How to Relieve Trigeminal Neuralgia Pain

Risk is 400 times greater in people with multiple sclerosis

Woman clenching mouth in pain
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Trigeminal neuralgia (TN) can be one of the more excruciatingly aspects of multiple sclerosis (MS). It is a type of nerve dysfunction characterized by extreme stabbing, shooting, or burning sensations, usually on one side of the face or jaw.

In cases of typical trigeminal neuralgia (referred to as type 1 or TN1), the pain can last a few seconds or minutes but may repeat in quick succession over the course of several hours.

Others may suffer from atypical trigeminal neuralgia (type 2 or TN2) which is lower in intensity and less debilitating than TN1.

Causes and Treatment of TN

TN is caused by a process known as demyelination in which the insulating membrane surrounding the nerve (called the myelin sheath) is gradually destroyed. It is the central feature of MS, the disorder of which is classified as a demyelinating disease.

While TN is relatively uncommon in people with MS, occurring in less than five percent of cases, the risk is said to be 400 times greater than that of the general population. Moreover, people with MS are more likely to experience TN on both sides of the faces (albeit never at the same time).

Treatment typically involves the use of medications and complementary treatments to help manage or alleviate pain. Of the currently available drug options, Tegretol (carbamazepine) and Trileptal (oxcarbazepine) are considered the most effective.

The main downside to drug treatment is the increased likelihood of side effects, including the possible worsening of MS symptoms. In extreme cases, surgery or radiation therapy may be recommended for those who have not responded to other treatments and whose quality of life has severely suffered.

5 Complementary Treatments That May Help

While medications are often crucial to the management of TN, a number of complementary approaches have proven useful in dealing with the condition.

In fact, many people are able to manage TN without the use of drugs by employing a few simple yet effective home strategies:

  • Avoiding triggers is the first and best step to managing TN. Over time, you will begin to know which movements, events, or foods are likely to set off an attack. These may include chewing crunchy foods, drinking icy beverages, using a water flosser, or catching a cold breeze. Whatever the cause, make a note of it and do whatever you can to avoid the trigger. This may include changing from an electric to a non-electric razor or wearing a scarf around your face in cold weather.
  • Applying heat directly to the pain can provide relief, particularly if the TN triggered by cold or chewing. Warm compresses, heating pads, and microwaveable bean bags can usually do the trick. Hot showers may also help, but be careful as they can end up aggravating symptoms of fatigue.
  • Applying cold may also help in cases where the pain is accompanied by throbbing. Applying a cold pack (wrapped in a thin towel or pillowcase) directly on the pain can have a numbing effect. Avoid this technique if the TN was triggered by cold.
  • Topical pain treatments are commonly used by people with TN. Over-the-counter products include such mainstays as Vicks Vapor Rub, Noxema face cream, Blue Star ointment, and Anbesol oral pain reliever. For products not commonly used on the face (such as Anbesol), perform a patch test by applying a little on the back of your chin and waiting a few of hours to ensure you don't have a reaction.
  • Be aware of stressful situations. And not because cause stress causes TN (it doesn't) but rather because stress may cause you to grit your teeth, grimace, or tense the parts of your face most vulnerable to TN. While you can't necessarily avoid stressful situations, you can make an effort to consciously unclench your jaw or face if faced with one.

Source:

Truini, A.; Prosperini, L.; Calistri, V et al. "A dual concurrent mechanism explains trigeminal neuralgia in patients with multiple sclerosis." Neurology. 2016; 86(22):2094-9.

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