5 Ways to Make Trigeminal Neuralgia Pain More Bearable

About five in every 100 people with MS will face this painful condition

woman with facial pain
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Trigeminal neuralgia, one of the most excruciatingly painful medical conditions, occurs in about five in every 100 people with multiple sclerosis (MS). It causes extreme stabbing, shock-like, or burning sensations, usually down one side of the face or jaw.

During an attack of typical trigeminal neuralgia (TN1), the pain can last a few seconds or minutes, but may repeat in quick succession over the course of several hours.

Some people, however, suffer from "atypical" trigeminal neuralgia (called type 2, or TN2), which may be at a lower intensity than typical TM but consists of burning, stabbing, and sometimes aching pain that is always present to some degree. 

What Causes Trigeminal Neuralgia?

While a variety of conditions can cause TN—including nerve compression from a tumor, a brain vessel abnormality called an arteriovenous malformation, and even injury to the trigeminal nerve during sinus surgery, oral surgery, or facial trauma—it is much more common in people with multiple sclerosis than in the general population. People with MS are 400 times more likely to be diagnosed with TM, and it usually occurs because of damage to the myelin sheath around the trigeminal nerve. 

How Is Trigeminal Neuralgia Treated? 

If you are suffering from pain that fits the description of TM—or new pain of any type—you'll need to schedule an appointment with your doctor right away.

 Given how devastating this condition can be for your quality of life, it's vitally important to treat the pain as soon as possible—even though many patients feel the available treatments don't fully address their pain. While I have never suffered from the bring-you-to-your-knees-in-agony pain from a full-force attack of trigeminal neuralgia (TN), I have had some small “mini-TN” episodes that are enough to give me an idea of what it might be like.


Medications are often crucial to the management of TM, and surgery or radiation therapy may also be used in extreme cases. There are also several complementary approaches that have proven helpful for many patients. Whether medically or scientifically sound or not, many people out there are finding some level of relief from these everyday tips and none of them are harmful. While most people say that none of these techniques completely eliminate their discomfort, they do claim to experience a reduction in the pain. To me, this sounds better than nothing and worth a try.

Apply Heat

During my mini-TN attacks, I find that a very hot shower brings me a little relief, although this approach can crank up some of my other MS symptoms (like fatigue and loss of proprioception). Others take hot baths or sit in saunas. If you try this, do so safely; have someone nearby that can help you if you get wobbly. Ideally, this is something to try if you can rest afterward.

Others recommend applying heat locally in the form of a warm/hot compress or hot pack. I read one person’s suggestion to heat up a beanbag and put it up high on the jaw, next to the ear, on the affected side for 10 minutes. I have dampened a washcloth, wrung out the excess water, folded it and put it in the microwave for 45 seconds.

I then wrapped it in a thin cloth and used this for my hot compress.

Apply Cold

Although some people find that their TN pain is triggered by exposure to cold (such as a cold wind or draft), many people get relief by applying pressure to the face with a cold pack wrapped in a pillowcase or a thin towel. Hold it in place for at least 30 minutes each time with the goal of numbing the area. Some report that alternating hot and cold packs works great.

Apply Pressure

Some people are helped by applying considerable pressure to a large area of their face with the palm of their hand. During sleep, a light touch from a blanket might also set off your TN pain (although, fortunately, most people are not affected by TN during sleep).

Some people find that pressing the affected side firmly into their pillow prevents the pain from being triggered.

Topical Pain Treatments

I encountered one suggestion for applying Anbesol (the ointment that is used to reduce baby teething pain or other oral pain) to the outside of the face. This person recommended covering up the Anbesol with a thick cream, such as a diaper cream. Other things that I have seen suggested are: Vicks vapor rub, Noxema face cream, and Blue Star ointment. I would recommend doing a “patch test” before smearing anything all over one side of your face (just dab a tiny amount in a non-obvious area and wait for a couple of hours to make sure that you don’t have any sort of reaction).

Avoid Triggers

Clearly, if we knew what it was that caused our TN to act up, then we could always avoid those triggers and life would be great. But sometimes the pain flares up for no reason. Other times, it is triggered by fairly essential activities that we actually can't avoid, like eating or talking. However, even these actions can be modified to prevent some of the pain.

I have seen suggestions to eat different kinds of food that do not require chewing, such as smoothies, broths, and shakes. I have also heard of people carrying around a tiny note pad to avoid talking (and even one suggestion that people experiencing TN learn sign language). People who feel like their TN is triggered by drafts might want to take a look at where their air conditioner vents are pointed and avoid sitting in the direct air flow. Wind can be avoided to some extent by wearing a scarf wrapped high on the face. One person tracked her pain onset closely and found it was triggered by peppermint candy.

It is also worth taking time to note how you feel after talking to or being in the company of different people. You may find that some people provide excellent distraction, whereas conversations with other people just happen to frequently “coincide” with TN attacks. I truly believe that negative people or unpleasant interactions can bring on or worsen my MS symptoms, so I try to gravitate towards the people that boost my mood and limit my contact with those who have the opposite effect.

A great source to check out is TNA: The Facial Pain Association. You have to register as a member to access most of the information, but it is worth the effort. You will find a number to contact for support, a database of doctors who treat TN, and a wealth of articles about the various aspects of TN. I highly recommend consulting this resource in your search for relief.


Facial Neuralgia Resources website: Reader Tips. Accessed November 2009.

National Institute of Neurological Disorders and Stroke, Trigeminal Neuralgia Fact Sheet.

TNA: The Facial Pain Association. 

Author: Manish K Singh, MD; Chief Editor: Robert A Egan, MD. Medscape, Trigeminal Neuralgia. 


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