Trigeminal neuralgia (TN) is a type of chronic pain medical condition that directly affects a specific nerve in the face and head region, the trigeminal nerve. This particular nerve has the responsibility of carrying sensations in the facial region to the brain. If it starts to experience issues, pain will be experienced in specific areas of the face. The pain is nearly almost always sudden and quite severe. It may come and go. Most describe it as “sharp” and/or “shooting” pain. It is similar to that of shocks of electricity. Trigeminal neuralgia issues are triggered by regular activities such as talking, chewing, and/or touching the face.
What is the Trigeminal Nerve?
The trigeminal nerve is considered to be one of the main nerves associated with the face. In some instances, it is referred to as the “fifth cranial nerve”. This nerve is split into three unique branches. They are as follows:
- Ophthalmic Branch – This branch goes to the area around the eyes, the forehead, and the scalp.
- Mandibular Branch – This branch goes directly into the area of the jaw.
- Maxillary Branch – This goes into the cheek region.
Each of these branches transmit sensations – such as touch and pain – from the face, teeth, mouth, and jaw to the brain. This nerve is also responsible for controlling the muscles that are used for chewing and the production of both tears and the saliva.
What are the Symptoms of The Trigeminal Nerve Being Triggered?
When the trigeminal nerve is triggered, one will typically experience severe pain that comes on suddenly. The pain may last as little as a couple of seconds or as long as a couple of minutes. The pain is normally isolated to just one side of the face in and around the cheek and jaw region. Involuntary facial movements may occur.
While the pain is usually the only symptom that occurs and the nerve functions as it is supposed to, it may be very troublesome for the sufferer. The good news is, physical therapists are capable of assisting those with trigeminal neuralgia issues.
What Causes the Trigeminal Nerve to be Triggered?
In a large percentage of cases, the underlying cause of trigeminal nerve being triggered is a blood vessel that is pressing on the root of the nerve. In other cases, a tumor, abnormalities located at the base of the skull or multiple sclerosis may be to blame. Of course, there are those cases where no cause can be uncovered.
Progression of Trigeminal Neuralgia Issues and Who it Affects
The very first attack associated with trigeminal neuralgia often develops fast and without any type of warning. The sufferer may experience the bursts of pain occasionally or multiple times each day. It is possible for the first pain session to go on for days, a few weeks, or even months. Following this, the sufferer will typically go into remission. As time progresses, the episodes experienced are more severe as the pain increases. Age results in the severity of the issue, too.
How are Trigeminal Neuralgia Issues Diagnosed?
The diagnosis is usually diagnosed if the sufferer experiences the pain associated with the condition. A doctor may order an MRI scan in the event that the condition cannot be pinpointed and diagnosed based on the symptoms experienced. In some instances, a sufferer may have an underlying condition, the patient is younger than 40 years old, and/or the patient is not responding to the treatment provided.
Treatment Options
There are several different types of treatment options available for those that suffer from trigeminal neuralgia issues. These include medications, physical therapy, deep brain stimulation, and surgery. Each of these treatment options are outlined below:
Medications
There are several types of medications that are known to be highly beneficial to trigeminal neuralgia issues. The first and most common medication is Carbamazepine. This medication quiet downs the impulses from the nerve. Effectiveness is typically experienced in 1-2 days. Sufferers that take this medication may find that they become drowsy, experience nausea, and may even become dizzy. The other medications that may be prescribed includes Lamotrigine, Baclofen, Gabapentin, and Oxcarbazepine.
Physical Therapy
Generally speaking, when one has trigeminal neuralgia issues, the physical therapy treatment focuses on manual techniques that are relatively gentle.
Physical Therapy Treatments for Trigeminal Neuralgia include soft tissue release, trigger point therapy, joint mobilizations, the utilization of a TENS unit that will help in blocking signals of pain, exercise therapy, and relaxation techniques.
When you make an appointment with a physical therapist, they will require a consultation. Then, a care plan designed just for you will be created that has the primary goal of reducing pain and improvements in the ability of you to perform daily activities.
Deep Brain Stimulation
If treatments do not provide ample relief, deep brain stimulation is an option. Electrical impulses are sent to the brain to aid in relieving the pain. In most instance, this is a method that is used in a trial conducted for research purposes. Very few people opt for this treatment.
Surgery
If medications do not provide pain relief or result in uncomfortable side effects, there are a couple of surgical options that may help. These include the following:
- Decompression – This surgery moves or removes the blood vessel that is pressing on the trigeminal nerve. Stroke and deafness are two risks that are associated with this major operation.
- Ablative Surgery – This surgery includes those like gamma knife. These options are less invasive. What happens is part of the nerve is destroyed and that is to help to reduce the amount of pain that is experienced. It is not an advised treatment course because
Are There Any Complications Associated with Trigeminal Neuralgia
The pain associated with trigeminal neuralgia include pain levels that could be so severe that they are distressing. Many sufferers become depressed and anxious due to the flare ups and the degree of pain. It is common for sufferers to avoid dental care due to the pain. Many may elect not to eat to avoid flare ups and as a result, they may lose weight or experience malnutrition issues. If you have this condition, it is advised that you make an appointment with a physical therapist right away so that a treatment plan may be customized for your issue.
When is a Brain Scan or Other Tests Required?
Yes, there are situations in which a brain scan and/or other tests are required. These include having symptoms that are not typically experienced with the condition, an underlying cause that is not usual for the condition is suspected, a person under the age of 40 is having issues, the condition fails to improve with treatment, and when surgery is being considered to treat the condition. If any of these conditions come into play, an MRI scan will likely be ordered.
What are the Diagnostic Criteria for Trigeminal Neuralgia Issues?
In order to be diagnosed with trigeminal neuralgia issues, there must be pain in the area where the trigeminal nerve is located that is recurrent and it lasts for anywhere up to a total of two minutes. The pain experienced must be intense and must be similar to shocks of electricity. It may be diagnosed as “Classical TN”, “Secondary TN” or “Idiopathic TN”.
Little Known Information Regarding Trigeminal Neuralgia
This condition is occasionally referred to as “tic douloureux” or “tic”. In terms of pain, it results in some of the worst pain known to humans. It may affect all areas of the face from the bottom of the face to up above the eye area. Tegretol is considered to be the most effective medication. Other medications may be prescribed but none of them seem to have the same level of effectiveness that Tegretol has. If a surgical procedure is recommended, it must first be established what branch of the nerve is affected.
Are There Conditions That Mimic TN?
Yes, there is one issue that is similar to TN and that is hemifacial spasm. This includes abnormal discharge from the facial nerve which causes twitches of the muscles and spasms. If this is experienced, common treatments include Botox infections. These weaken the facial muscles. Both TN and hemifacial spasm have the ability to decrease a person’s quality of life.
Contact Us
We here at Back to Motion Physical Therapy offer a wide array of solutions for those that suffer from trigeminal neuralgia issues. If you research our website, you will discover information about the many services that we offer to our patients. If you want to set up a consultation, we will go over your symptoms and create an individualized care plan that will help you. The plan may include exercise therapy, TENS treatment, and/or manual maneuvers. Ultimately, the goal is to reduce the pain that you experience and restore your ability to function. You will find that by working with us, your pain will be reduced and your quality of life will be increased. We offer personalized care on other issues, too. We are your one shop treatment stop. Call us now at: 303-832-5577