Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition that causes severe facial pain. The pain stems from the fifth cranial nerve and can be extremely painful and debilitating, sometimes so much so that sufferers cannot continue work or daily life. This article discusses six treatments for trigeminal neuralgia, including symptom management medications and lifestyle changes.What is trigeminal neuralgia?
Trigeminal neuralgia is a condition that causes puffy, itchy, painful facial skin reactions after a trigger event such as a scratch or an irritation. The sensitive, affected skin mass may follow these events and provoke more irritation or scratching.
The pain is in various parts of the face, neck, shoulders, chest and stomach. Pain receptors along the neural pathways that transmit pain signals to the brain trigger the pain.
The symptoms of trigeminal neuralgia can range from feeling “one-sided” in the neck to “visceral” pain in the neck that covers the back of the neck and shoulder blades. People with the most serious cases of trigeminal neuralgia experience symptoms in multiple locations and may be unable to function on pain-relieving medication.
How to diagnose trigeminal neuralgia
Once you’ve suffered an episode of pain, your healthcare provider may help you identify what is triggering the painful events and give you a prescription for medical and lifestyle changes.
This is important because you may need to change your medication or modify your treatment plan as needed to resolve your symptoms.
Many people with trigeminal neuralgia will need pain medications to treat the pain, although your healthcare provider may also suggest other medications to help control symptoms and improve your quality of life. These may include antihistamines, antidepressants, immune-modulating medications and blood pressure medications.
You may also need to make lifestyle changes. You may want to start decreasing certain stimulants, use diuretics or remain hydrated.
Treating trigeminal neuralgia
There are many treatment options for mild-moderate trigeminal neuralgia. Your healthcare provider may use many different techniques to help relieve symptoms, including prescription pain medications, chiropractic workups, massage therapy, hydration and meal replacement plans. Use these and the treatment options in the table below to find what may be right for you.
Corticosteroid dose level
Oral glucocorticoids may be helpful in reducing inflammation and pain, but they may cause side effects such as dry mouth and sleep disruption. Your healthcare provider can help determine which of these medications is right for you. For mild cases, your doctor may decrease the dose of some of the medications.
Dry Mouth Warning: If your medication includes suspension of dried herbs or powders, you should check with your doctor to ensure that you are not putting yourself at risk for a rare but serious reaction known as epiglottic acid bacterial meningitis. This reaction can be life-threatening if left untreated.
What is Trigeminal Neuralgia
The pain in the trigeminal area can present as sudden sharp, shooting, punched-like or puffy. This pain usually starts at the top of the front of the neck and travels down the back of the neck and upper body. The pain can be located just under the skin or along the back.
Pain can be a single incident or get worse over time. This pain can run in the background of many people’s lives, affecting everything from sleep to relationships. There can be no cure for trigeminal neuralgia, but some people can manage the condition with the right treatment.
The condition typically begins in early adulthood and is most common in people 65 and older, according to the Arthritis Foundation.
Symptoms of trigeminal neuralgia can vary widely, but they most often include:
- Dry, cracked mouth
- Red, scaly skin
- Facial swelling that causes the foreheads to hang lower than usual
- Loss of coordination
- Weakness and muscle atrophy
- Facial expression changes including intense emotions or what you might see as anger
These signs and symptoms typically occur 24 to 48 hours after an injury to the nerve.
Tips for treating Trigeminal Neuralgia
Treating trigeminal neuralgia can be difficult, so take the following steps toward better treatment and a better quality of life:
Lifestyle changes can be helpful in treating the condition.
The pain can have such a profound effect on your life that drastic adjustments to your lifestyle are often necessary to improve.Dr. Tobias Meyer, physiatrist and director of pain medicine at Lenox Hill Hospital.
Try sticking with a treatment regimen that is symptom-management friendly.
For me, the most helpful way to treat this condition is to keep the pain to a manageable, short level of intensity and allow the muscles to recover so that, with time, they can return to their pre-injury level.Dr. Meyer
This way, you can start using more of your muscles and get back to a healthy lifestyle.
Maintain healthy habits in terms of nutrition, stress management, sleep, movement and social interaction.
Unlock an ancient potential for your body to respond to pain. By patching up the various neuralgia conditions that can be caused by lack of sleep, lack of nutrients and negative stress.Dr. Meyer
Apply Warm Compresses
For example, massage your area with warm compresses to help soften the affected area. Use over-the-counter pain relievers and speak with a healthcare professional about any other issues.
Embrace the idea you can heal yourself.
Our body can adapt to painful stimuli.Dr. Meyer
The pain in the present day is caused by pain receptors in the peripheral nervous system sending pain signals to the central nervous system.Dr. Nate Feliciano wealthy Californian neurologist
This pain is constant and it usually worsens with every movement.Dr. Nate Feliciano
One of the reasons neck and jaw pain can be so intense. Is because the cranial nerves that connect to the neck and jaw normally function only between 40–120 minutes after injury.
After that time, these nerves lose their functionality. Meaning they no longer send pain signals to the central nervous system, explains Dr. Petrosian.
Quadranty happens when your muscles tense up and tense muscles in other areas of your body, causing additional pain.
In some cases, the pain can be alleviated by taking an anti-inflammatory drug, but medication isn’t the solution to trigeminal neuralgia.
However, the best treatment for tic douloureux is a combination of medication and lifestyle changes, says Feliciano.
The treatment includes pharmacotherapy, including the selective serotonin reuptake inhibitors (SSRIs), anti-inflammatory agents, and muscle relaxants, to cope with the pain.Feliciano
The sixth target is lifestyle changes such as stretching, meditation, social interaction and physical activity.
Does stress cause tic douloureux
Stress-related facial pain can also be a side effect of medications used to help with anxiety, depression and sleep problems, so it’s important to talk to your doctor about your triggers. Possible causes of a tension headache include chronic stress and anxiety, although, as with most things in medicine, everything is probably an allergy or inflammation, argues Feliciano.
Do you need more than one treatment?
There is extensive research on treating trigeminal neuralgia with various medications and a combination of medication and lifestyle changes with little to no side effects.
The treatment is good at relieving the pain completely and improving quality of life. However, the damage done to the tissue by the injection of medication is not erased following the treatment.Feliciano
So, as you continue to face pain after the initial treatment, you’ll likely have further damage to the tissue, leading to more severe symptoms as your pain medication cycle continues.
Since landmark studies have shown eculizumab (a prescription antispasmodic given to treat inflammatory cholestasis in patients with ulcers) to be effective in treating trigeminal neuralgia, Qsymia may be the prescription for you. “Qsymia is believed to be effective for most types of pain associated with the trigeminal neuralgia multisystem, with symptoms being either partial, intractable, local and generalized.
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