr. Merson confirms your diagnosis, she makes personalized treatment recommendations. Depending on your needs, that may include:

• Antiseizure medications to block pain signals and reduce muscle spasms
• Baclofen, to relax specific facial muscles
• Nerve blocks for temporary pain relief
• Yoga and meditation
• Biofeedback
• Acupuncture
• Osteopathic Treatment (OMT) to alleviate somatic dysfunctions

Many people benefit from a combination of these treatment approaches. However, if your symptoms persist, you may be a candidate for surgery. For example, a microvascular decompression procedure can relieve pressure on your trigeminal nerve caused by blood vessels, providing lasting pain relief.

We can help you manage trigeminal neuralgia

Trigeminal neuralgia can significantly affect your quality of life and make simple activities, like chewing, nearly impossible. If you’re tired of trying to manage facial pain on your own, professional treatment can help.

To get started, contact us today. Schedule an appointment by calling our office at 561-499-7020 or booking online.