One of the most painful chronic conditions known to man happens in bursts of a few seconds. Known as trigeminal neuralgia – the pain is debilitating and highly unpleasant for thousands of Americans that suffer from this condition each and every year. But what is trigeminal neuralgia and how can peripheral nerve blocks help alleviate the symptoms?
What is trigeminal neuralgia?
Trigeminal neuralgia is a chronic facial pain syndrome. Pain occurs in short sharp bursts. The pain is intense and feels like a sharp stabbing pain that lasts for up to 2 minutes (however in many patients attacks can last a few seconds).
There are a number of factors that can increase an individual’s risk of developing trigeminal neuralgia which include:
- Increasing age (older people are more likely to develop the condition – which is very rare in children)
- Diseases such as multiple sclerosis
- Being female
- Having a diagnosis of hypertension
The pain occurs because of abnormal signals in a nerve known as the trigeminal nerve. This nerve has 3 major subdivisions known as the occipital, maxillary and mandibular regions that supply muscles of the face and also receive sensation from these areas of skin.
What treatments are likely to be offered for trigeminal neuralgia?
Once a diagnosis has been made – you may be offered a number of different treatments. Whilst nerve blocks are an effective way to alleviate pain these are not usually the first line. Most patients will receive medication first. This is normally an anticonvulsant like carbamazepine. These drugs are normally used for epilepsy but reduce activity in the neurons and so are used to dampen down the abnormal signals coming from the trigeminal nerve in trigeminal neuralgia. If there is a compressive cause for the trigeminal neuralgia (ie a structure in the brain is pushing on the nerve) then a neurosurgical procedure known as a microvascular decompression may be offered. However, for many patients, these treatments aren’t enough and they live in constant fear of attacks. For these individuals attending a specialist clinic for pain and spinal medicine may be their best bet. These specialist clinics can be found across the United States and provide more specialized therapies.
One of these therapies is a peripheral nerve block – where a steroid (to reduce inflammation) and local anesthetic (to reduce activity in the nerve) is injected around the trigeminal nerve. This is a tried and tested method for trigeminal neuralgia, being used for more than 20 years. In one study the effects of one injection last for up to 3 months when higher concentrations of local anesthetic were injected.
If you or somebody you know suffers from trigeminal neuralgia – and hasn’t had adequate symptoms relief from the first line medications offered by their doctor, consider getting in contact with a specialist clinic about the possibility of a trigeminal nerve peripheral block.