I’m here for my partner (47yo), after some dental work in June 2016 she started to feel some “shocks” when touching right eyebrow, it may have started earlier, but was certainly aggravated by the laser clean, over time it progressed to right lip as well, we tried some acupuncture, seemed to help initially but over time was less effective.
Week before xmas it got severe, needed ambulance trip to emergency, prescribed Lyrica which seemed to be of minimal benefit, only used it for 2 weeks, then tapered off.
Over xmas & new year was hell, but I did notice a pattern if she spent too much time sitting/curled up watching tv etc it would aggravate, walking seemed to bring some relief, so that was the beginning of our posture hypothesis and I think the greatest benefit from the acupuncture was lying flat on her back.
We did a run with chiropracter, no benefit really there, we are now sleeping on floor (thin mattress) that does seem to help posture and have started seeing osteopath may be helping, too early to tell.
Have read lots of posts here, very keen to explore the neck relationship (cervicogenic? hypothesis), quickly read the 27 page report Tn7, looking for exercises and physical therapies to overcome the Tn2.
She has developed a few methods of puffing face up and using exagerated expressions to trigger pain, then break through and find the pain free times beyond, sometimes longer than others.
There is a direct relationship between upper shoulder/neck tension and the tn severity, question is which is the driver or is there a third factor driving both.
We are convinced it is related to posture, but have yet to zero in on the root cause.
That is the million dollar question, what is in fact the relationship between neck and the pain.
Several members here feel there is a strong relationship between neck/posture and TN pain.
I am one of those people and myself and another member (@anon67464382) have discussed it many times.
I also can change my pain by puffing my mouth and also when i get the worst pains I can change or reduce it merely by changing neck position/posture. The relationship between neck and TN pain is undeniable in my case (and in your wife’s case).
The report you read is probably the most comprehensive list there is.
The anatomy of the TN pain doesnt really lend itself to the idea that neck position can be the CAUSE of tn pain, perhaps there is a correlation. I wish i knew.
There are some upper cervical chiropractors and craniosacral therapist who do claim to be able to help people in these by manipulating neck/head.
But there is no solid theory yet that could relate them together as far as i know.
I even had a cervical MRI but it showed nothing significant.
So i think this theory is a bit of a dead end:
- doesnt really give a causative explanation
- doesnt really lead to a treatment option
The only thing that it helps is that YOU know what aggravates your TN pain and you try to work around it. But if you take this explanation to a neurosurgeon there is very little they will do with it.
H
I’d disagree that there is no anatomical evidence between TN and the cervical spine.
Folk think an MRI discounts it. MRI static position, normal findings, great nothing nasty to be seen, party. Outside of pathology it means jack shit.This is ultra frustrating, as in an MRI will not highlight tight muscles/ joint restriction due to potentially posture/ trauma/ stress, exaggerated potentially by poor diet/ drinking too much etc.
H, I despair, you are one of few who actually research TN on this site and you conclude;
So i think this theory is a bit of a dead end:
- doesnt really give a causative explanation
- doesnt really lead to a treatment option
Read TN7 again and it provides a causative explanation, the trigeminal nucleus extends to the the neck at least half way down, it isn’t there for fun, and the reason is stated in TN7.
So it leads to a treatment option, sort your neck out, if an issue. You don’t even need neck pain.
How?
Stress relief ( for e.g. get thrown out of a second floor window, by your loved one, some years prior, might need addressing)
Physical Therapy, after being assaulted,
Collapsing in a heap in a corridor, after a miscarriage.
I’ve dealt with all of these, and in the case of the latter, after TWO months of not sleeping- tooth and face pain fine, after two weeks, “I feel great”, in the US she’d still be on sodium channel blocker waiting for some destructive intervention- MVD. ( does general anesthetic have any impact on the cervical spine and it’s musculature?)
If your neck is pathology free, even if it isn’t, both free or otherwise can cause TN. The anatomy is not a discussion but fact. Surely neck position aggravating symptoms confirms.
Reckon I should charge circa $1500 dollars for treatment, maybe people would take the issue of cervicogenic seriously before destructive intervention.
Thank you so much for your replies,
A bit more background, we are 10 year veterans of Graves Disease (hyper-thyroid), 7 yrs treatment, 3 yrs remission. Initially her Endochronologist said she would have to choose RAI (kill thyroid) or Surgery(remove thyroid), we resisted both options and over time she was able to heal and keep her thyroid which has returned to normal functioning, naturally the Endo took the credit for healing forgetting entirely the early remarks recommending thyroid ablation, so we have some experience in the process of researching health outcomes, though we do fully recognise Tn is a completely different beast.
Throughout the process we switched to a Paleo diet, though that has become a bit slack the last few years, we have tightened up the dietary side again grain/gluten free, we also became quite familiar with a variety of supplements, so are starting to rehash that side as well. Our philosophy was to increase nourishment and decrease toxicity in all aspects of life, so covering diet, emotion/mental/behavioral & physical. The last five years of that journey were very difficult as a close family member was going through a major depressive/delusional episode, having to deal with mental health sectors tested everyone’s limits, like many health conditions it’s hard to tell whats worse, the disease or the treatment. My partner thinks this episode seriously increased her anxiety levels which was a in her mind a precursor to the Tn
I did spend quite a few years on Thyroid & Paleo forums, so have been through the baptism of fire on a few occasions.
I need to re read that Tn7 paper, as first time was a speed read, there is so much detail I need to contemplate and follow up on.
As mentioned earlier we have engaged an osteopath, but are still searching for the right practitioner, we feel that a full spinal assessment would be a good starting point, though not quite sure who would be able to provide that assessment, as a wild card we have just made an appointment with a local physiotherapist on Monday, see what comes out of it.
There’s a couple of topics I’d like to throw open so I’ll open some new threads for them.
Coincidence, I had a patient today, which I hadn’t seen for circa 14 months, and forgotten about, might add she had never a diagnosis of TN. Saw her then: migraines, facial pain and tooth pain, two treatments she had been great, although she stated today, migraine of much reduced severity during her time of the month, Research has shown connection of hormones with the trigeminal nucleus, and TN. Anyhow face/ tooth pain still good but painful neck, armpit and chest. Stressful period with work. Examination= rash= shingles. Neck separate issue, though probably due to stress. Even so, still no face or tooth pain, which she had for some extended period on first visit. Just saying.
Sparky1,
I like your approach to illness, and to me makes perfect sense, as a starting point, in many cases it would be an end point. We seem to forget the innate healing power of the body should we give it the right tools. Thumbs up.
Hi Sparky1,
Welcome. I have not been diagnosed yet - it’s only been a year (sad, right?). I have what I think is atypical facial pain after a tooth extraction. Tooth pain, jaw pain, ear pain, face shocks, head pain. My husband is an osteopath so I get access to having my questions answered round the clock - he is a firm believer in the cervical connection. I am on gabapentin and nortriptyline. I also take klonopin at bed. I did 8 intense weeks of physiotherapy with a doctor who specializes in upper cervical and tmj issues. I do not have tmj and my cervical issues (bulging) don’t happen until lower down at C4/5/6. It did not take my pain away completely but I have to say the stretches are good enough to get me out of a pain attack that is coming. The stretches that work best for me are the scm muscle stretches. When I do those, I can feel it working all the way through my jaw up to my ear. I also do chin tucks. I do all of these in my car after dropping off the kids at school. It’s a great way to make use of the drive time. I swear by them. I do also think stress is a factor. As hard as it is, de-stress as much as possible. I’m a completely different person now - somehow in a good way in that I am in tune with my stress levels and I am very appreciative of pain free days or hours. I’ve been thinking of the paleo diet - makes sense to remove the inflammatory substances like sugar and processed foods.
Melanie
Would love to know your husbands take on facial pain with regards to previous patients, which may be few as I imagine an osteopath is not a first port of call, would he be willing??
Had Physio session today, all went well, he seems adept & knowledgeable, did a postural analysis, tested limit of movement of some neck & shoulder joints, then discussed some exercises & supplied exercise sheet, there was no immediate benefit as expected, but we will continue weekly for a while to see what comes of it and put a temporary hold on osteopath program.
Just curious, your husband is an osteopath yet you went to a physiotherapist, how does your husband view the Tn?
Just curious you talk about patients, what is your field? I have been searching out your posts on cervicogenic relationship to Tn, is that your speciality?
My husband is an osteopath orthopedic surgeon. He does believe in the cervical connection to certain face pain - but limited to upper cervical areas. I have arthritis in my neck (I’m 47 years old). If this pain occurred spontaneously (as opposed to after a dental extraction) - I think he’d be more convinced that this is arthritis/muscle related. I ended up with a physiotherapist because an oral maxiofacial surgeon at University of PA diagnosed me with Atypical Face Pain (possibly pre-TN) and TMJ. The physiotherapist I went to specializes in TMJ and upper cervical. My husband thinks it is a type of chronic pain syndrome due to having an abundance of dental work. This happens in other areas of the body after surgery, but it is called RSD.
Sparky1,
I wish that was my specialty - I decorate model homes for a living.
I’m a physical therapist of a sort, I don’t like to disclose what type, because I think depending on the therapist they might have something to offer. Facial pain is an huge interest of mine. When there is such a low incidence of people, though more than the medical profession claim, it is hard to claim it is my speciality, certainly it is where my interest is. In 20+ years I have seen numerous folk,perhaps more than expected. The majority with great results. These patients in the main have consulted me early on in their experience, and as far as I am concerned they don’t know how lucky they potentially are, avoiding further medical intervention. Those I know I have helped in a very limited way are those I’ve asked to return to their medical professional and provide me with their MRI results, to tailor treatment. I can only assume they are asked questions and then convinced I will be of no help, despite the fact in every one of these cases I can aggravate their symptoms by palpating/ squeezing trigger points in their neck. That said the majority of the med prof. don’t accept the neck as a cause, through ignorance.
I would love to hear more about the connection over time to TN. I have many theories about why I got trigeminal neuralgia. One is flu mist administration the week prior, another is my having fertility treatments for nearly 3 years, and my third is the YOGA CLASS and shoulder stands I was attempting to do the day before I started to have TN shocks. During the worse of my TN pain I was certainly having positional issues, at certain points having nearly no comfortable lying down positions at all as they would trigger shocks/pain due to my neck position. Currently touch to my neck initiates TN pain, as does turning my head in certain positions, which the Drs discounted immediately when I brought up the cervical connection.
Upper cervical chiropractic without question relieved my TN…I’d try two or three upper cervical specialist chiropractors before giving up on it… I can say from experience that not all know what they’re doing.
The other thing that is worth trying is elimination of viruses from nervous system… I think a virus in the nervous system may be the root cause of TN. More info here…
Understand entirely, thanks for all the input you do have given and it was very encouraging for me when I joined up to find I wasn’t the only one who had suspicions about neck & posture involvement.
I have also kept that idea on the table, but have been unable to form a coherent hypothesis yet.
The Herpes/cold sore virus resides in the trigeminal ganglion, some people report they can feel the irritation moving down the cheek before an outbreak on lips, we have started using lysine powder to keep the virus dormant.
Chicken pox/shingles resides in spine, I don’t know any particular treatment for this.
The thing we need to consider with viruses is that only a very small percentage is pathogenic & the vast majority is either neutral or beneficial, so just like bacteria have been realised to be essential to human life viruses may be the same or even more vital. Even with some of the pathogenic ones are they only detrimental because our immune system is susceptible because of years of poor nutrition & toxic behavior.
People have reported completely and permanently eliminating the Herpes virus outbreaks using olive leaf. In some of my other posts, I’ve talked about combining that with Lysine to attempt to eliminate those viruses from the nervous system. For me, it seems to have worked, I’m at a year now completely pain free, zero drugs or surgery.
My understanding is that the virus cannot cross the blood brain barrier and enter the nervous system. With TN and MS patients, I believe it gets there through mechanical disturbance such as a spinal tap or dental work, where virus moves from the blood to residing in the nervous system. Once there, most drugs can’t reach it to suppress the effects. The virus begins destroying the nerve from the inside out.