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Managing Trigeminal Neuralgia Pain: A Step-by-Step Guide

Updated: Sep 8, 2023

Trigeminal Neuralgia Pain

Trigeminal Neuralgia, also known as Tic Douloureux, can be an incredibly distressing and challenging condition to manage. This condition involves intense facial pain stemming from the trigeminal nerve, often triggered by simple daily activities such as eating, talking, or even a gentle touch. Trigeminal neuralgia can be an incredibly challenging condition to manage, due to the lack of knowledge of this condition and its unknown etiology. But with the right approach and guidance, you can find relief and improve your quality of life.

Keep in mind, as you read this article, that my belief as a healthcare provider is that you exhaust all non-invasive options prior to having any surgeries performed. I have successfully treated patients with trigeminal neuralgia for over 5 years and I have seen all varieties of this condition. I hope to continue to help any individual who suffers from TN and I'm here to provide you with a step-by-step guide to help you effectively deal with trigeminal neuralgia pain.

Step 1: Consult a Healthcare Professional

Before embarking on any healthcare journey, it's crucial to consult a healthcare professional that you can trust. This could be a neurologist, primary care provider and/or an upper cervical spine specialist. They can accurately diagnose your condition, determine the severity, and recommend appropriate treatment options.

Step 2: Understand Your Triggers

Work with your healthcare provider to identify specific triggers that exacerbate your trigeminal neuralgia pain. These triggers can vary from person to person and may include activities such as talking, chewing, or exposure to cold wind. Triggers are not only limited to physical touch or sensation, see below. Understanding your triggers will allow you to take preventative measures to minimize pain episodes.

Step 3: Using Cold and Heat to Your Advantage

Cold compresses can offer a temporary reprieve from trigeminal pain by numbing nerve endings and reducing inflammation. Apply a cold pack wrapped in a cloth to the affected area for about 20 minutes at a time. However, be cautious not to apply it directly to the skin to prevent frostbite. Cold therapy can be particularly useful during acute pain episodes.

While cold compresses can be beneficial during acute episodes, heat therapy can provide soothing relief during periods of milder discomfort. Applying a warm compress or using a heating pad on a low setting can help relax tense muscles and ease pain. Always ensure the temperature is comfortable and avoid prolonged exposure to avoid burns.

Step 4: Pain Management and Addressing Any Potential Causes


Your healthcare provider may prescribe medications to help manage trigeminal neuralgia pain. Anticonvulsant medications like carbamazepine or gabapentin can help stabilize nerve activity and reduce pain signals. Follow your doctor's instructions closely and be aware of any potential side effects or interactions with other medications you might be taking.

Upper Cervical Care

Trigeminal Cervical Nucleus

There is a portion of the trigeminal nerve, known as the trigeminal cervical nucleus, that is located in the upper cervical region of the spinal cord inside the C1 and C2 vertebra. This portion of the nerve has a primary function of relaying pain to the face. If this nerve is irritated or compressed, which can occur from a neck injury or structural misalignment, an upper cervical specialist may be able to help manage, or even eliminate, an individual's trigeminal pain. For more information on how upper cervical care can help patients with TN, click here: Upper Cervical Care and TN


Acupuncture, a key component of traditional Chinese medicine, involves the insertion of thin needles at specific points on the body to stimulate energy flow and restore balance. In the context of trigeminal neuralgia, acupuncture is believed to modulate pain perception by promoting the release of endorphins, which are natural pain-relieving chemicals in the body. Additionally, acupuncture may help relax muscles and reduce inflammation around the trigeminal nerve, leading to a reduction in pain intensity and frequency for some individuals.

Step 5: Stay Hydrated and Maintain a Healthy Diet

Dehydration can sometimes trigger or worsen pain episodes. Ensure you're staying adequately hydrated throughout the day. Additionally, a diet rich in anti-inflammatory foods can contribute to managing trigeminal pain naturally. Incorporate foods high in antioxidants, such as colorful fruits and vegetables, turmeric, as well as omega-3 fatty acids found in fish and flaxseeds. Avoiding triggers like excessive caffeine and processed foods can also help maintain a balanced nervous system and reduce inflammation.

Step 6: Gentle Oral Care

Practice gentle oral hygiene to prevent triggering pain while brushing your teeth or using dental floss. Opt for a soft-bristle toothbrush and take your time to avoid unnecessary pressure on your facial muscles and nerves.

Step 7: Stress Management

Stress can contribute to trigeminal neuralgia pain. Engage in stress-reduction techniques such as mindfulness meditation, deep breathing exercises, progressive muscle relaxation, or yoga. These practices can help calm your nervous system and reduce pain perception.

Step 8: Avoid Cold and Windy Conditions

Cold air and wind can trigger pain in individuals with trigeminal neuralgia. In colder weather, wear protective clothing, cover your face with a scarf, and use a humidifier to keep the air moist indoors.

Step 9: Supportive Devices

If specific activities trigger your pain, consider using supportive devices. For example, wearing sunglasses with side shields can protect your eyes from wind exposure. Discuss with your healthcare provider about any recommended devices.

Step 10: Surgical Interventions (if necessary)

In some cases, when medication and conservative measures aren't effective, surgical interventions might be considered. Microvascular decompression, radiofrequency ablation, or gamma knife radiosurgery are options that your healthcare provider can discuss with you based on your condition.


Managing trigeminal neuralgia pain requires a comprehensive approach that takes into account your individual triggers, lifestyle, and medical history. By working closely with your healthcare provider, following these steps, and adopting a proactive mindset, you can effectively manage your pain, reduce the frequency of episodes, and enhance your overall quality of life. Remember, every person's journey is unique, so it's important to tailor these steps to your specific needs under the guidance of a healthcare professional.

About the Author

Dr. Culig

Dr. Culig, DCCJP is an upper cervical spinal specialist located in Atlanta, GA. He became interested in migraines because his younger sister suffered from them since she was 13 years old. He began to seek out natural ways to treat migraines without the use of drugs or surgery. As a Doctor of Upper Cervical Chiropractic, he has spent over 300 hours in post-graduate courses regarding migraine and has successfully treated hundreds of migraine patients. He has a diplomate in the craniocervical junction (DCCJP) which is a 3-year post graduate program focused on the upper cervical spine and related neurovascular conditions such as Migraine, Trigeminal Neuralgia and Vertigo.

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