When Is Facial Pain a Sign of Trigeminal Neuralgia?

Pain comes in all shapes and sizes, and identifying the type, level, and location of pain you’re experiencing can help pinpoint the cause. That’s certainly true with trigeminal neuralgia (TN), which causes pain that could involve several areas of the face.

Dr. Wade Steeves is a board-certified neurologist and headache specialist at Valley Neurology in Spokane Valley, Washington. He focuses full-time on diagnosing and treating headaches and conditions that cause facial pain, including trigeminal neuralgia.

Learn more from Dr. Steeves and his team about the characteristics of facial pain caused by TN.

Trigeminal neuralgia basics

Trigeminal neuralgia is a chronic pain disorder affecting the trigeminal nerve, which transmits sensations from the face to the brain.

The hallmark of trigeminal neuralgia is sudden, intense, electric shock-like pain in areas of the face innervated by the trigeminal nerve. These include the cheek, jaw, teeth, gums, lips, forehead, and scalp.

Signs and symptoms of trigeminal neuralgia

Signs of trigeminal neuralgia include symptoms that differ from other conditions causing facial pain, including:

Type of pain

The pain associated with trigeminal neuralgia is often described as an excruciating stabbing, shooting, or burning pain that feels like an electric shock. Pain can occur in any or all areas the trigeminal nerve serves.

TN pain is typically brief, lasting a few seconds to a couple of minutes, but can recur throughout the day. Symptoms usually involve only one side of the face, most often the right side, and rarely develop during sleep.

Initially, TN pain tends to be sporadic, but episodes may become more frequent as the condition worsens. Some people develop pain that’s less severe but continuous, affecting the entire side of the face and scalp.

Triggers

Certain triggers can provoke or exacerbate TN pain episodes, including touching the face, chewing, speaking, teeth brushing, or exposure to cold air. For some individuals, a gentle breeze is enough to generate TN pain.

Distinguishing trigeminal neuralgia from other conditions

The symptoms of trigeminal neuralgia are distinct but can overlap with other facial pain conditions, sometimes leading to misdiagnosis or delayed treatment.

Conditions that may include pain resembling trigeminal neuralgia include:

Dental problems

Tooth decay, abscesses, or other dental issues can cause facial pain, particularly in the jaw and mouth areas.

Temporomandibular joint (TMJ) disorders

TMJ dysfunction can result in facial pain, especially around the jaw joint and muscles.

Sinus infection

Sinus infections or inflammation can cause facial pressure, pain, and tenderness, often accompanied by congestion and nasal discharge.

While these conditions may cause discomfort that resembles TN, the differences are distinct. For instance, along with aching pain, TMJ dysfunction can cause difficulty chewing and jaw stiffness or locking related to problems within the joint.

On the other hand, TN pain is intense, may occur in the jaw area, lasts for seconds to minutes at a time, and has the electric shock sensation of nerve involvement.

Treating trigeminal neuralgia

At Valley Neurology, treatment for TN starts with a detailed evaluation and discussion of your symptoms. Dr. Steeves also examines the face, jaw, and mouth to identify any abnormalities or potential triggers.

Depending on the evaluation results, he may suggest imaging studies such as an MRI to rule out structural abnormalities or compression of the trigeminal nerve.

Dr. Steeves then develops a personalized treatment strategy that may include medications, nerve blocks, or other injection-based therapies to relieve nerve irritation. If conservative measures fail to relieve your symptoms adequately, surgery may be an option.

Schedule an evaluation at Valley Neurology today by calling the office or requesting an appointment online.