Trigeminal Neuralgia: what it is and how we help

Trigeminal neuralgia at a glance

Trigeminal neuralgia is sudden, severe facial pain, often described as an electric shock, caused by irritation of the trigeminal nerve. Attacks last seconds to minutes and can be triggered by light touch, eating, talking, brushing teeth or a breeze. It is most common over 50 and in women. Medication is the first-line treatment, and specialist options exist when that is not enough.

Symptoms of trigeminal neuralgia

• Sudden stabbing or shock-like pain in the cheek, jaw, teeth, gums or around the eye
• Usually on one side of the face
• Attacks triggered by touch, chewing, speaking or wind
• Pain-free periods between episodes, sometimes lasting months

What causes it?

Most often a blood vessel pressing on the trigeminal nerve near the brainstem. Less commonly, it is linked to multiple sclerosis or another cause, which is why a doctor should assess new facial pain.

How is it treated?

A GP usually starts an anticonvulsant medicine such as carbamazepine, which is effective for most people. If medication does not work or causes side effects, a neurologist or neurosurgeon may discuss procedures such as microvascular decompression.

How we support trigeminal neuralgia in Chiswick

• Acupuncture: small studies suggest it may reduce pain for some people; used gently and alongside medication, never instead of it.
• Psychological support: for the anxiety and anticipation of pain that attacks bring.
• Yoga and relaxation: stress management, which some people find reduces flare frequency.
• Ayurveda: routine and wellbeing support.

What does the evidence say?

Carbamazepine has the strongest evidence. Evidence for complementary therapies is limited, and we are clear that they support rather than replace medical care.

What triggers attacks?

Everyday actions often trigger attacks: touching the face, washing, shaving, applying make-up, brushing teeth, eating, drinking, talking, smiling or a cold breeze. Many people start avoiding these activities, which can affect eating, social life and mood. Keeping a diary of triggers helps you and your doctor plan treatment.

Trigeminal neuralgia or dental pain?

Because the pain is often felt in the teeth, jaw or gums, many people see a dentist first. Trigeminal neuralgia usually causes brief, electric shock-like pain triggered by light touch, whereas dental pain is more often a constant ache or throbbing that is sensitive to hot, cold or biting. If dental treatment has not helped, ask your GP about trigeminal neuralgia.

Can trigeminal neuralgia go away?

Some people have long periods of remission, lasting months or even years, between episodes. For many it is a long-term condition that tends to recur. Medication controls pain for most people, and surgical options can give long-lasting relief for those who do not respond.

What to expect at Omnia

We begin with a careful history, including your diagnosis, triggers, medication and how attacks affect daily life, and we never touch sensitive trigger areas without your agreement. Treatment may include gentle acupuncture away from the face, relaxation support and psychological help for the fear of attacks. We work alongside your GP or neurologist and never change your medication.

What you can do at home

• Keep a diary of triggers
• Protect your face from cold wind with a scarf
• Try softer foods and a straw during flares
• Contact the Trigeminal Neuralgia Association UK for peer support

Facial pain has many causes. See our guide to what can be mistaken for trigeminal neuralgia.

Related: shingles and nerve pain. Omnia Lifestyle, Chiswick W4. Book online or call 020 4515 0000.